Dear Dr. Roach,I’m a 73-year-old man dealing with moderate to severe arthritis in my right knee. Pain management is a big concern for me.I’m currently taking apixaban (5 mg daily) to prevent blood clots, which means NSAID painkillers are off the table. I’m wondering if there are any long-term risks associated with taking acetaminophen, specifically two 500mg tablets once or twice a day. — P.D.
Dear P.D., One potential concern with long-term acetaminophen (Tylenol) use is kidney problems. Research has shown a link between extended acetaminophen use and an increased risk of chronic kidney disease after several years. You’d need to consume a notable amount — roughly 2 to 4 kilograms over a lifetime — to double your risk. That translates to about 5,000 tablets or four daily pills for eight years.However, other studies haven’t found a strong connection. It’s important to be aware of “medication overuse headaches,” which can occur when someone prone to headaches, like migraines, takes painkillers regularly, including over-the-counter ones.Stopping the medication usually resolves the headaches. While this is more common with opioid and barbiturate medications like Fiorinal, it’s something to keep in mind with any frequent painkiller use.As a precaution, anyone taking painkillers daily should have their kidney function checked annually.
Dear dr. Roach, I’m a 70-year-old woman in good physical shape. My routine includes daily water aerobics and weightlifting three times a week. Recently, I was diagnosed with osteopenia. I’ve been reading about vibration plates as a way to improve bone density, balance, and muscle strength – all of which are important to me. Though, I’m concerned about reports linking vibration plates to increased risks of cardiovascular problems, cancer, and retinal detachment. Could you shed some light on the potential benefits versus risks? — B.S.
Dear B.S., Research on using vibration therapy for osteoporosis has yielded mixed results. Some studies indicated a slight increase in bone density in postmenopausal women,but not in younger women. Many studies, though, did show a positive impact on balance and a reduced risk of falls. Along with exercise, ensure you’re getting enough calcium in your diet, have your vitamin D levels checked, and discuss your FRAX score (frax.shef.ac.uk/FRAX/tool.aspx) with your doctor. This score is the best indicator for determining if medication is recommended for your situation.
What role do choice therapies play in managing arthritis pain effectively?
Interview with Dr.Roach: Navigating Pain Management,Osteopenia,and Alternative Therapies
Editor (Time.news): Thank you for joining us today, Dr. Roach. we’ve received insightful questions from our readers regarding pain management and health concerns associated with aging. Let’s start with a common issue: arthritis pain management. A reader, P.D., is concerned about long-term risks associated with taking acetaminophen while on apixaban. What can you share about this?
Dr. Roach: Thank you for having me.Acetaminophen is a widely used pain reliever, especially for those who can’t take NSAIDs because of bleeding risk associated with blood thinners like apixaban. While it can be an effective option for managing pain, long-term use does raise some concerns, primarily regarding kidney function. Research indicates that extended acetaminophen use may lead to an increased risk of chronic kidney disease,but important risks only emerge after consuming large quantities over years—about 5,000 tablets or four pills daily for several years.
Editor: That’s vital data for our readers who might be taking acetaminophen regularly. You mentioned “medication overuse headaches” as a concern. Can you elaborate on who might be affected and how to mitigate this risk?
Dr. Roach: Certainly! Medication overuse headaches can occur in individuals who frequently utilize painkillers, including over-the-counter options like acetaminophen. ItS particularly relevant for those prone to migraines. The best way to mitigate this risk is by monitoring medication intake and taking breaks when possible. I also advise anyone on daily painkillers to have annual kidney function screenings to catch any potential issues early.
Editor: Let’s shift gears to another reader, B.S., who is interested in vibration therapy for improving bone density due to a recent osteopenia diagnosis. What are the potential benefits and risks associated with vibration plates?
Dr. Roach: Vibration therapy has shown mixed results in studies. Some research indicates that it can definitely help increase bone density in postmenopausal women but shows less effectiveness in younger women. However, one of the notable benefits is improved balance and reduced risk of falls, which is critical for older adults. That said, there are concerns over potential risks, including reports linking vibration plates to cardiovascular problems and other health issues.
Editor: What should someone like B.S. consider before using vibration plates?
Dr. Roach: It’s essential for individuals interested in vibration therapy to consult with their healthcare provider first. Alongside vibration therapy, maintaining a calcium-rich diet and monitoring vitamin D levels are vital. also,discussing one’s FRAX score with a doctor can help evaluate the need for medications to address bone density concerns.
Editor: Thank you, Dr. Roach, for sharing your expertise. To wrap up, what advice would you give our readers who are managing chronic conditions or exploring alternative therapies?
Dr.Roach: My primary advice is to communicate openly with your healthcare provider about any medications or therapies you’re considering. Regular monitoring of health status, especially when managing chronic conditions or introducing new treatments, is crucial. It empowers patients to make informed decisions tailored to their health needs.
Editor: Thank you again,Dr. Roach. Your insights will undoubtedly help our readers navigate their health concerns wisely.