Pharmacy Times

Arthritis Watch

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For Less Stress on Joints, Run Barefoot

Running in modern running shoes may actually exert more stress on the hip, knee, and ankle joints, compared with running barefoot or walking in high-heeled shoes. This theory was studied by Casey Kerrigan, MD, of JKM Technologies LLC, and colleagues from the University of Colorado and the University of Virginia, whose results were published in the December 2009 issue of PM&R: The journal of injury, function and rehabilitation.

Knee osteoarthritis is the largest source of disability in the elderly than any other disease. Even though running has been shown to have health benefits in many other ways, including cardiovascular health, it can cause stress in the joints of the hip, knee, and ankle. To research their theory, Kerrigan and colleagues recruited 68 healthy young adult runners who typically ran in running shoes. The participants ran with shoes (without specific design characteristics that appeared generic) and also barefoot on a treadmill at a controlled running speed, during which the researchers observed them with a motion analysis system. Compared with barefoot running, Kerrigan and colleagues found that running in running shoes resulted in:
• Increased joint torques at the hip, knee, and ankle
• Large increases in the hip internal rotation torque and in the knee flexion and knee varus torques
• Average torque increases were: 54% in hip internal rotation, 36% in knee flexion, and 38% in knee varus

After these measurements, the researchers concluded that although modern running shoes support and protect the feet, they increase stress on the hips, knees, and ankles—probably due to an elevated heel and extra material under the medial arch.


Do Magnets Pull Their Weight in Helping Arthritis Pain?
Magnetic straps and bracelets have become a popular pain relief option for arthritis patients seeking an alternative to painkillers. Although they are believed to stimulate the release of the body’s natural painkillers or increase blood flow to tissue and are generally considered safe, recent studies have found little real benefit for their use.

In 2004, a study was conducted that found some benefit of magnetic bracelets in patients with osteoarthritis (OA) of the knee and hip (December 18, 2004, issue of BMJ). After studying 194 men and women aged 45 to 80 years who had OA of the hip or knee, the researchers concluded that pain from OA of the hip and knee decreased when wearing magnetic bracelets, although they were not sure why. Then, however, an analysis of studies in 2004 found contrary evidence and concluded that more research was needed.

Most recently, Stewart J. Richmond and colleagues researched the effectiveness of a typical magnetic wrist strap for reducing pain and stiffness and for improving physical functioning among patients with OA. In the United Kingdom, 45 patients were recruited and wore a commercially available magnetic wrist strap, a weak magnetic wrist strap, a demagnetized wrist strap, and a copper bracelet over a 16-week period in a crossover design. The researchers concluded that magnetic and copper bracelets are generally ineffective for managing pain, stiffness, and physical function in OA, as stated in the October-December 2009 issue of Complementary Therapies in Medicine.


Flu Vaccine Efficacy Decreased in RA Patients on Rituximab
A recent study published in the January 2010 issue of Arthritis & Rheumatism looked at the efficacy of influenza vaccination in rheumatoid arthritis (RA) patients treated with rituximab and the duration of the possible suppression of the humoral immune response following rituximab treatment. This study represented the largest study to date of the effectives of the flu vaccine in RA patients on rituximab.

Sander van Assen, MD, and colleagues recruited 72 individuals for the study—23 RA patients taking rituximab, 20 RA patients taking methotrexate, and 29 healthy individuals; the rituximab patients either received the influenza vaccine 4 to 8 weeks after rituximab treatment or 6 to 10 months after rituximab treatment. The researchers found that, although the flu vaccine is safe, it is ineffective in the first 6 months following rituximab treatment. The flu vaccine response is partially restored in RA patients 6 to 10 months after rituximab treatment. ■



FAST FACT: By 2030, it is projected that 25% of the US population (almost 67 million individuals) will have physician-diagnosed arthritis.



➜  For pharmacist-recommended products for arthritis, go to www.OTCGuide.net/pain_relief.