| T O P I C R E V I E W |
| Dave |
Posted - 08/09/2004 : 09:06:45
Common Drug for Knee Pain No Better Than Placebo
Fri Aug 6, 2:23 PM ET
NEW YORK (Reuters Health) - Painkillers containing acetaminophen are recommended for treating osteoarthritis of the knee, but French investigators report that a sugar pill is just as effective.
Acetaminophen, known in many parts of the world as paracetamol, is the active ingredient in Tylenol and many other brands of medicine.
Clinical trials have shown that acetaminophen reduces knee pain, but Dr. Maxime Dougados, of Rene Descartes University, Paris, and colleagues say these trials "have been relatively small, and variable daily doses of paracetamol have been used."
The team conducted their own trial, reported in the Annals of the Rheumatic Diseases. They examined the efficacy of paracetamol for treating osteoarthritis of the knee in 779 patients who had knee pain of at least 30 on a 100-point visual scale during physical activity.
The participants were randomly assigned to treatment with 4 grams per day of paracetamol or an inactive placebo, for six weeks. The main outcome target was a 30 percent decrease in pain intensity of the knee.
The proportion of participants who achieved this level of pain relief was almost the same in the paracetamol and placebo groups, at 52.6 percent and 51.9 percent, respectively.
Twenty-six percent of the patients in the paracetamol group and 30 percent of those in the placebo group withdrew from the study. "Withdrawals due to treatment failure were noted in 14 percent and 18 percent in the paracetamol and placebo groups, respectively," the authors write.
Given these findings, Dougados' team says "the use of paracetamol in symptomatic osteoarthritis of the knee might be further explored."
SOURCE: Annals of the Rheumatic Diseases, August 2004.
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| 4 L A T E S T R E P L I E S (Newest First) |
| JosephB |
Posted - 08/10/2004 : 14:46:59
Sarno’s MBP, page 128, states, “Cousins cured himself through the application of what he called “positive emotions,” to counteract the effect of “negative emotions.” He also credited high doses of Vitamin C for his recovery, but admitted that this might have been the result of a placebo effect.”
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| tennis tom |
Posted - 08/10/2004 : 09:59:09
Dave,
The article about painkillers jibes with my experience. I have not taken a painkiller since my hospitalization for a duodenal ulcer this past January--and I feel BETTER. I was conducting my own experiment with Alleves and discovered you can spring a leak if you take more than the prescribred dose for too long. The cure was worse than the disease.
Afterwords, I was told to use Tylenol if I needed a painkiller. Fortunately, I have not needed one since. The ER experience was a big wake-up call and I will only take a painkiller for something accute, immediate, and temporarily. I had been taking various OTC's for years in big doses, (ibuprophen, aspirin, naproxen), and now realize their effects were mostly placebo. I took them before exercise, to prevent pain and after to minimize pain. I don't take anything now including supplemtnts and I feel BETTER and I feel they are mostly placebo. I'm sure a big motrin would change the pain sensation but I think in the long run TMS thinking would be the best and certainly the healthyest in every way.
Rheuamtoid and osteo-arthritis, for medical purposes, are two entirely different conditiions. They were lumped together under rheumatology many years ago for lack of a better classification system by early medicine. They both effected the joints so the joint docs got 'em--so much for the exactness of medicine. Osteo is the common form that we all get as we age, "gray hair of the joints". Rheuamtoid is a whole different thing and more serious. I would suspect that their could be a TMS element to it. Sarno writes about tension and it's relationship to heart disease and heart attack, so to some degree long term stress IMHO could cause serious auto-immune disorders such as rheumatoid arthritis. |
| bernard lewis |
Posted - 08/10/2004 : 03:35:15
The Norman Cousins book, that I have read, does not talk much about "positive emotions". It talks about "vitamin C" which was used by the author in massive dosis.
By the way, paracetamol is considered a weak analgesic and probably not appropriate for arthitis that may cause important pain. The fact that paracetamol does not cause significant effect on arthritis does not mean that there are no other drugs that do.
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| JosephB |
Posted - 08/10/2004 : 02:14:04
Osteoarthritis / Rheumatoid Arthritis
Interesting to note that the placebo effect, just as well as the administration of conventional painkillers, equally relieved the pain of osteoarthritis of the knee, and that the results of their study was published in Annals of the Rheumatic Diseases.
There is a medical distinction between osteoarthritis and rheumatoid arthritis, and the difference is briefly discussed in Sarno’s MBP. See Osteoarthritis (pp. 75, 90) and Rheumatoid Arthritis (pp. 127-129).
Osteoarthritis is described as a degenerative change in joints as a person ages. Rheumatoid arthritis is described as a disease of the joints, a classic autoimmune disorder, a malevolent malfunction in the immune system, with or without permanent tissue damage, perhaps caused by an adrenal exhaustion which impairs immune function.
Sarno further discusses Norman Cousins’ experience in overcoming his serious rheumatoid arthritis by effectively applying what he called “positive emotions”. As I pointed out in my Placebos posting on 08/07/2004, his mindbody solution to physical ailments, as described in his book, Anatomy of an Illness, published in 1979, is still valid today and will be valid eternally. I highly recommend that this book be added to the List of TMS-Related Books.
Dave – Thanks again for your many thoughtful contributions to this TMS Forum. I read every one of your replies, and they always seem to “hit the nail on the head” as an answer to the individual’s TMS problem, rather than his/her “physical” problem. I especially appreciated reading and rereading your three recent responses to Sis’ “physical”/TMS problem posted on 07/19/2004.
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