A yearlong study offers rigorous new evidence against using prescription opioids for chronic pain. In patients with stubborn back aches or hip or knee arthritis, opioids worked no better than over-the-counter drugs or other nonopioids at reducing problems with walking or sleeping. And they provided slightly less pain relief.The opioids that were tested included the generic version of Vicodin. The nonopioids they were up against included generic Tylenol and ibuprofen.
So, basically, Tylenol beat Vicodin. Sounds like a good reason to chuck the Vicodin in the trash. After all, as a doctor quoted in the article says, if opioids don’t work better, there’s no reason to use them considering “"their really nasty side effects -- death and addiction.”
In case you’re wondering, the study randomly put patients in either the opioid taker or non-opioid taker groups. Further details:
Patients reported changes in function or pain on questionnaires. Function scores improved in each group by about two points on an 11-point scale, where higher scores meant worse function. Both groups started out with average pain and function scores of about 5.5 points. Pain intensity dropped about two points in the nonopioid group and slightly less in the opioid patients.Many of you already know my position on medication for chronic knee pain. Personally, I took as little as I could. I wasn’t worried about becoming a drug addict, but rather the fact that the drugs muted the signals from my knees that I was trying to listen to in order to figure out how to get better.
Hi Richard,
ReplyDeleteI want to ask you something
You emphasize constantly high rep - low load, for example walking and bicycling,
Is there any correct form of them? I mean walking for 1 hour is right or dangerous? Should i walk for short time, periodically? I have pfps in my both knees and after walking for 1 hour i feel a little bit pain. Could you share the philosophy behind this long time movement?
Thank you
On correct form, if you mean how to step and stride, I'm probably not the best person to weigh in on that. I just tried to go slow, at first, to minimize the impact on my joints. If you have trouble with continuous walking for an hour (that does seem rather long, at one go, unless your knees are in good shape), walking shorter distances with breaks in between might make more sense. The philosophy behind high repetition-low load is that that's the kind of movement that is most beneficial for joints and for adapting the cartilage inside the joint. You'll find more on that in my book, or on this blog, if you look around some.
DeleteHi Richard and all,
ReplyDeleteI have been very silent. The reason is that I found someone who has really helped me and one part towards beating my knee pain is basically to not hurt my nerves. Sounds simple, but talking, writing about how bad or even how good my knees are gives them constant attention and triggers the neuropathic pathways that are causing the problem. I am proud to say that I am much much MUCH better though, so I think I can risk a quick message here. :)
Baseline is that I am foremost being treated using a CRPS-protocol. At the core this includes mind manipulations, but I am also on an antidepressant in combination with pregabalin (lyrica) to calm down my nervous system. At the same time I am slowly, very slowly increasing my step counts and exercises. I am now on 5000steps/day and am so happy and proud about it, and am back to doing some simple squats in chest-deep water every morning. I started with one, now I am doing 10, and so on. But I would not have gotten here without medications, or the journey would have been harder. The reason is that my knees were giving me signals that were really wrong (and still are doing that, which I am busy to ignore). So my path was and is to first figure out which signals are actually the ones that really injure my tissue, and which ones are generated by my brain. So in this, medication (pain killers in the widest sense) are and were absolutely critical for me. But I must also say that I tried 2 years without and I before taking anything I also took months to establish a baseline for what I can do and what I can’t. My advice, stay away from medication first but in a CRPS scenario, I think they are critical.
All the best to you,
Jannes
Jannes, good to hear from you. This is good, well-considered advice. I'm not a big fan of medicating knee pain, but as you point out, sometimes this is the best option. Glad to hear you're much to the third power better! Congrats.
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