Arthritis

Arthritis Relief

Arthritis is often referred to as a chronic disease. This means that it can affect the person afflicted with arthritis over a long period of time, perhaps for the rest of a person's life. It cannot be cured, but it can be treated through a variety of products, both prescription and over-the-counter, as well as natural and medical-related methods. Learning how to manage your pain over the long term is an important factor in controlling the disease and maintaining a good quality of life. The following information is a brief overview of some of the methods and products that arthritis sufferers can use to alleviate many of the symptoms associated with both osteoarthritis and rheumatoid arthritis, especially joint pain.

Over-the-Counter and Prescription Drugs Used for Osteoarthritis

Osteoarthritis is caused by the deterioration or destruction of cartilage within the joint. At this time, there are no prescription drugs that have been shown to slow or halt the damage to the afflicted joint. Despite this, there are many drugs, both over-the-counter and prescription, which can help ease pain and stiffness associated with arthritis and some over-the-counter supplements that studies suggest slow the deterioration of cartilage in arthritic joints.

Acetaminophen

People afflicted with osteoarthritis often times have very little inflammation. As such, pain relievers such as acetaminophen (the active ingredient in Tylenol) are often effective. Acetaminophen is a pain reliever but does not reduce swelling. In many cases, the acetaminophen is the first and only drug needed to control the joint pain associated with osteoarthritis. Acetaminophen is often recommended because of its low cost, pain relief effectiveness, and lack of serious side effects. It does not cause stomach irritation and is less likely than nonsteroidal anti-inflammatory drugs (NSAIDs), described later, to cause long-term side effects. Research has shown that acetaminophen relieves pain as effectively as NSAIDs for many patients with osteoarthritis. People with liver disease, people who drink alcohol heavily, and those taking blood- thinning medicines or NSAIDs should use acetaminophen with caution.

Glucosamine and Chondroitin

Many people with osteoarthritis find relief from nutritional supplements such as glucosamine and chondroitin. Both glucosamine and chondroitin are synthesized by the body and are naturally found in cartilage. Studies indicate that glucosamine and chondroitin can help alleviate joint pain related to osteoarthritis and improves general joint function including greater joint flexibility. Several of these studies indicate that glucosamine may help as much as nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, naproxen, and tolmetin in relieving symptoms of osteoarthritis, particularly joint pain, with fewer side effects. Other studies even suggest that glucosamine and chondroitin may actually help rebuild damaged joint cartilage. It appears that together they help offset joint space narrowing and the loss of cartilage within the joint, and provide the necessary building blocks to rebuild cartilage damaged by injury, repetitive motion, and osteoarthritis, while stimulating production of new cartilage. Researchers theorize that glucosamine assists in the creation of new cartilage, while chondroitin slows cartilage destruction.

Prescription Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

This class of drugs includes aspirin and ibuprofen that are used to reduce pain and inflammation and may be used for both short-term and long-term relief in people with osteoarthritis and, more commonly, rheumatoid arthritis. NSAIDs also include Vioxx (rofecoxib), Celebrex (celecoxib), and Bextra (valdecoxib), all of which are classified as COX-2 inhibitors. COX-2 inhibitors work by blocking an enzyme known to cause an inflammatory response. COX-2 inhibitors had been approved for short-term use in the treatment of pain, and for longer-term use to treat the signs and symptoms of osteoarthritis and rheumatoid arthritis.

**Please see latest FDA Alerts regarding Vioxx, Celebrex, and Bextra recall**

Viscosupplements/Hyaluronic Acid Products

Although viscosupplements are technically not drugs, these new injectable products, Hyalgan and Synvisc, have been approved by the Food and Drug Administration to help ease the joint pain of osteoarthritis in the knee only. It is theorized that these drugs mimic a naturally occurring body substance, hyaluronic acid, which lubricates the knee joint and permits flexible joint movement without pain. Hyaluronic acid products are typically administered in a series of three or five weekly injections directly into the affected joint. They are most effective for people with mild to moderate osteoarthritis in the knee.

Corticosteroids

Corticosteroids can be taken by mouth or given by injection directly into the affected joint. Prednisone is the corticosteroid most often given by mouth to reduce the inflammation of rheumatoid arthritis. In both rheumatoid arthritis and osteoarthritis, the doctor also may inject a corticosteroid into the affected joint to stop pain. These hormones are very effective in treating arthritis but cause many side effects, including damage to the cartilage. In fact, frequent injections may cause damage to the cartilage, and as such, they should only be done once or twice a year.

Over-the-Counter and Prescription Drugs Used for Rheumatoid Arthritis

There are many different drugs used in the treatment of rheumatoid arthritis. Some are used primarily to ease the symptoms of RA such as pain and inflammation, while others are used to slow or stop the deterioration associated with the disease and to prevent additional structural damage to the afflicted joints. These drugs are either prescription or over-the-counter/nutritional supplements.

Ibuprofen/Aspirin

People afflicted with rheumatoid arthritis generally have pain caused by inflammation and often benefit from aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin or Advil) and naproxen sodium (Aleve). Ibuprofen and naprosen sodium combines anti-inflammatory with pain relief, but does typically cause some stomach discomfort if not taken with food and have been linked to gastric ulcers and bleeding with long-term use.

Prescription Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Nonsteroidal anti-inflammatory drugs include more than a dozen different medications to ease arthritis pain and inflammation. Some NSAIDs are available over-the-counter, including aspirin and ibuprofen, as reviewed above, and some are available by prescription only. These NSAIDs are called COX-2 inhibitors and include Vioxx (rofecoxib), Celebrex (celecoxib), and Bextra (valdecoxib), all of which are available by prescription only. COX-2 inhibitors work by blocking an enzyme known to cause an inflammatory response. COX-2 inhibitors had been approved for short-term use in the treatment of pain, and for longer-term use to treat the signs and symptoms of osteoarthritis and rheumatoid arthritis.

**Please see latest FDA Alerts regarding Vioxx, Celebrex, and Bextra recall**

Disease-Modifying Antirheumatic Drugs (DMARDs)

These drugs include Arava, methotrexate, hydroxychloroquine, penicillamine, and gold injections. Typically, these are drugs used to treat people with rheumatoid arthritis who have not responded to NSAIDs or are no longer taking NSAIDs because of the FDA recall of Vioxx, Celebrex, and Bextra (COX-2 inhibitors). It is theorized that DMARDs are drugs that work slowly to slow or stop disease progress by influencing and correcting abnormalities of the immune system responsible for a disease like rheumatoid arthritis. Doctors have found that starting a patient on DMARDs early in the treatment process can help prevent irreparable joint damage that might occur if use was delayed. In addition, doctors often prescribe two or more DMARDs together. Due to the likelihood of adverse side effects, treatment with these medications requires careful monitoring by the physician.

Analgesics

For more severe pain, doctors may prescribe narcotic analgesics such as tramadol (Ultram), oxycodone (OxyContin), or propoxyphene hydrochloride (Darvon). These drugs treat the pain only and do not affect the inflammation associated with rheumatoid arthritis, nor do they offset the structural damage or deterioration of the joint. Because of the risk of addiction, doctors prefer to use them for as short a time as possible and in doses as low as possible.

Topical Analgesics

Many people find temporary relief from the pain associated with rheumatoid arthritis through a variety of medications in the form of over-the-counter or prescription creams that can be applied directly to the area around the afflicted joints to ease pain at that site. Topical analgesics contain one or more active ingredients that can work by disturbing the nerve endings in order to divert the brain's attention from the joint pain or by prevent the body from producing chemicals associated with pain. These topical analgesic include counterirritants (Icy Hot), salicylates (Aspercreme, Ben-Gay, Flexall, Mobisyl and Sportscreme), and capsaicin (Capzasin-P).

Glucocorticoids

Glucocorticois, including prednisone (Deltasone, Orasone), prednisolone (Prelone) and methylprednisolone (Medrol), are powerful and quick-acting anti-inflammatory medications that are often used to get potentially damaging inflammation under control. Because of the risk of side effects with these drugs, doctors prefer to use them as a short-term solution to severe inflammation, typically while waiting for NSAIDs and DMARDs to take effect, and in the lowest doses possible.

Biologic Agents/Biological Response Modifiers

These drugs include etanercept (Enbrel) and infliximab (Remicade) and are used for the treatment of rheumatoid arthritis through reducing the inflammation in the joints. It is theorized that they block the reaction of a substance called tumor necrosis factor (TNF), an immune system protein that the body produces as a part of the normal immune response to infection. Although tumor necrosis factor production is a normal response to an infection, the level of TNF that is typically produced in the joints because of a disease such as rheumatoid arthritis is excessive. The disproportionate amount of TNF can cause irreparable damage to the joint structures, including the underlying bone. Because of their high cost, most doctors prescribe Enbrel and Remicade to people whose rheumatoid arthritis has not responded well to DMARDs.

Corticosteroids

Corticosteroids can be taken by mouth or given by injection directly into the affected joint. Prednisone is the corticosteroid most often given by mouth to reduce the inflammation of rheumatoid arthritis. In both rheumatoid arthritis and osteoarthritis, the doctor also may inject a corticosteroid into the affected joint to stop pain. These hormones are very effective in treating arthritis but cause many side effects, including damage to the cartilage. In fact, frequent injections may cause damage to the cartilage, and as such, they should only be done once or twice a year.

Natural Methods for both Osteoarthritis and Rheumatoid Arthritis

Heat and Cold

Since heat and/or cold is not recommended to alleviate symptoms associated with all types of arthritis, the decision whether to use it or not should be discussed with your doctor or physical therapist. If appropriate for use on your arthritis pain, it must be determined which kind of temperature treatment should be used. Moist heat, such as a warm bath or shower, or dry heat, such as a heating pad, placed on affected joint for about 15 minutes may relieve the pain. An ice pack wrapped in a towel and placed on the sore area for about 15 minutes may help to reduce swelling and stop the pain. If you have poor circulation, do not use cold packs. Heat and cold are more effective on joint pain that stems from overuse, typically through athletic activity or sports.

Joint Protection

A splint or brace can be used to allow joints to rest and keep them from being used, which can exacerbate the condition and may lead to additional injury. As with many other treatments, your physician or physical therapist can make recommendations and possibly provide you with the brace.

Massage

This method is associated with temporarily relieving one of the major symptoms associated with arthritis, joint pain, rather than treating the underlying cause, loss of cartilage. A massage therapist will lightly stroke and/or knead the painful muscle, which increases blood flow to the stressed area. It is important to realize that arthritic joints are very sensitive, so the massage therapist must be familiar with the disease and problems associated with the affected joints.

Exercise/Weight Reduction

Stretching exercises, swimming, walking, low-impact aerobic exercise, and range-of-motion exercises may reduce joint pain and stiffness while increasing joint mobility. In addition to alleviating some symptoms, the weight loss associated with an exercise program is beneficial in relieving the stress of extra weight on weight-bearing joints, especially the hips and knees. Studies have shown that overweight women who lost an average of 11 pounds substantially reduced the development of osteoarthritis in their knees. In addition, if osteoarthritis has already affected one knee, weight reduction will reduce the chance of it occurring in the other knee. A physical therapist or gym trainer can help plan an exercise program that will give you the most benefit with the least stress on the arthritis-stressed joints.

Medical-Related Methods to Treat Osteoarthritis and Rheumatoid Arthritis

Transcutaneous Electrical Nerve Stimulation (TENS)

Transcutaneous electrical nerve stimulation (TENS) is a small device that is placed over the area afflicted with arthritis and directs mild electric pulses to nerve endings in and around the arthritic joint. TENS seems to work by blocking pain messages to the brain and by modifying the body's perception of pain. It may relieve some joint pain associated with arthritis but doesn't seem to offset the inflammation that is associated with arthritis.

Surgery

In advanced cases of patients with arthritis, surgery may be necessary. The surgeon may perform an operation to remove the synovium (synovectomy), realign the joint (osteotomy), or in extreme cases, replace the damaged joint with an artificial one (arthroplasty). Total joint replacement has provided not only dramatic relief from pain but also improvement in motion for many people with arthritis.

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I used to think that stiff, swollen joints were just something that went along with getting older. Since prescription medicines never agreed with me,
I'd given up on finding an effective treatment.
Then a friend recommended Synotrex,
and I've rediscovered what it's like
to live without joint pain.
Valerie K,
Age 55, Providence, RI

Synotrex is a great product. I have been using it for 6 months straight and it has made a huge difference. Before Synotrex, playing basketball with my kids was tough. I could play for awhile, but eventually my knees
would just hurt too much. With Synotrex, it feels
like my knees are lubricated with WD-40 :-)
and I donít feel a thing.
Lydia Whitney,
Age 41, Portland, OR

Before finding Synotrex, I was really starting to miss out on a lot lifeís special ďmomentsĒ. Iíve had arthritis for years and have always struggled with it. Iíve never really was an active person, but when my grandchildren started to run around a lot more, I struggled to keep up. Thatís what prompted me to start looking for a good solution. I found Synotrex online and it seemed to address my needs. Well, after using it consistently for 4 months, Iím a new
person. My RA has gotten a lot better and more
importantly, I can keep up with the little ones.
I no longer feel like Iím missing out!
Beatrice Williams,
Age 64, Chicago, IL

After suffering a pretty bad knee injury in college 20 years ago, I have been dealing with bad knee pain. Iíve tried all kinds of stuff, but no matter what, nothing really makes it feel better. My wife saw an ad for Synotrex guaranteeing that it would work, so she bought me some. I took it reluctantly, but amazingly
enough it really worked. Synotrex has made a
huge difference and am now able to be
active again (pain free).
Woody Jackson,
Age 43, Denver, CO

Synotrex is the best! Iíve tried all kinds of home remedies (I refuse to take joint pain medication) and it is by far the most effective supplement out there. I have wasted my money on all kinds of products and I can guarantee you, nothing works as well as Synotrex. It has all of the right ingredients to reduce
joint pain. Donít waste your time and money like
I did trying other products. Get Synotrex today
and start feeling better!
Carl Brown,
Age 51, Dallas, TX

I used to think that stiff, swollen joints were just something that went along with getting older. Since prescription medicines never agreed with me, I'd given up on finding an effective treatment. Then a friend recommended Synotrex, and I've rediscovered what it's like to live without joint pain.

Valerie K,
Age 55, Providence, RI

Synotrex is a great product. I have been using it for 6 months straight and it has made a huge difference. Before Synotrex, playing basketball with my kids was tough. I could play for awhile, but eventually my knees would just hurt too much. With Synotrex, it feels like my knees are lubricated with WD-40 :-) and I donít feel a thing.

Lydia Whitney,
Age 41, Portland, OR

Before finding Synotrex, I was really starting to miss out on a lot lifeís special ďmomentsĒ. Iíve had arthritis for years and have always struggled with it. Iíve never really was an active person, but when my grandchildren started to run around a lot more, I struggled to keep up. Thatís what prompted me to start looking for a good solution. I found Synotrex online and it seemed to address my needs. Well, after using it consistently for 4 months, Iím a new person. My RA has gotten a lot better and more importantly, I can keep up with the little ones. I no longer feel like Iím missing out!

Beatrice Williams,
Age 64, Chicago, IL

After suffering a pretty bad knee injury in college 20 years ago, I have been dealing with bad knee pain. Iíve tried all kinds of stuff, but no matter what, nothing really makes it feel better. My wife saw an ad for Synotrex guaranteeing that it would work, so she bought me some. I took it reluctantly, but amazingly enough it really worked. Synotrex has made a huge difference and am now able to be active again (pain free).

Woody Jackson,
Age 43, Denver, CO

Synotrex is the best! Iíve tried all kinds of home remedies (I refuse to take joint pain medication) and it is by far the most effective supplement out there. I have wasted my money on all kinds of products and I can guarantee you, nothing works as well as Synotrex. It has all of the right ingredients to reduce joint pain. Donít waste your time and money like I did trying other products. Get Synotrex today and start feeling better!

Carl Brown,
Age 51, Dallas, TX

 

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