Posts Tagged ‘osteoarthritis’
Wednesday, December 30th, 2009
Know your Pain Relief Options
The term “arthritis” refers generally to an inflammation of the joints and is typically associated with stiffness and joint pain. The different forms of arthritis vary in terms of cause, severity and potential pain relief treatments.
Management of arthritis pain depends not only upon the specific condition, but also upon your age, lifestyle, and unique response to different treatment methods.
Osteoarthritis and Rheumatoid Arthritis
The two most common forms of arthritis are osteoarthritis and rheumatoid arthritis. Together these conditions affect approximately 40 million people in the United States alone.
* Osteoarthritis is a degenerative condition involving deterioration of the cartilage in the joints, resulting in joint pain or stiffness.
* Rheumatoid arthritis is an inflammatory disease affecting the lining of the joints. While osteoarthritis is far more common, rheumatoid arthritis is often a much more severe form of the disease.
Before assessing your arthritis pain relief options, it is important to consult with a physician to determine whether you have arthritis, and if so, which type since treatment options differ.
Common Causes of Arthritis Pain
The joint pain associated with arthritis may be caused by a variety of factors. Most commonly, arthritis pain originates from:
* Inflammation of the tendons, ligaments or lining of the joints. This inflammation may be accompanied by swelling or redness, which results in joint pain.
* Joint tissue damage, which may be related to an injury or excess pressure on the joints.
* Fatigue, which is sometimes a result of arthritis and can make the joint pain seem more intense and the condition more difficult to cope with.
Arthritis Pain Treatment Options
There are a variety of ways to treat arthritis pain and other joint pain. It’s essential to be aware that people respond differently to different treatments. An individual’s response to pain and pain relief treatments is affected by the particular disease or condition he/she suffers from, the severity of the pain, and a range of psychological and emotional factors.
Short Term Pain Relief
One of the most important considerations when evaluating arthritis pain relief treatment options is to be clear about whether you are focusing on short or long term pain relief.
For short term relief from arthritis pain, many people use hot or cold therapy, depending on the type of pain and the specific condition. Cold therapy in the form of an ice pack can sometimes provide pain relief by reducing swelling, but may not be a good option for patients with poor circulation. Heat therapy, either moist or dry, acts as a muscle relaxant, and can also provide short term pain relief.
Certain drugs can also give quick, short term relief from the joint pain associated with arthritis. Depending on the amount of inflammation, doctors will often recommend a pain relief medication such as acetaminophen or a non-steroidal anti-inflammatory drug (NSAID) like aspirin or ibuprofen.
Another non-drug alternative that provides some patients with short term relief from arthritis pain is TENS, or transcutaneous electrical nerve stimulation. A TENS unit delivers electrical pulses to nerves in the affected area. The pulses block pain messages that the nerves would normally deliver to the brain, thereby bringing pain relief to the patient.
TENS therapy may also raise the level of endorphins produced by the brain. Endorphins are substances that are produced naturally in the body and contribute to feelings of well-being and pain relief.
Long Term Pain Relief
Because both rheumatoid arthritis and osteoarthritis are chronic conditions, sufferers often need to look for long term options to deal with their joint pain.
Drugs such as NSAIDs provide some level of pain relief. In the case of rheumatoid arthritis, disease-modifying antirheumatic drugs (DMARDs) target the immune system and are helpful for some patients. Corticosteroids are hormones that are sometimes prescribed for treatment of the joint pain and inflammation that typically accompany arthritis.
For many people with arthritis pain, exercise and physical therapy can help reduce stiffness and joint pain. Depending on the severity of the condition, walking, swimming, and a variety of strengthening and/or aerobic activities may be helpful, not only in pain relief but also from the standpoint of improving patients’ self-confidence and psychological and emotional well-being.
Overweight people suffering from arthritis pain are frequently advised to lose weight, since additional weight places an added burden on the joints.
In a small minority of cases, medication and lifestyle changes do not provide the desired pain relief and doctors may recommend surgery. Surgical procedures can remove tissue within the joint, or else realign or replace the joint.
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Friday, July 10th, 2009
Being told that you have osteoarthritis (OA) can be troubling. After all, no one wants to deal with arthritis pain. The pain and stiffness caused by the condition prohibit many people from engaging in physical activities if they do not manage their condition properly. Fortunately, there are ways to manage your pain and stay active.
Remember that having OA, though at times inconvenient and painful, does not mean that you can’t live a productive and fulfilling life. Here are some tips that may help you deal more effectively with osteoarthritis.
1. Learn about your condition
Many people suffer unnecessarily from the pain of OA because they are uninformed. Learn everything you can about OA from reliable sources of information. It’s a good idea to write down questions questions as you think of them and ask your doctor later. Remember not to be shy about asking them; doctors are professionals trained to deal with all sorts of conditions and diseases that many people are embarrassed to talk about. Get a second opinion if you think you could benefit from one.
Because OA is characterized by continual “wear and tear” of the cartilage in your joints, you should be aware that your pain and stiffness might worsen over time if left untreated. Being informed about how your particular case of OA is progressing will help you to better manage your condition, as well as prepare for what difficulties you may have to face in the future .
2. Identify your risk factors and take steps to minimize them
Factors such as age, heredity, weight, prior joint injury and certain medical conditions can increase your chance of getting OA. Be sure to identify what puts you at the most risk for the condition and act accordingly to minimize those risks you can control.
If you are starting to approach middle age and you don’t feel as limber as you once did, it may simply be a sign of age. However, an unusual amount of pain or stiffness that occurs more frequently or lasts longer than you are accustomed to may be an indicator of osteoarthritic damage to your joints. The same goes for if an old injury to your joints bothers you more than it used to, or if your joints feel more stressed than they when you weighed less.
Talk to your doctor about activities that cause you joint pain and what you can do to minimize the discomfort you feel.
3. Modify your exercise routine
Though it may be disheartening to realize that OA may keep you from engaging in certain activities that never previously gave you any trouble, modifying your exercise/activity routine in light of OA can keep you fit and healthy while reducing joint pain and damage. For example, those weekend basketball games may be more trouble than they’re worth if your knee is stiff and in pain for several days afterward.
If you have a routine of exercise or physical activity that is difficult to maintain because of OA, you might want to consider seeking out new activities that place less stress on the affected joints. You may want to try walking or riding a bike instead of jogging. Sure, it may take you a while to adjust to the difference in routine. But your joints will thank you for it later by not being as inflamed.
Swimming is known to be one of the most beneficial of all exercises for a number of reasons. Chief among these for people with OA is that there is no impact on the joints. Swimming and pool training have long been practiced by people looking for a challenging workout without negatively impacting their joints. Specially designed aquatic fitness programs benefit many people with arthritis. Just don’t forget the sunscreen if your pool is outdoors!
4. Know which treatments work best for you and utilize them
Knowing which treatments work best for treating your OA is critical to minimizing the pain and inflammation caused by the condition. Obviously, you wouldn’t consider surgery for your OA if your condition isn’t that serious. Likewise, a treatment such as a hot or cold pack may offer some relief but is not going to resolve severely debilitating pain.
Many patients, particularly elderly individuals, underreport pain for a variety of reasons. Some patients fear complaints will not be taken seriously. Others believe that adequate pain remedies are simply not available or worry about becoming hooked on painkillers. Though it is true that some physicians do not treat pain sufficiently because they fear that patients will become addicted to pain medications, this shouldn’t hold you back from talking to your doctor about what treatments are most appropriate for you and your situation. Injection into the joint with a corticosteroid can also help to reduce pain and improve mobility.
Taking such steps will help you learn what to expect from your condition, the limitations that may result, and what you can do to ease your OA. It may also help to remember that OA won’t be as likely to keep you inactive and away from doing what you love if you treat symptoms of OA in the most effective manner possible .
5. Involve family and friends
Many people are unaware that they may be at risk for developing OA as they age. You may choose to involve your spouse in your new routine to minimize OA. Having a companion will also make those walks or bike rides more meaningful and enjoyable than they would be otherwise. Plus you’ll both be doing something to help yourselves look and feel better.
6. Don’t get frustrated
If the pain and inconvenience of OA has gotten you down, don’t blame yourself. There are many disorders over which the individual has little or no control. Consider yourself lucky that OA is not one of them. Though OA can be a pain at times, most individuals with the condition are able to live full, healthy lives with little or no compromise. By working with your doctor, sticking with treatments that work best for you and keeping a positive attitude, you should be able to overcome the obstacles OA throws your way.
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Monday, June 1st, 2009
Ankylosing spondylitis (AS) has a strong genetic component, but there is no known way to prevent the disease. However, patients who are aware of a family history of this disease can watch for signs and symptoms. Early detection of AS provides the best chance to treat the disease before it causes irreversible damage.
In addition, patients who are diagnosed with AS can help reduce the chance of further damage by quitting smoking. Patients with AS sometimes develop stiffness in the rib cage that reduces their ability to breathe fully. Damage to the lungs caused by smoking can worsen these symptoms. Researchers have also found smoking to be a risk factor for other forms of arthritis, including rheumatoid arthritis and osteoarthritis.
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Monday, May 4th, 2009
Most joints with pseudogout deposits revealed by x-ray do not cause any pain. When painful attacks do occur, however, pseudogout may manifest itself in ways similar to a variety of other disorders, such as:
* Gout. It is difficult to clinically differentiate between gout and pseudogout. Because gout and pseudogout crystals are composed differently, it must be established which crystal type is causing the joint inflammation. Crystal deposits associated with pseudogout are made primarily of calcium, unlike gout crystals, which are made of uric acid. Furthermore, attacks of gout typically occur in joints of the toes and feet, whereas pseudogout typically occurs in the knees.
Awareness of these patterns alone is insufficient in making a distinction between gout and pseudogout; further testing is required. Usually, the only difference is the type of crystal in the joint. Pseudogout crystals extracted in an arthrocentesis are positively birefringent (able to split a ray of light in two) under a polarized light microscope, but gout crystals are negatively birefringent. Trauma, surgery or illness may cause attacks of gout, pseudogout or a combination of the two.
* Osteoarthritis. Many people with pseudogout exhibit degeneration of one or more joints in ways similar to osteoarthritis (deterioration of cartilage in the joints). Calcium pyrophosphate Osteoarthritis is the most common type of arthritis and is caused by joint cartilage deterioration.dihydrate (CPPD) crystal deposits, which cause attacks of pseudogout, are often present in osteoarthritic joints. CPPD crystal deposits are thought to play a role in the progression of osteoarthritis in some cases, although the reason for this is uncertain.
* Rheumatoid arthritis. People with rheumatoid arthritis experience inflammation of multiple joints. Certain symptoms of pseudogout may closely resemble rheumatoid arthritis, such as stiffness, fatigue and persistent restricted range of motion in joints. Furthermore, pseudogout may worsen the damage caused by rheumatoid arthritis if both are present in the same joint.
* Neuropathic joint disease. Diseases that can cause one or more joints to deteriorate and lose sensation (e.g., diabetes, tabes dorsalis and syringomyelia) may be accompanied by CPPD deposits. The affected joint is known as a Charcot joint. In these instances, the underlying cause of Charcot joint may be strengthened by the presence of a CPPD deposit.
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Tuesday, March 31st, 2009
Arthroscopy may be used to confirm diagnosis of or treat a large number of conditions, including acute trauma to soft tissues. These may be removed, repaired or reconstructed. Examples of such injuries, which often occur during sports, include:
* Rotator cuff injuries. Injury to muscles and tendons that connect the upper arm bone (humerus) to the shoulder blade (scapula). Arthroscopic surgeons can complete tasks such as repairing tears or performing An ACL tear involves the anterior cruciate ligament of the knee joint and is a cause of knee pain.acromioplasty, which involves shaving bone from a point (acromion) on the scapula.
* Anterior cruciate ligament (ACL) tears. A complete tear requires extensive rehabilitation to restore function and ease knee pain.
* Meniscus injury. Injury to the cartilage disc (meniscus) between the two surfaces of a joint. These are often allowed to heal naturally. However, arthroscopy may be used to repair these injuries if the tear is complex or the symptoms occur daily. Also, it may be completed if general function is hindered or if leaving the injury unrepaired may cause further damage.
* Achilles tendon injuries. Arthroscopy may be used in treating tears to the Achilles tendon, a common cause of foot pain.
Other conditions in which arthroscopy may used include::
* Rheumatoid arthritis. A chronic, inflammatory form of arthritis. Affected portions of the synovium (fluid sac lubricating the joints) may be removed with arthroscopic assistance.
* Infectious arthritis. Arthritis caused by infection. Arthroscopy may be used to wash out the joint. This may provide minor, temporary relief.
* Osteoarthritis (OA). Degenerative bone arthritis. The use of arthroscopy in the treatment of OA is controversial. Some studies suggest that it provides little or no more benefit than a placebo. However, arthroscopy may be used to smooth off the roughened edges of bone. This is widely done in the knee. It may offer temporary relief of symptoms and may slow down the arthritic process, but it cannot stop the disease.
Osteoarthritis
* Chondromalacia. Softening or degeneration of the cartilage in the joint. This may be identified with arthroscopy. If it is not extensive, it can be treated with arthroscopy, but extensive chondromalacia may require other treatment methods.
* Patellofemoral syndrome (runner’s knee). Arthroscopic shaving of the patella (kneecap) is sometimes recommended to address difficult cases of this overuse injury, a common cause of knee pain.
* Articular debris. Loose fragments of bone or cartilage in the joint. These may be identified and removed with arthroscopy.
* Carpal tunnel syndrome. Carpal tunnel syndrome is a compression of the median nerve in the wrist that causes wrist pain. Tennis elbow is a repetitive stress injury that causes elbow pain during specific arm movements.
* Tennis elbow (lateral epicondylitis) or golfer elbow (lateral epicondylitis). Types of repetitive stress injury that affect tendons and muscles in the elbow. Arthroscopic surgery can removed damage tissues and release tendons to relieve these causes of elbow and arm pain.
* Hemarthrosis. Accumulation of blood in the joint. The blood can be drained during arthroscopy.
* Mechanical dysfunction. This may include the abnormal alignment or instability of the joint. Arthroscopy may be used to correct this.
* Osteophytes (bone spurs). These may be removed via arthroscopy.
* Fractures. Sometimes arthroscopy is used to determine whether surgery is needed for a broken bone, such as in the glenohumeral region of the shoulder.
Fractures can be incomplete (only cracked or partially broken) or complete (in two pieces). Hip replacement surgery involves inserting a plastic cup and metal ball into an enlarged hip socket.
* Torn labrum. Damage to the cartilage rim of the socket-like acetabulum in the hip. In some cases, arthroscopic repair of a torn labrum may prevent degeneration of the hip and avert or delay the need for a hip joint replacement (arthroplasty).
* Synovitis. Inflammation of the synovium. Synovectomy (removal of the synovium) may be performed with arthroscopic assistance.
* Osteomyelitis or other joint infections. Joint tissue biopsies may be collected and some instances of infection treated during arthroscopy.
* Radial tunnel syndrome. Impingement of the radial nerve in the elbow. Symptoms are similar to those of tennis elbow. Arthroscopy may be recommended if conservative treatments such as occupational therapy fail.
* Gout or pseudogout. Arthroscopy may be used to examine crystal formations in these arthritic conditions.
* Frozen shoulder (adhesive capsulitis). Arthroscopy might be an option if noninvasive methods fail to stretch the capsule, increase range of motion and ease shoulder pain.
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Sunday, March 29th, 2009
Arthroscopy is the examination of a joint with a device called an arthroscope inserted through a small incision in the skin. An arthroscope is a small, illuminated camera at the end of a narrow tube. It is connected to a monitor to allow for examination, diagnosis and repair of joint problems.
Sometimes arthroscopy is used only to do a visual inspection and make a diagnosis. With arthroscopic surgery, instruments such as scissors or lasers are inserted through additional small incisions that are much less invasive than traditional open surgeries.
Arthroscopy can be used in treating a number of conditions. In many cases, such as osteoarthritis, this treatment addresses certain symptoms and may be only temporary. However, it may be the only needed treatment for certain other conditions, particularly trauma to a joint, such as torn cartilage (meniscus) in the knee.
Osteoarthritis is the most common type of arthritis and is caused by joint cartilage deterioration. Medial meniscus injury (and knee pain) can occur by twisting the knee violently or by normal aging.
Before the procedure, the patient’s medical history is evaluated and a physician performs a physical examination. X-rays are taken of the joint, and other tests such as MRI or blood tests may be performed.
Arthroscopy is performed with the patient under anesthesia. The surgeon makes an incision in the skin near the joint and inserts an arthroscope. Surgical instruments can be inserted to repair or remove damaged tissues. However, arthroscopy cannot resolve some joint problems, which may need traditional open surgery.
It is usually an outpatient surgery, with the patient going home after spending a few hours in a recovery room. Medications may be prescribed for pain, inflammation and prevention of infection. The patient can usually resume normal activities in a few days. Risks of arthroscopy are low, and complications are rare. When they do occur, complications are usually minor and treatable.
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Sunday, March 22nd, 2009
Rheumatoid arthritis (RA) is one of the most debilitating types of arthritis. It can cause the joints to swell and eventually become deformed, making it difficult to perform routine tasks.
RA begins in the joints, where two or more bones meet. There are several types of joints. Arthritis occurs mostly in synovial joints, which can move, such as those in the hands, wrists, ankles, knees and feet. For each synovial joint, a space enclosed by the ligaments and adjoining bones forms a cavity called the joint capsule. The outer layer of the capsule is formed by a fibrous membrane. The inside of the capsule is lined with a membrane called the synovium. This membrane secretes synovial fluid, which fills the joint capsule and provides lubrication. The ends of the bones encased in the capsule are cushioned in soft cartilage. The cartilage and synovial fluid permit the bones to move without rubbing against each other.
People with RA experience inflammation in the joint capsules, which affects the movement of the joint and causes pain. RA is an autoimmune condition, which means people with RA have an abnormal immune response. Normally, the immune system protects the body from outside invaders, such as germs. Immune cells (e.g., white blood cells) attack these invaders and flush them out or make them inactive. Part of this process normally produces some inflammation in tissue.
For someone with autoimmune response, the immune system misidentifies regular body tissue as an outside invader. It attacks the tissue and tries to destroy it. In RA, certain types of white blood cells attack parts of the synovium, causing the inflammation that characterizes RA. The process by which this occurs is not well understood. The synovium thickens, which causes the joint to swell. The synovium can form a body called a pannus, which has granular tissue that covers the bone and cartilage. The pannus tissue reacts with enzymes and erodes the bone surface.
RA usually begins in the smaller joints of the fingers or feet. It frequently occurs in the same joints on both sides of the body. It eventually may move to involve more joints, including the wrists, ankles, elbows and knees.
RA is a chronic condition, but attacks may vary. There are periods of severe inflammation called flare-ups, and RA can go into remission for long periods of time. A few people may experience one flare-up followed by remission. However, RA is generally a progressive (worsening) illness. It may start in a few small joints and eventually spread to other joints and tissues, such as cartilage, bones and ligaments. Some RA patients eventually have substantial functional disability that prevents them from working.
RA is a systemic disease, meaning it can involve other body systems. RA can affect the linings of the heart, lungs and blood vessels, and increases the risk of heart disease and heart failure. It can also affect the eyes and the nerves. Inflammation of the blood vessels (vasculitis) can be life-threatening, causing skin ulcerations and infections, bleeding ulcers, hemorrhage and nerve problems.
Rheumatologists classify the status of RA patients based on their ability to function:
* Class I. Completely able to perform usual activities of daily living.
* Class II. Able to perform usual self-care and work activities, but limited in other activities (i.e., sports or chores).
* Class III. Able to perform self-care activities but limited in work and other activities.
*Class IV. Limited in ability to perform usual self-care, work and other activities.
RA can occur at any age and in all races and ethnic groups. It generally begins between the ages of 30 and 50. Although adults are primarily affected, there is also a disease called juvenile rheumatoid arthritis that can affect children.
Women are more commonly affected by RA than men. Of the 1.3 million Americans with RA, at least two-thirds are women, according to the Centers for Disease Control and Prevention (CDC). Women with RA tend to experience remission of symptoms during pregnancy and flare-ups after giving birth or while breastfeeding.
RA is not the same as osteoarthritis (OA), the degenerative form of arthritis most common among elderly people. Although both forms of arthritis cause joint pain, there are several major differences:
* OA involves degeneration of joint cartilage. RA involves inflammation of the membranes lining joints, caused by immune dysfunction.
* RA usually occurs symmetrically, such as in both hands or both knees. OA may occur on one side (e.g., in one knee).
* OA affects only the joints. RA can affect other systems in the body, including the lungs, nerves or heart.
* OA usually affects people over age 50. RA affects people between 20 to 60 years of age.
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Friday, March 20th, 2009
Also called: RA, Systemic Rheumatic Disease, Rheumatoid Disease, Rheumatic Joint Disease, Subacute Rheumatic Arthritis, Acute Rheumatic Arthritis
Osteoarthritis is the most common type of arthritis and is caused by joint cartilage deterioration. Rheumatoid arthritis (RA) is an autoimmune condition that involves joint inflammation and pain. Although less common than osteoarthritis, RA is more debilitating and usually starts earlier, between the ages of 30 and 50.
About 1.3 million Americans, at least two-thirds of them women, have RA, according to the Centers for Disease Control and Prevention (CDC).
The cause of RA is not entirely understood. It begins with an altered immune response, in which immune cells attack normal cells in the joints. This causes inflammation and pain in the joints, frequently in the same joint on both sides of the body. RA can also affect the eyes, heart and other organs.
RA may begin as pain, swelling or stiffness in a few joints. The progress of the disease varies. It may remain the same for many years or progress to other joints and systems in the body. The swelling can deform the bones and tendons in the joints, which may make the joints difficult to use. Some people eventually lose the ability to work or perform daily tasks.
Physicians may use multiple blood tests and a physical examination to diagnose RA. Guidelines to classify the disease include joint pain or swelling in multiple joints for more than six weeks.
There is no known cure for RA. Treatment concentrates on pain relief and slowing the progression of the disease.
Great strides have been made in recent years with drugs that can slow RA’s progress. Drug treatment may include basic pain relievers such as acetaminophen or anti-inflammatory drugs. Other drugs modify the disease’s progress or work on parts of the immune system that malfunction to trigger RA. The course of RA is different for each patient and different drug combinations may provide relief. No drugs can reverse damage inflicted on the joints.
Some surgical procedures can remove parts of damaged joints or even replace a joint (arthroplasty).
Research into the causes and progress of RA continues. Scientists are studying genetics and the biochemistry of the immune system. Other studies focus on potential new drugs, drug combinations or other treatment methods.
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