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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. This is a brief overview of some of the methods and products that arthritis sufferers can use to alleviate many of the symptoms associated with arthritis, especially joint pain.
People afflicted with osteoarthritis often times have very little inflammation. As such, pain relievers such as acetaminophen, the most well know of which is Tylenol, may be effective. Acetaminophen is a pain reliever but does not reduce swelling. Acetaminophen 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.
On the other hand, 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). Ibuprofen combines anti-inflammatory with pain relief, but does typically cause some stomach discomfort if not taken with food and have been linked to ulcers with long-term use.
Glucosamine and chondroitin are components of natural joint cartilage. Studies indicate that glucosamine and chondroitin can help alleviate joint pain related to osteoarthritis and improves general joint function including greater joint flexibility. It appears that together they help offset joint space narrowing, the loss of cartilage within the joint, seen with osteoarthritis by stimulating production of new cartilage. Both glucosamine and chondroitin are synthesized by the body and are naturally found in cartilage. Researchers theorize that glucosamine assists in the creation of new cartilage, while chondroitin slows cartilage destruction. Some 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 in the knee, with fewer side effects.
Prescription Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
This class of drugs includes aspirin and ibuprofen that are used to reduce pain and inflammation, as noted above, 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.
Biological Response Modifiers
These drugs include Enbrel and 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, an immune system protein involved in immune system response.
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 these drugs influence and correct abnormalities of the immune system responsible for a disease like rheumatoid arthritis and other rheumatic diseases. Due to the likelihood of adverse side effects, treatment with these medications requires careful monitoring by the physician.
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.
Hyaluronic Acid Products
These drugs include Hyalgan and Synvisc. It is theorized that these drugs mimic a naturally occurring body substance that lubricates the knee joint and permits flexible joint movement without pain.
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.
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.
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.
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.
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.
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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