Joint Pain Remedy
Joint pain stems from many sources; the most common are athletic strain/injury, and arthritis. Joint pain and injury from sports or athletic stress are typically mild, and can be treated with rest, heat or ice, and aspirin. More serious injury or damage can require surgery or the use of casts or braces to allow the joint to heal. Chronic joint pain is typically an indication of either severe injury, or a symptom of arthritis. Joint pain is the most common symptom of osteoarthritis and rheumatoid arthritis, both of which are chronic diseases that can affect sufferers over a long period of time. Arthritis cannot be cured, but the symptoms can be treated through a variety of over-the-counter and prescription products as well as natural and medical methods. Learning how to manage your joint 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 these products and methods arthritis sufferers can use to alleviate many of the symptoms of arthritis, specifically joint pain.
Over-the-Counter Products
Acetaminophen
Acetaminophen is a pain reliever but does not reduce swelling, which is a common symptom associated with injury and some types of arthritis, specifically rheumatoid arthritis. As such, acetaminophen, the best known of which is Tylenol, may be effective for people afflicted with osteoarthritis which often times have very little inflammation. In addition, 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.
Ibuprofen
Ibuprofen is a pain reliever that combines anti-inflammatory properties with pain relief. People afflicted with rheumatoid arthritis generally have pain caused by inflammation and often benefit from aspirin or ibuprofen, the best know of which are Motrin and Advil. Unfortunately, ibuprofen products and aspirin typically cause some stomach discomfort if taken without food and have been linked to ulcers with long-term use.
Both glucosamine and chondroitin are synthesized by the body and are components of natural joint cartilage. Studies indicate that glucosamine and chondroitin can help alleviate joint pain related to osteoarthritis and rheumatoid arthritis through improvements to the general joint function including greater joint flexibility. It appears that together they help offset joint space narrowing, which is the loss of cartilage within the joint, seen with osteoarthritis by stimulating production of new 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 Products
Prescription Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
This class of drugs includes aspirin and ibuprofen as well as Vioxx (rofecoxib), Celebrex (celecoxib), and Bextra (valdecoxib), which are classified as COX-2 inhibitors. Aspirin and ibuprofen 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 but are more commonly used to treat symptoms of rheumatoid arthritis. The other drugs under NSAIDs are COX-2 inhibitors that 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.**
Biological Response Modifiers
This class of drugs includes Enbrel and Remicade, and is often used for the treatment of joint pain associated with rheumatoid arthritis by reducing the inflammation in the joints. Biological response modifiers theoretically block the reaction of an immune system protein involved in immune system response called tumor necrosis factor.
Disease-Modifying Antirheumatic Drugs (DMARDs)
This class of drugs includes Arava, methotrexate, hydroxychloroquine, penicillamine, and gold injections. Because of the likelihood of side effects, these drugs are 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
Corticosteroids are hormones that 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.
Natural Methods of Relief
Heat and cold
Heat and/or cold therapy is not recommended to alleviate symptoms associated with all types of arthritis and as such, the decision whether to use it or not should be discussed with your doctor or physical therapist. If your care provider determines that the use of heat and/or cold is 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 or bag of frozen vegetables 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.
Joint protection
In order to relieve the stress of everyday activity on an afflicted joint, which can exacerbate the condition and may lead to additional injury, a splint or brace can be used to allow joints to rest and keep them from being used. As with many other treatments, a medical care provider such as a physician or physical therapist can make recommendations and possibly provide you with the brace.
Massage
Massage is associated with temporarily relieving joint pain, one of the major symptoms associated with arthritis, rather than treating the underlying cause of a loss of cartilage. A massage therapist will typically lightly stroke and/or knead the muscles around the joint, 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
Low-impact exercises such as stretching exercises, swimming, walking, low-impact aerobics, and range-of-motion exercises may reduce joint pain and stiffness while increasing joint mobility. 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.
Weight Reduction
In addition to alleviating some symptoms, the weight loss associated with an exercise program is beneficial in relieving the extra stress that extra pounds put on weight-bearing joints such as the hips and knees. Studies have shown that overweight women who lost approximately 10 pounds substantially reduced the development of osteoarthritis in their knees. In addition, these studies suggested that if osteoarthritis has already affected one joint such as the knee or hip, weight reduction would reduce the chance of it occurring in the other knee or hip. 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 Methods
Transcutaneous electrical nerve stimulation (TENS)
Transcutaneous electrical nerve stimulation uses a small device that is placed near the joint afflicted with arthritis and directs mild electric pulses to nerve endings in and around the arthritic joint. It is theorized that TENS blocks the pain messages sent to the brain from the nerves and modifies the body's perception of pain. Although TENS relieves some joint pain associated with arthritis, it doesn't offset the joint inflammation that is associated with arthritis.
Surgery
In some extreme cases of persons with severe injury or arthritis, surgery may be necessary. The surgeon may perform an operation to remove the synovium, realign the joint, or in extreme cases, replace the damaged joint with an artificial one. Total joint replacement provides not only dramatic pain relief but also significant improvement in joint motion and mobility for many people with arthritis or severe damage from injury.
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