Opioids for back, knee, and hip pain? A chat with Dr. Erin Krebs

You have undoubtedly heard about the opioid crisis. It is a near daily part of my life since treating pain is a hefty part of what most doctors do. In addition, I am fortunate to work in an academic health setting so I am surrounded by researchers and teachers. Just this week, one of my friends and colleagues, Dr. Charlie Reznikoff was in Washington DC where he testified about opioids to members of Congress. So you might say I’m surrounded by smart people on this issue.

In this post, I want to draw your attention to some new information about treating arthritis pain.  A new study was recently published in JAMA (one of the most respected journals in existence) which concluded that for chronic back pain and arthritis pain of the hips and knees, opioids are no better than other remedies.

Let me say that startling conclusion again:  opioids are no better than non-opioid treatments at relieving low back, knee, and hip pain.  There is NO advantage, and plenty of risk, in using opioids to treat these chronic pain conditions.

This is big news.  For me, it is just a little bigger because the lead author of the study is a Minneapolis physician from my medical school class, Dr. Erin Krebs. Dr. Krebs is a leading researcher in this area and I may add, a terrific doctor and person. To her, I say, well done! To learn more about Dr. Krebs, check out her site from the VA here.  You can also learn more about her from the University of Minnesota Medical School.

I reached out to Dr. Krebs and she graciously responded to some of my questions about her research.  I offer her insights to you below.  This is a rare chance to hear from a physician-scientist, uncluttered from what you may find elsewhere on the Internet.  Often people ask me what where to get reliable information on health issues.  On this issue, this is as reliable as it gets.  I’ll include a couple links as well, including one to an audio interview with Dr. Krebs.  Read on.
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Quick tips: tremors, blood pressure, constipation

Hey, everybody.

Some of my most popular posts are these Quick Tips in which I do relatively brief answers to health topics raised by listeners to the Healthy Matters radio broadcasts.

This time, I’ll cover these three topics from actual listener questions.

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New feature: Dr. Hilden in the News


Just a brief post to call your attention to a new feature right here on MyHealthyMatters. Since I do a fair amount of media work – including TV, radio, online, and in print, I thought it might be good to do a collection and put links all in one place.

It’s right there at the top of the page: called Dr. Hilden in the News.   

In putting this together I noticed that much of my media appearances involve influenza.  Guess that’s what the media wants to talk about!

That being said, there are a few other links on the Dr. Hilden in the News page that I want to call your attention to:

Photo by Holger, Ellgaard

AirTalk™ on Southern California public radio.  This is an 18-minute discussion about whether you really need an annual physical.  It aired just last month and you can listen to the audio.

10 things to ask your doctor on your next visit.  I did this print interview with the Minneapolis Star Tribune.  Not an exhaustive list but just some things I thought may help equip you for your next clinic visit.

One piece I’m quite proud of is from 2010 when I was interviewed by The New York Times about end-of-life conversations.  I really encourage you to read this one.


All these and more available in Dr. Hilden in the News.  Link right at the top of this page.



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Learning about depression with psychiatrist Eduardo Colón

Dr. Eduardo Colon

Hey, everybody.   Check out this fact:  about 16 million people in the United States will experience an episode of depression every year.  That’s about 7% of the population.  By some estimates, depression is in the top 3 causes of disability (source:  World Health Organization).

To help us learn a bit more about this condition, I asked my colleague Dr. Eduardo Colón to be my in-studio guest on last Sunday’s Healthy Matters broadcast.  It was a great show!  Dr. Colón is the Chief of Psychiatry at HCMC and he has been on the show a few times over the years.  This is terrific since you will not find a wiser and kinder psychiatrist than he.  I really encourage you to listen to the podcast so you can hear Dr. Colón explain things much better than I can in this written form.  

You can learn more about Dr. Colón from this Minneapolis Star Tribune article which appeared shortly after he was named Chief of Psychiatry.  He gives an insider perspective on mental health care in our community that is worth a read.

I’ll use this blog post as a written companion of sorts for the audio podcast of that radio show.  I’ll try to encapsulate a few topics from the show and include some links for more information.

First of all, download the audio podcast here to listen to whenever you want.  Once at the podcast site, select Healthy Matters show #475, February 11, 2018).


A wealth of information on depression

Here’s what Dr. Colón covered on the show, and you can click the links to jump to specific topics that interest you.

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Posted in Health in the News, Mental Health, Psychiatry, Tips from Healthy Matters radio broadcast | Tagged , , , , | Leave a comment

Quick tips: influenza, angina, kidneys, & blood pressure

Hi, everybody.  I’m back with one of these “Quick tips” posts where I answer questions that were sent to me on a recent Healthy Matters radio broadcast.  Regular listeners will know that I never can get to all of the questions, particularly those sent by text message, so I will try here to do some brief answers.  I’ll keep it to just a few topics, and will do more posts in the near future.

Here are the topics in this post.  Click the links to jump right to a specific topic.

As always, I invite you to listen to the Healthy Matters broadcasts, either live or via podcast.  Here are ways to listen:

  • Live on News Radio 830 WCCO on your AM dial.  Sunday mornings, 7:30 Central Time.  You’d be surprised how far the WCCO signal reaches from our downtown Minneapolis studios.
  • Live on WCCO.COM.  Sunday mornings, 7:30 Central Time, from anywhere on Earth with Internet
  • At your convenience, via podcast.  Simply click on the “Listen to Podcasts” link right here on MyHealthyMatters.org or go directly to WCCO.COM on the “Audio” link and find Healthy Matters.   You can listen directly online or you can download the podcast to your phone, tablet, or computer and listen anytime at your own convenience.  Without commercials!
  • Or just click the logo here:


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Do you need an annual physical?

I’m a doctor (duh).  I do annual physicals sometimes (duh, again).  But I recently was put in the position of debating another doctor – on live radio –  about whether or not the annual physical is doing anybody any good.

Of course, physicals help people to, well, stay healthy.  Right?  Not so fast!  This isn’t as simple a question as it may seem.

Do people really need an annual physical?

The big debate occurred about a couple weeks ago when I was asked to be on Southern California Public Radio, KPCC 89.3 FM out of Los Angeles.  I was on the long-running show AirTalk®, hosted by Larry Mantle.  It was set up as a “pro vs. con” debate between me and a physician-researcher from Harvard, Dr. Ateev Mehrotra.  Dr. Mehrotra has done a great bit of research on just such topics.

I invite you to listen to the audio segment from SoCal Public Radio.  It’s about 18 minutes long, and you can access it from their website, KPCC.ORG, under the AirTalk® section.  It ran on Wednesday, January 17, 2018 so go to that date in the archives and scroll to the bottom. Continue reading

Posted in Dr. Hilden's reflections, Preventive care, Primary Care | Tagged , , , | 2 Comments

Scenes from a frozen Minnesota lake

On Lake Harriet, Minneapolis

Hey.  This is going to be a weird post.

I went for a run today on a balmy January day near my home in Minneapolis.  Along the way I encountered frozen canoes by a lake shore, ducks swimming in a rare patch of open water, and thousands of people on a frozen lake – walking, swinging on gigantic wooden swing sets, biking, fishing, running, dressing up like butterflies, even standing in a circle while singing old hymns.  I saw guys running in shorts.  OK, that last part is not too weird, after all, it was 39 degrees today.  In Minnesota that qualifies as shorts weather in January.

Of course, I wore headphones playing a mix of Prince songs.  It was a terrific Minnesota kind of day.

I’m going to share a bit of it with you, my Healthy Matters friends.  There’s no medical talk here – no influenza or heart disease or illness or any kind.   To those of you feeling sick today, I hope you feel better soon!  But for now just some thoughts and pictures from a day when I felt really alive.  Surrounded by active, artsy, whimsical people.  Today I’m thankful for nature, for winter days, for my Minnesota neighbors – and I’m going to share a bit of it with you.

So if you wish, I invite you to check out some scenes from a frozen Minnesota lake .  .  .  (with some links to cool stuff) . . .

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Your arthritis questions answered!

By James Heilman, MD via Wikimedia Commons

Hey, what were you doing on Sunday morning, December 3?  I know what I was doing – I was on the air with my colleague Dr. Rawad Nasr – and we were talking about arthritis.  Dr. Nasr is a rheumatologist and the hour on the air just flew by.  We had so many questions that we only got to a small fraction of them.

I guess you all want to learn about arthritis!

I’ve been promising to do a post with Dr. Nasr’s answers to some of the questions we didn’t get to that morning.    I asked him to give written answers to listener questions, and he has begun that huge task, so the first batch of questions is here!

I do invite you to listen to the actual audio of the radio broadcasts, which are conveniently available as podcasts, without commercial breaks, for you to listen to on your computer or mobile device.  To do that, click this logo to reach the main podcast page, then select Healthy Matters show #465, December 3, 2017.


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Posted in Joint and Muscle issues, Tips from Healthy Matters radio broadcast | Tagged , , , , , | 2 Comments

In case you missed it: our most popular topics

I have been writing My Healthy Matters for nearly two years, and over that time there have been over 50,000 views to the site.  To all of you who read along with me, THANK YOU!

I took a pause in writing new posts today to look at the statistics on what most of you are reading on the blog.  It is really fascinating to see what strikes your collective fancy, so I thought I’d do a little retrospective post to highlight the most popular posts of the past.  You may wish to go back and read what you missed.

I’ll rank them in order of popularity, based on number of people who viewed them in 2017, and I’ll include links to the posts in case you want to read them.

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Posted in Diabetes, Diet and exercise, Dr. Hilden's reflections, Health and wellness, Preventive care, Quick tips, Tips from Healthy Matters radio broadcast | Tagged , , , , , , , , , | 2 Comments

New blood pressure guidelines: 130 is the new 140

Dr. Marty Stillman reassures me about my blood pressure

For many years I have been telling listeners and patients that “one-third of you have high blood pressure and many of you don’t know it.”  Turns out I need to update that to “nearly one-half of you have high blood pressure and many of you don’t know it.”

That is because the American College of Cardiology / American Heart Association guidelines for hypertension – high blood pressure – were recently updated.  Like any good scientific process, the guidelines change as our knowledge of the science changes.  That is exactly what occurred this past month.

I mentioned all this on the most recent Healthy Matters radio broadcast.  I started the show off with this information, all of which you can listen to on the podcast by clicking Healthy Matters show #463, November 19,2017.

Your doctor may be . . . should be . . .  talking about this with you at some future visit.  In this post I’ll try to break the new guidelines down for you a bit.  If you read on, you’ll find:

  • New 2017 blood pressure guidelines
  • Bad effects of high blood pressure
  • A word about garden hoses and metal pipes.  Huh?
  • How to measure your own blood pressure.
  • Treatments for high blood pressure.
  • Tips about healthy living.

Let’s get to it.

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