New Study Shows 40% Fracture Reduction With Use of Hip Protectors

Smoking May Exacerbate Muscle and Joint Pain

FDA Announces Tougher Dietary Supplement Regulation

New Study Shows 40% Fracture Reduction With Use of Hip Protectors

Previous studies involving hip protectors have produced positive and negative results, but a recent study by Dr. Gabriele Meyer and colleagues from the University of Hamburg in Germany found that hip protectors greatly reduced hip fractures in the study participants. Osteoporosis and hip problems are both potential problems in patients with spondylitis. These results were published in the January issue of the British Medical Journal.

External hip protectors generally have a very poor acceptance rate, so the German researchers conducting the trials tried to see whether patients receiving additional information about hip protectors were more likely to use them than patients receiving brief, basic information. The devices are designed to help protect individuals from future fractures during everyday activities. They are usually made with plastic pads or shields that are padded or constructed with foam-type materials, and they fit into specially-designed pockets in undergarments or pants.

Results: Dr. Meyer and his colleagues contacted 86 nursing homes in Hamburg, Germany, of which 42 agreed to participate. A total of 942 residents took part in the study to randomly receive either "usual care" or "intervention".

"Usual care" consisted of a ten minute introduction and demonstration of the hip protector.

"Intervention" involved the researchers actually conducting an education session lasting 60-90 minutes for the nursing home staff that covered information about the risk of hip fracture and related morbidity, strategies to prevent falls and factures, effectiveness of hip protectors, etc. The staff then relayed the information to study participants, and offered three free hip protectors to each person who expressed interest in trying the device.

They found the following:

• 40 out of 483 (8%) participants in the "usual care" group used hip protectors
• 158 out of 459 (34%) in the "intervention" group used hip protectors
• Hip protectors protected residents from hip fracture in both groups.

Dr. Meyer and colleagues did not find any significant differences between the two groups in the frequency of fractures elsewhere in the body, or in the frequency of falls. They conclude that hip protectors should be provided on prescription for elderly people at high risk of hip fracture.

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Smoking May Exacerbate Muscle and Joint Pain

New York (Reuters Health) -- A recent study shows that smokers complain more often of discomforting or disabling musculoskeletal pain than people who have never smoked. The association was even found in "ex-smokers", which suggests that smoking may cause long-term damage to muscle tissues, or a change in the brain's response to pain. Dr. K.T. Palmer of Southampton General Hospital in Southampton, UK and colleagues published their results in the January issue of Annals of Rheumatic Diseases.

Previous studies have suggested links between smoking and pain (especially chronic back pain), but most of these studies did not factor out lifestyle factors, such as on-the-job manual labor, as possible contributing causes.

Results: 12,907 adults filled out detailed questionnaires that covered topics like their smoking history, work activities, and levels of sporadic or chronic musculoskeletal pain.

They found that current smokers had a 50% higher incidence of reporting "pain the past year that prevented activity" (meaning pain so severe that it prevented the person from going to work or performing housework or hobby activities) compared to those who had never smoked. Pain in the lower back, shoulders, elbows, hands, neck, and knees was higher in smokers than never-smokers. This association held even among people who had white-collar or other jobs that did not require heavy lifting or moving.

Studies have suggested the following explanations for why smoking may raise pain levels:

• Nicotine is such a powerful stimulant that "could affect the manner in which the brain processes sensory stimuli and the central perception of pain", which may increase the smoker's pain response.
• Tobacco smoking may cause general damage to musculoskeletal tissues by reducing blood flow, raising clotting risks, or reducing the flow of nutrients to muscles and joints.
• Those who choose to smoke might be psychologically predisposed to feel or report pain at lower thresholds than non-smokers. Past studies suggest that smokers react more quickly to painful stimuli than nonsmokers.

These researchers conclude that the pain-related effects of smoking can last for years due to tissue damage or a "prolonged resetting of the threshold for pain."

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FDA Announces Tougher Dietary Supplement Regulation

The U.S. Food and Drug Administration (FDA) has announced new programs intended to protect consumers against improper marketing and safety risks of herbs and dietary supplements.

Promotions for fraudulent products often appear in newspapers, magazines, mail-order catalogs, stores, and on television "infomercials". The Internet is an easy way in which to market fraudulent health products from around the world.

According to the new FDA report:
"Hoping to cure illness or improve their appearance, consumers often fall victim to products and devices that cheat them out of their money and steer them away from proven treatments. These fraudulent products pose specific dangers including: substituting unproven treatments for proven medical treatments; harmful interactions with prescription or over-the-counter drugs; taking products that have no health benefits or that have adverse effects; and economic loss."

The FDA has created a new Consumer Health Information for Better Nutrition Initiative, which will:

• Issue guidance on qualified health claims for conventional foods and dietary supplements. Claims must be pre-approved by the FDA and include support by a credible body of scientific evidence.
• Strengthen enforcement of rules against false or misleading claims about dietary supplements.
• Establish an FDA Task Force on Consumer Health Information for Better Nutrition to help consumers obtain accurate, up-to-date, and science-based information about conventional food and dietary supplements.

Further information can be found at www.fda.gov/bbs/topics/NEWS/2002/NEW00859.html.

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