More than 40 million Americans suffer from some form of arthritis. Osteoarthritis (above right) is by far the most common form of arthritis, affecting about 16 million Americans, while rheumatoid arthritis (above left), which affects about 2.1 million Americans, is the most crippling form of the disease. Gout Is also classified as a type of arthritis, affecting an estimated 6 million Americans, and may contribute to the development of osteoarthritis.
The pain of arthritis may come from different sources. These may include inflammation of the synovial membrane (tissue that lines the joints), the tendons, or the ligaments; muscle strain; and fatigue. A combination of these factors contributes to the intensity of the pain. The pain of arthritis varies greatly from person to person, for reasons that doctors do not yet understand completely. Factors that contribute to the pain include swelling within the joint, the amount of heat or redness present, or damage that has occurred within the joint. In addition, activities affect pain differently so that some patients note pain in their joints after first getting out of bed in the morning whereas others develop pain after prolonged use of the joint. Each individual has a different threshold and tolerance for pain, often affected by both physical and emotional factors.
Hot and cold—The decision to use either heat or cold for arthritis pain depends on the type of arthritis and should be discussed with your doctor. Moist heat, such as a warm bath or shower, or dry heat, such as a heating pad or microwaved rice bag placed on the painful area of the joint may relieve the pain. An ice pack wrapped in a towel and placed on the sore area may help to reduce swelling and stop the pain. You can (should) alternated heat and cold every 15 minutes for maximum benefit. If you have poor circulation, be careful with cold packs.
Nonsteroidal anti-inflammatory drugs (NSAIDs) —These are a class of drugs including aspirin, ibuprofen, naproxin (Aleve), 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 rheumatoid arthritis. Care must be taken as extended use or over use has the potential to create ulcers in the stomach. Trading one problem for another is counter productive. Your doctor or pharmacist is very versed in the proper use of these medications. Don't be afraid to ask, we all want to help you succeed.
Transcutaneous electrical nerve stimulation (TENS)— A small TENS device that directs mild electric pulses to nerve endings that lie beneath the skin in the painful area may relieve some arthritis pain. TENS seems to work by blocking pain messages to the brain and by modifying pain perception. Some TENS can be used to strengthen muscles around injured joints. This may also help to relive pain and prevent injury when physically active. Ask your doctor if this kind of therapy is right for you. If so your insurance may even help with the cost.
Massage—In this pain-relief approach, a massage therapist will lightly knead the painful muscle. This may increase blood flow and bring warmth to a stressed area. However, arthritis-stressed joints are very sensitive so the therapist must be very familiar with the problems of the disease. There is some research that suggests, human touch (like massage) may improve and modulate the immune system and stimulate healing at a very basic level. If for nothing else, massage feels great!
Joint Protection— Using a splint or a brace to allow joints to rest and protect them from injury can be helpful. Be careful of improperly fitted braces or securing them too tightly. These can cause additional problems or make the joint pain worse. Your physician or Pharmacist can make recommendations.
Acupuncture— This procedure should only be done by a licensed acupuncture therapist. In acupuncture, thin needles are inserted at specific points in the body. Scientists think that this stimulates the release of natural, pain-relieving chemicals produced by the brain or the nervous system. Always ask for references & ask the practitioner about there sterilization procedures. Anyone who is proud of their clinic will be pleased to see you are intereted is safety and quality.
Weight reduction — Excess pounds put extra stress on weight-bearing joints such as the knees or hips. 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.
Disease-modifying anti-rheumatic drugs (DMARDS ) — These are drugs used to treat people with rheumatoid arthritis who have not responded to NSAIDs. Some of these include methotrexate, hydroxychloroquine, penicillamine, and gold injections. These drugs are thought to influence and correct abnormalities of the immune system responsible for a disease like rheumatoid arthritis.
Treatment with these medications requires careful monitoring by the physician to avoid side effects.
Corticosteroids — These are hormones that are very effective in treating arthritis. These are not the same type of steroids (anabolic steroids) abused by some bodybuilders. Corticosteroids can be taken by mouth or given by injection. 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. Because frequent injections may cause damage to the cartilage, they should only be done once or twice a year. If you have diabetes or other metabolic disorders, corticosteroids must be used sparingly and with caution.
Exercise — Swimming, walking, biking, low-impact aerobic exercise, and range-of- motion exercises may reduce joint pain and stiffness. In addition, stretching exercises are helpful. A physical therapist can help plan an exercise program that will give you the most benefit. Studies have shown that exercising an arthritic joint is more effective at pain reduction than any other therapy.
Surgery — In some patients with arthritis, surgery may be necessary. The surgeon may perform an operation to remove damaged tissue, realign the joint (osteotomy), or in advanced cases replace the damaged joint with an artificial one. Total joint replacement has provided not only dramatic relief from pain but also improvement in motion for many people with arthritis.