Exercise to prevent Falls and Fractures The University of Manchester News, 2/10/2014
Boosting your activity levels and doing strength and balance exercises significantly reduces your risk of breaking a bone as a result of falling if you are over 60, according to experts from an international research group based at The University of Manchester. Following International Older People’s Day on 1 October ageing experts at The University of Manchester are advising people 60 plus to increase their exercise to reduce the risk of potentially fatal trips and falls.
Often exercise programs need to be tailored for older individuals to take into account preexisting injuries or current physical limitations. Physiotherapists are ideally positioned to assist given their training encompasses both treatment and exercise prescription. Ensuring you have a well rounded program (fitness, strength, flexibility and balance) that is appropriate for you, means that you are working to your potential and improving on your weaknesses.
October: Medication Update
Risks of opioids outweigh benefits for headache, low back pain, other conditions. American Academy of Neurology News, 30/9/2014
According to a new position statement from the American Academy of Neurology (AAN), the risk of death, overdose, addiction or serious side effects with prescription opioids outweigh the benefits in chronic, non–cancer conditions such as headache, fibromyalgia and chronic low back pain. The position paper is published in the September 30, 2014, print issue of Neurology. “More than 100,000 people have died from prescription opioid use since policies changed in the late 1990s to allow much more liberal long–term use,” said Gary M. Franklin, MD, MPH, research professor in the Department of Environmental & Occupational Health Sciences in the University of Washington School of Public Health in Seattle and a Fellow with the AAN. “There have been more deaths from prescription opioids in the most vulnerable young to middle–aged groups than from firearms and car accidents. Doctors, states, institutions and patients need to work together to stop this epidemic.”
Studies have shown that 50 percent of patients taking opioids for at least three months, are still on opioids five years later. A review of the available studies showed that while opioids may provide significant short–term pain relief, there is no substantial evidence for maintaining pain relief or improved function over long periods of time without serious risk of overdose, dependence or addiction. The AAN recommends that doctors consult with a pain management specialist if dosage exceeds 80 to 120 (morphine–equivalent dose) milligrams per day, especially if pain and function have not substantially improved in their patients.
Common painkillers + other drugs = high risk of GI bleeding
American Gastroenterological Association News, 6/10/2014
Nonsteroidal anti–inflammatory drugs (NSAIDs) – such as ibuprofen and aspirin – increase one’s risk of upper gastrointestinal bleeding. When taken in combination with other drugs, this risk is significantly higher, according to new research appearing in the October issue of Gastroenterology. “These findings may help clinicians tailor therapy to minimize upper gastrointestinal bleeding, and are especially valuable in elderly patients who are likely to use multiple drugs at the same time,” said Gwen Masclee, MD, lead study author from Erasmus Medical Center in Rotterdam, the Netherlands.
This study identified that:
Single therapy (one drug) with non–selective NSAIDs (the commonly found NSAIDs, which contain both COX–1 and COX–2 enzymes) is more likely to cause upper GI bleeding than single therapy with COX–2 inhibitors or low–dose aspirin
Combination therapy (more tan one drug) significantly increases the risk for internal bleeding, with simultaneous use of non–selective NSAIDs and steroid therapies increasing the risk to the greatest extent
The risk of upper GI bleeding is always higher for drug combinations with non–selective NSAIDs than that for low–dose aspirin or COX–2 inhibitors
Simultaneous use of non–selective NSAIDs or low–dose aspirin, but not COX–2 inhibitors, with corticosteroids, aldosterone antagonists (diuretic drugs) or anticoagulants (which prevent the blood from clotting) produces significant excess risk of upper GI bleeding
Final recommendation was that when NSAIDs are necessary, they should be used at the lowest effective dose for the shortest possible duration.
Check with your GP if you have questions about the medications that you are on, in just the same way as you would ask your physio about your exercise program as each treatment is tailored for your personal needs and situation.