Hot pepper rub eases arthritis pain in hands

Q: I have arthritis in several joints, especially my wrists and fingers. A number of years ago, I began applying a rub that contains capsaicin, the heat from hot peppers. I find it very effective if used daily.

I also have added turmeric to my regimen. That offers additional pain relief.

A: Capsaicin, the compound that gives hot peppers their zip, has long been used in arthritis liniments such as BenGay, Heet or Sloan's liniment. It also is available in gel or cream form. You may have seen Capzasin or Zostrix-HP. Zostrix was developed to treat the nerve pain that may linger after a shingles rash clears.

If you apply a capsaicin product every day or several times daily, it can help ease arthritis pain (Progress in Drug Research, 2014). The idea is that it depletes substance P, which is essential for the sensation of pain.

You might want to use disposable gloves to apply your rub. Getting even a tiny amount in your eyes, nose or other delicate tissues could be extremely uncomfortable.

Turmeric, the yellow spice in curry, has anti-inflammatory activity. You can learn more about it in our “Guide to Alternatives for Arthritis.” This online resource covers a number of foods, medications and supplements that can help. It is available at our website:

Q: Approximately 18 months ago, I started taking Xarelto for atrial fibrillation. I started having shoulder pain a short time later. After six months, my doctor switched me to Eliquis.

The shoulder pain and elbow discomfort are tolerable, but the joint and muscle pain in my knees and the burning sensation throughout the night are unbearable. I have been to a rheumatologist, and all my blood tests have come back negative. All of these symptoms didn’t start until I began the blood thinners. I am not able to sleep because of the knee pain.

Have others reported similar side effects with Eliquis and Xarelto?

A: Rivaroxaban (Xarelto) and apixaban (Eliquis) are anticoagulant drugs. People with atrial fibrillation take such medicines to keep a clot from forming and lodging in the brain as a stroke.

Because these medications prevent clotting, they can lead to bleeding. The prescribing information focuses primarily on these complications.

Back pain, arm or leg pain, muscle spasms and osteoarthritis are listed as potential side effects of Xarelto. We could not find such side effects listed in the official information on Eliquis.

We did find a few inquiries like yours on patient online bulletin boards. In addition, the Food and Drug Administration has received hundreds of reports of such problems linked to Eliquis in its adverse event reporting system. Please be sure to discuss this with your doctor. It is dangerous to stop such medications suddenly.

Q: I've been on levothyroxine for years to treat hypothyroidism. I did not know that "take on an empty stomach" meant no coffee as well as no solid food.

When I learned that, I also read that with Tirosint you could have caffeine and even solid food. I persuaded my doctor to switch me to Tirosint. Now I don’t have to wait an hour after taking my thyroid medicine before having breakfast.

A: Tirosint capsules were developed to be better absorbed than levothyroxine tablets such as Synthroid. This medicine can be taken with breakfast, and there is no effect on absorption (European Journal of Endocrinology, January 2014).

You pay for this convenience, of course: Tirosint costs more than Synthroid and about 10 times as much as generic levothyroxine.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website: Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”

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