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Arthritis

Knee Irrigation Eases Pain Via 'Placebo Effect'

By Charnicia E. Huggins

NEW YORK, Jan 30 (Reuters Health) - Irrigating the knee to remove

calcium deposits and other debris has long been thought to reduce the pain

of osteoarthritis. Now, new study findings suggest that the benefits of this

treatment may largely be due to a placebo effect, in which patients feel

better simply because they expect the treatment to work.

In tidal irrigation, saline fluid is pushed into and withdrawn from

the joint capsule within the knee through a needle to reduce pain resulting

from inflammation caused by accumulated debris. The joint capsule is a

saclike structure enclosing the joint that contains a lubricating fluid.

" Joint injection therapies, including tidal irrigation, may provide

symptomatic benefit for variable lengths of time, (but) at least some of the

benefit is attributable to a placebo effect, " Dr. D. Bradley of the

Indiana University School of Medicine in Indianapolis, told Reuters Health.

Bradley and his colleagues studied 180 individuals with knee

osteoarthritis who were randomly assigned to a study group that received

tidal irrigation or a comparison group that received a sham irrigation

treatment, in which the needle did not puncture the joint capsule.

At follow-up, the investigators found that the study groups'

improvement in knee swelling and tenderness, pain, stiffness and walking

speed was nearly identical to that seen in the comparison group, according

to the report in the January issue of Arthritis & Rheumatism. In fact, the

comparison group exhibited a slightly greater, albeit insignificant,

improvement.

Neither group, however, showed a significant improvement in the

quality of their well-being--such as mobility, physical and social

functioning--or their anti-inflammatory or painkiller use.

These study results " demonstrate that placebo effects can be

'durable,' " Bradley said, noting the 12-month follow-up period incorporated

into the study.

In light of the findings, " we have to be very careful about assuming,

based on observational studies, that medical treatments--and particularly

invasive medical procedures--are effective, " he said.

" The key elements of medical osteoarthritis management remain

exercise, weight reduction, minimization of injury and pain control

medications, " Bradley concluded.

SOURCE: Arthritis & Rheumatism 2002;46:100-108.

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Amen to Mr. Yoshimura!! Hope it is done safely well within our lifetimes!!

Suzanne

[ ] HealthBytes from RealAge

> Rheumatoid Arthritis Therapy Effective in Mice

> By Emma Hitt, PhD

> " I believe we can conquer RA completely in the near future, "

Yoshimura

> concluded.

>

> SOURCE: Journal of Clinical Investigation 2001;108:1781-1788.

>

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