Ask the Doctor: Synvisc, Meniere's disease and gallstones

Dr. Rob Riley joins us each week from the South Bend Clinic. Here are his responses from October 1st.

George: I have rheumatoid arthritis in my knees. My doctor thinks Synvisc might help. How long might it help?

Synvisc is the brand name of a product containing hyaluronic acid, which is one of the building blocks of the cartilage in joints. This substance is injected directly into the knee, typically every week for three consecutive weeks. We have much more experience with this substance in treating people with osteoarthritis, which is the more common wear-and-tear type of arthritis, but it has been used, though less frequently, in people with rheumatoid arthritis. Unfortunately, this is not a wonder cure for arthritis. Some people get no benefit at all and others only notice a small improvement. Any beneficial effect people get typically lasts in the 3-6 month range and then the process needs to be repeated. An additional challenge sometimes is that this medication is expensive and insurance companies don’t always pick up the costs.

Erin: What is Meniere’s disease?

Meniere’s disease is one of the causes of attacks of dizziness, specifically vertigo, which is that kind of dizziness where people have the feeling that things are moving or spinning. People with this condition also usually experience ringing in the ears and decreased hearing. The attacks tend to occur repeatedly over time. The cause isn’t known. It’s thought to be due to some sort of problem with the inner ear. The biggest concern for people with this condition, other than the disruption these bouts of dizziness cause, is that over time it’s associated with more permanent hearing loss. We don’t have a cure for this condition but some things can be done to help. High salt intake, caffeine, alcohol, and nicotine seem to be associated with attacks so dietary and lifestyle modification can be helpful. There are also some medications and some exercises people can do to help.

Shelby: Can gallstones hurt the left side of your back?

I’d hate to say never, but that would be really unusual. The gall bladder is located in the right upper part of the abdomen and it can cause pain if the opening out of it is blocked by a gallstone. That pain is typically located right there in the right upper part of the abdomen but can be felt more in the upper middle part or radiate around to the back or shoulder blade area on the right side. Pain on the left side of the back is more commonly due to something else like strain of a muscle. A kidney stone on the left side could cause left-sided back pain, too.