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Insider Arthritis Tips July 2014
July 05, 2014

A successful man is one who makes more money than his wife can spend. A successful woman is one who can find such a man. Lana Turner

Got back pain? Think you need to see the doc right away… maybe not…find out why…next

Study Finds Most Recover From Back Pain Whether Or Not They Get Treatment

Jill Adams writing in the Washington Post reported on a study led by Wolf Mehling, a professor of medicine at the University of California at San Francisco, finding that “most people recover from back pain whether they’re treated medically or not.” In his study, he and colleagues “interviewed 521 people six months after they’d seen doctors for acute back pain; 81 percent of them were completely recovered or much improved, while 16 percent were the same or slightly improved and 3 percent were worse off.”

Comment: Like many medical conditions, not all maladies need immediate treatment.

Why do patients with psoriatic arthritis often have other disease conditions like diabetes and hypertension? The answer coming up…

Protein in blood links psoriasis to other metabolic conditions

Heidi Splete writing in Rheumatology News reported that the concentration of a protein known to be involved in insulin resistance was significantly higher in serum of both lean and obese psoriasis patients, based on data from 80 adults. The protein also is up-regulated in psoriatic skin lesions, noted Dr. Sascha Gerdes of the University Medical Center Schleswig-Holstein, Kiel, Germany, and colleagues.

Comment: This makes sense and probably means doctors need to be on the lookout for other problems when they see a patient with psoriasis or psoriatic arthritis.

Do biologic drugs increase the risk of cancer recurrence in RA patients? Find out the answer next…

Biologics don’t increase recurrence of cancer in RA

Sara Freeman writing in Rheumatology News reported that the risk of cancer recurrence in patients with rheumatoid arthritis was not increased with the use of biologic therapy according to a recent British study. Investigators from the Arthritis Research UK Epidemiology Unit at the University of Manchester studied 425 patients with prior cancer who were treated with biologics. Not only was the rate of recurrence not increased but there was an apparent decrease of 50% when compared with patients treated with traditional disease modifying anti-rheumatic drugs only.

Comment: Well there it is. I think that’s comforting news.

What devastating problem can occur with osteoporosis treatment… coming up next…

Elderly Women Who Take Bisphosphonates Long-Term May Have Increased Risk Of Atypical Femur Shaft Fractures

Nicola Garrett writing in Rheumatology Update reported that research published in Osteoporosis International indicated that “elderly women who take bisphosphonates long-term have an increased risk of atypical femur shaft fractures...but the overall benefits of treatment still outweigh the risks.” Researchers “found that each additional year of bisphosphonate treatment showed a progressive increase in subtrochanteric/femoral shaft fractures.”

Comment: While this is not new news, it underscores the need to be vigilant and probably have patients go on a drug holiday- meaning taking a year off the medicine- if they have been on medication for more than 5-7 years or so.

Does pot help autoimmune disease? Next…

Medical Marijuana May Be Effective Treatment For Autoimmune Diseases

Thomas Carannante writing in Science World Report revealed that “researchers at the University of South Carolina” have “conducted a study” in mice “that analyzed the effects of THC in marijuana on patients with autoimmune diseases because the drug has previously shown to have an immunomodulatory activity.” In this study's case, the researchers found that the application of marijuana has the ability to suppress an immune response to treat autoimmune diseases, such as arthritis, lupus, colitis, multiple sclerosis, and others. The new findings are published in the Journal of Biological Chemistry.

Comment: I understand it was a joint effort that led to these conclusions.

Pricey non-steroidal now available as a generic… next

FDA approves first generic versions of celecoxib

Reported in Medical News Today, The U.S. Food and Drug Administration has approved the first generic versions of Celebrex capsules, a treatment for rheumatoid arthritis, osteoarthritis, short-term (acute) pain and other conditions. Teva Pharmaceutical Industries received approval to market celecoxib capsules in 50 milligram, 100 mg, 200 mg and 400 mg strengths, and has 180-day exclusivity on the 100 mg, 200 mg and 400 mg strength products.

Comment: Good and bad news. Let’s see if the generic is as good as the brand name because they often aren’t.

Who feels pain more after surgery… men or women? The answer will surprise you…

Gender May Impact Perception Of Pain Following Surgery

Agata Blaszczak-Boxe writing for CBS News reports that a new study presented at this year’s Euroanaesthesia meeting in Stockholm has determined that men “were 27 percent more likely to report higher pain ratings after a major surgery such as a knee replacement, while women were 34 percent more likely to report experiencing more pain after procedures that the researchers labeled as minor, such as biopsies.” Researchers interviewed 10,200 patients from the University Hospitals of the Ruhr University of Bochum, Germany, following an operation, over the course of more than four years. Although the researchers are uncertain of the cause for these differences, “they speculate that a lot may depend on the kind of surgery a person is undergoing,” with procedures such as cancer-related biopsies taking “a particularly serious emotional toll on women.”

Comment: So there’s the answer… it depends.

What advice about smoking do you hear from your rheumatologist. According to one study, it’s not much…

Study: Rheumatologists Give Inconsistent Smoking Cession Advice

Nicola Garrett writing for Rheumatology Update reported a study found that “two out of three rheumatologist give smoking cessation advice to their patients,” with physicians who smoked less likely to offer the advice. However, “brief advice given by a doctor could increase quit rates by 66%, and when the intervention is more intensive the estimated effect was 88%.” Meanwhile, “only 1 in 5 rheumatology departments had either a specific protocol or written advice for smoking cessation.” The authors called for recognizing tobacco dependence is a disease often requiring repeated interventions and “clear, strong and personalized advice” for patients.

Comment: Smoking is a horrible habit with major health risks. More needs to be done to stop it.

So… do herbal supplements help or hurt arthritis… the surprising answer next…

Study: Herbal Remedies May Help With Osteoarthritis

Hugo Wilcken writing for Rheumatology Update reported that an analysis of 49 studies with 6,000 participants found that treatment with Boswellia serrata improved osteoarthritis symptoms. Additionally, “the herbal supplement Piascledine, containing extracts of soybean and avocado, also seemed to improve symptoms.” Still, the authors said that radiographic joint space width didn’t change and that “the evidence over the longer term was ‘less convincing.’ “

Comment: Herbal therapies remain controversial but more evidence regarding their efficacy appears almost every day.

An exotic new therapy for fibromyalgia… next

A new pilot study reveals that vibration exercise help to lower pain and enhance quality of life in fibromyalgia patients

Benita Matilda writing for Science World Report discovered that researchers at Indiana University found that whole-body vibration exercise might be the best therapy for reducing symptoms of pain and improving quality of life among those diagnosed with fibromyalgia, an illness that leads to chronic pain in muscles and ligaments. "Our findings are promising, but it is not entirely clear whether these improvements were the result of added vibration or just the effects of being more active," said lead author Tony Kaleth, at Indiana University-Purdue University Indianapolis.

Comment: Jury is obviously still out… but it is interesting.

Got an artificial joint? Want to know how long it will last… the shocking answer next…

Artificial Knees Last 15-20 Years

Gretchen Reynolds reported in the New York Times about the longevity and health of artificial knees. While current ones can be expected to last 15 to 20 year, “a patient’s health and habits can affect that time frame significantly.” Obesity, intense distance running training, can shorten that time. “Moving up- and downhill or falling” can also strain the knees.

Comment: Good news maybe. But having an artificial joint definitely limits the amount of activity you can engage in.

Like herbal therapies… here’s one you should know about… next…

Small Study Suggests Curcuminiods Help With Osteoarthritis Pain

Nancy Walsh writing in Medpage Today reported that an Iranian study of 40 patients, published in Phytotherapy Research, found that “Curcuminoids, the bioactive components of the spice turmeric, were effective in alleviating the pain associated with knee osteoarthritis.” The researchers suggested the results were due to the curcuminoids inhibiting “NF-kappa-B, thereby suppressing various mediators of inflammation such as cyclooxygenase-II,” as well as inhibiting pro-inflammatory cytokines’ release, scavenging free radicals, and alleviating oxidative stress.

Comment: Not really new news since the beneficial effect of this herb has been described before.

This new post falls under the “duh” category… see if you agree next…

WHO member states recognize psoriasis as chronic, non-communicable disease

Reported in News Medical.Net, this item. At the 67th World Health Assembly, the WHO member states adopted a resolution on psoriasis, recognizing it as "a chronic, non-communicable, painful, disfiguring, and disabling disease for which there is no cure." The resolution also acknowledges the psychosocial burden of the disease and that many people with psoriasis suffer due to lack of awareness and access to sufficient treatment.

Comment: For those sufferers who for many years socially isolated themselves because of their condition, this is welcome news but a little late I think.

Think that gimping around on a bum knee from osteoarthritis is a benign condition? Think again…

OA Walking Disability Increases Cardiovascular Risk

Patrice Wendling writing in Rheumatology News reported that walking disability is an independent predictor of death from cardiovascular events/. Also, total joint replacement reduced that risk by 40% according to a Canadian study from the University of Toronto and presented at the World Congress on Osteoarthritis.

Comment: So osteoarthritis is not such a benign condition. Treatment is important.

Wonder why the number of knee replacements done now is soaring… the not so surprising answer next…

Number Of Total Knee Replacement Surgeries In US Rising With Obesity Rates

Mary Elizabeth Dallas writing in Healthday reported that research published in the Journal of Bone and Joint Surgery suggests that “the number of total knee replacement surgeries in the United States are on the rise,” with “the demand for this surgery” seeming to “parallel the rise in overweight and obesity in America.” Investigators found that “weight problems account for 95 percent of the increased demand for knee replacement.”

Comment: Americans are the fattest people in the world. And here’s another cause of rising health costs.

So… in the battle of the genders, who is at risk for complications after joint replacement… men or women? Discover the answer next…

Men at higher risk after joint replacement

Patrice Wendling writing in Rheumatology News reported that a Canadian study from the University of Toronto indicated that men were more likely to suffer from complications after joint replacement than women. Complications included heart attack, infection, and revision surgery. The increased risk was particularly severe following total knee replacement. Findings were presented at the World Congress on Osteoarthritis.

Comment: So watch out guys. Be careful out there.

There’s a new use for beer you might want to know about…

Beer brewing waste could help bone regeneration

Reported in Science Daily from the University of Madrid…biomaterials for bone regeneration have been developed by researchers from beer brewing waste. The waste obtained from the beer brewing process contains the main chemical components found in bones (phosphorus, calcium, magnesium and silica), that after undergoing modification processes, this waste can be used as support or scaffold to promote bone regeneration for medical applications such as coating prosthesis or bone grafts, researchers report.

Comment: Cheers!

More news about pot and arthritis… next

Medical Marijuana To Be Tested For Pain Management Of Knee OA

Jeremy Warren writing for the Saskatoon Star Phoenix reported that in a first-of-its-kind study, Saskatoon, Canada-based CanniMed Ltd. “will test the safety and efficacy of using medical marijuana to manage arthritic pain.” Cannabis will be tested on patients with osteoarthritis of the knee (knee OA) in a “randomized, doubleblind, placebo-controlled trial run by a third-party contractor [that] will involve at least 60 patients and could last up to two years.” The trial “will use ‘vaporized’ marijuana, and will test different strains with varying levels of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), two common active ingredients in cannabis.”

Comment: Hmmm…I was wondering what that cloud of smoke coming from Western Canada was…

How close are we to a cure for arthritis? This next item takes us one step closer.

Molecular Imaging Gets to the Root of Rheumatoid Arthritis

Reported in Health Canal…the results of a study using SPECT, PET systems and respective imaging agents to detect the inflammation involved in the ongoing pathology of osteoarthritis and rheumatoid arthritis. Rheumatoid arthritis causes chronic pain for almost half of adults by the time they retire, but a new molecular imaging technique can visualize inflammation in the joints, giving doctors a clear read on chronic pain and possible joint destruction, say researchers at the Society of Nuclear Medicine and Molecular Imaging’s 2014 Annual Meeting.

In order to image arthritis inside the joints, researchers used multiple molecular imaging systems, positron emission tomography (PET) and single photon emission tomography (SPECT), both of which image physiological processes with the help of specialized detectors that pick up signals from injected radionuclide imaging agents.

Comment: OK. Good news.

ACL injuries… an epidemic perhaps? Next…

15- to 20-year-old females at highest ACL risk

Reported in Athletic Business, this item…Even years after an ACL injury, mobility can be impacted. Studies have found that 10 to 20 years after an ACL injury — regardless of whether it was surgically repaired — the rates for degenerative knee osteoarthritis are greater than 50 percent. That means teens with ACL injuries might be facing osteoarthritis as early as their 30s. Biomechanic, neuromuscular and hormonal factors may all contribute to the increased incidence of knee injuries in female athletes. And ACL injuries aren't limited to teenage female athletes.

Comment: With more and more girls playing sports, this problem has reached epidemic proportions.

Is it possible yet to predict who will get osteoarthritis? The answer next…

First biomarkers found to predict severe osteoarthritis

Reported in Medical Xpress, the results of a study presented at the European League Against Rheumatism Annual Congress identified a correlation between the presence of biomarkers in the blood, known as micro RNAs, and the development of severe osteoarthritis (OA) of the knee or hip joint. The findings suggest that miRNAs may be used as biomarkers to predict severe OA disease in individuals. Preventative measures and early treatments are considered to be the most effective way of managing OA, but to date there has been no way of identifying the disease early on. "These results indicate that for the first time we will be able to predict the risk of severe osteoarthritis, before the disease starts to significantly impact a person's life, allowing us to take preventative action early on. Through the early identification of osteoarthritis we can decrease both the impact of the disease on individuals and the major socio-economic burden severe disease poses," said Dr Christian Beyer, lead author from University of Erlangen-Nuremberg, Germany.

Comment: Interesting and perhaps an important piece in the puzzle that will lead to more effective treatments.

What’s new for psoriatic arthritis? Find out next…

Apremilast (Otezla)… new hope for psoriatic arthritis

The American College of Rheumatology puts out hotlines on new drugs. Here’s the one on apremilast. Apremilast is the first oral agent approved by the FDA for the treatment of PsA. While its efficacy profile is modest compared to biologic therapy, it has a favorable safety profile and the convenience of oral dosing. It may be most appropriate for patients with less severe joint and skin manifestations who may not yet require a biologic DMARD. There are also emerging data in patients with psoriasis only suggesting apremilast is moderately efficacious for controlling skin disease. There are no radiographic data available for apremilast. Although apremilast has not been associated with an increase in overall adverse events, infections, or malignancies, symptoms of depression, including suicidal thoughts/behavior, and weight loss, have been reported.

Comment: Safe but not as effective as I would like.

Is this the magic potion we’ve been looking for to treat osteoarthritis of the knee? Next…

New drug shows promise in knee OA

According to a new study published in Arthritis & Rheumatology, a journal from the ACR, treating osteoarthritis patients with sprifermin - also known as human recombinant FGF-18 - can result in reductions in total femorotibial cartilage thickness loss. The compound is still in clinical trials, but the findings underscored the effectiveness of the drug's treatment. The testing was conducted through a double-blind trial of 192 patients with osteoarthritis, who were randomized to varying levels of injections with sprifermin or a placebo. The researchers, led by L.S. Lohnmander, M.D., Ph.D., from Lund University in Sweden, measured cartilage thickness at six and 12 months using MRI scans. Of the recruited participants, 180 completed the trial and 168 were examined for changes in cartilage. After 12 months, the scientists found that the loss of total and lateral femorotibial cartilage was reduced.

Comment: Maybe yes… maybe no. Many compounds have shown initial promise but failed to go the distance.

So how does the average person ward off getting osteoarthritis of the knee. It’s simpler than you think… next…

Walking 6,000 Steps A Day Can Ward Off Knee Osteoarthritis (OA) Problems, Study Finds

Samantha Goodwin writing for HNGN reported that knee osteoarthritis (OA) is a health condition that affects 27 million Americans aged 27 and above. Treatment for this morbidity disorder depends on the severity of the condition. Though there are drugs, injections and medical surgeries that can help deal with this disorder, researchers of a new study have found a simple and cost-effective way to ward off OA all together. Researchers from Sargent College at Boston University found that walking 6,000 steps a day can protect those with or at risk of OA from developing mobility issues. "Our study examines if more walking equates with better functioning, and if so, how much daily walking is needed to minimize risk of developing problems with mobility in people with knee OA," said Daniel White, PT, ScD, from Sargent College at Boston University in Massachusetts. For the study, researchers measured daily steps taken by 1788 people with or at risk for knee OA for seven days. Two years later, researchers measured the functional limitations of these participants. Researchers found that those who walked 6,000 steps a day scored greater than 28 out of 68 in the Western Ontario and McMaster Universities Arthritis Index (WOMAC), a tool used to measure functional limitations, characterized by slow walking speed and deteriorated physical functions. It was seen that those who walked 1,000 steps a day experienced a 16 to 18 percent reduction in functional limitation. "Walking is an inexpensive activity and despite the common popular goal of walking 10,000 steps per day, our study finds only 6,000 steps are necessary to realize benefits. We encourage those with or at risk of knee OA to walk at least 3,000 or more steps each day, and ultimately progress to 6,000 steps daily to minimize the risk of developing difficulty with mobility," White said.

Comment: A pretty simple activity that most people can do.

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Omega-3 fish oils have been shown to be a remarkably effective and safe treatment for the inflammation of arthritis. 

Omega-3 fish oils have been recommended by more rheumatologists than any other dietary supplement for the control of the inflammation that accompanies rheumatoid arthritis, psoriatic arthritis, and other forms of inflammatory arthritis.


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Recipe of the Month!

Grilled Corn with Cilantro Lime Butter

by Meredith Steele


There's nothing better than a perfectly cooked sweet ear of corn slathered with salty butter in the summer.  


My family waits all year long for corn season and when it hits we have corn on the cob at least once a week. My favorite way to cook corn is to grill it. Grilling it in the husk steams the corn and creates a delicious bite that bursts with sweetness. Top that warm ear of corn with a salty bright herb butter such as cilantro lime and you have the ultimate easy summer cookout side dish!


Prep Time:  20 minutes  ~  Cook Time:  10 minutes




  • 4 ears of corn in their husks

  • 4 tablespoons unsalted butter, softened

  • 1 ½ tablespoons fresh cilantro, chopped

  • zest of 1 lime, grated

  • 1 teaspoon lime juice

  • ¼ teaspon salt



How to make it


  1. In a large bowl or the sink, soak the corn in water for 20 minutes.

  2. Preheat an electric grill to medium-high heat or a charcoal grill to a medium heat.

  3. Create the butter by mixing to combine, butter, cilantro, lime zest, lime juice, and salt. Set aside until needed.

  4. Place the corn still in their husks on the grill. Cover, leaving the vents open if using charcoal, and grill for 12 minutes turning occasionally for even cooking.

  5. To serve, carefully remove the husks from the corn and spread a spoonful of butter on each ear of corn. Serve warm.

FACT:  France's Eiffel Tower can grow by more than six inches in summer due to the expansion of the iron on hot days.

Simple Garden Tool-care Tips


Rinse soil off digging tools after each use, by making a pit stop at the garden hose. Dry thoroughly. A stiff brush hanging by the tap would make for even more thorough cleaning.


It’s often recommended to place a bucket of sand moistened with motor oil (even used motor oil, the prescription sometimes says) inside the garage, and quickly dip tools into the abrasive, lubricating mix a few times after using them.


Use linseed oil for tools with wood handles.


Avoid excessive moisture, get the tools indoors, and hang them up! Don’t lean them against the garage wall, touching the floor—even if it’s paved.


Good-quality pruning shears should last a long time—unless you let sap and other residues build up on the blades.  Treat them as if they were the silverware in your home.  After supper, wash them. A quick stop at the sink, with soap and a nail brush or scrubby pad, is ideal. Dry well, and replenish lubrication on the pivot point only.


Invest in stainless.  You’ll still need to care for your tools, but they provide more than a decade of sturdy service.

Wei's World, July 2014

In June, my wife and I along with our youngest child, Emily, a recent high school graduate went to New York City. The purpose of the trip was to see our second child, Jeffrey, who was appearing in a production of Oliver at a theater on 42nd Street.

What was interesting about this show was that it was sponsored by the National Asian Artists Project and consisted of an all Asian cast.

As in many fields, Asians are underrepresented in the performing arts. Often they are typecast for shows like the King and I or Miss Saigon but not considered for other shows. This performance of Oliver demonstrated the amazing depth of talent among musical theater performers in the Asian community. The director of the show was Baayork Lee, who played the role of Connie in the original Broadway production of A Chorus Line. And the show was cast by Michael Cassara, one of the most respected casting directors in the business.

I don’t think about my ethnicity that much nowadays. Maybe when I was a child, it bothered me to be different and to be made fun of. Now, the topic doesn’t really come into my consciousness… unless of course I happen to walk into a red neck bar by mistake…

It is somewhat amusing though when we go to a take-out restaurant. Since my wife is Caucasian, the person taking our order often assumes we’re not together.

And I remember the one occasion when some acquaintances went with my wife and me to a Chinese restaurant. The husband was a six foot two inch Caucasian blonde guy who spoke impeccable Mandarin. He did the ordering even though the order taker kept looking at me… the Chinese guy who couldn’t speak any Chinese.

Pretty funny.

Getting back to when I was a child, the atmosphere regarding race was a much less tolerant one. My children were raised in an area where there are people from all over the world. And that was a good thing since it prepared them to be successful in the real world. That being said, there is still room for progress, particularly for Asians in the performing arts.

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