April 01, 2011

Arthritis Treatment Options


Arthritis treatment generally includes occupational or physical therapy, exercise, drugs, and sometimes surgery to correct joint damage. Treatments for osteoarthritis can help relieve pain and stiffness, but the disease may continue to progress. The same was true for rheumatoid arthritis in the past. But treatments in recent years have been able to slow or stop progression of joint damage in people with rheumatoid arthritis.

The duration and intensity of pain and discomfort depend on the type of arthritis and the degree of severity.

Conventional Medicine for Arthritis

In the case of localized pain, stiffness, and immobility, the typical three-stage arthritis treatment consists of medication to relieve pain and inflammation, rest to let injured tissues heal themselves, and exercise to rebuild mobility and strength.

Joint Protection in Arthritis

Learning to protect your joints is an important part of arthritis treatment. With the help of an occupational therapist, you can learn easier ways to do your normal activities, such as avoiding positions that strain your joints, using your strongest joints and muscles while sparing weaker ones, wearing braces or supports for certain joints and using grab bars in the bath, modified door knobs, canes or walkers, as well as using devices to help you with tasks such as opening jars or pulling up socks and zippers.

Your doctor may recommend pain relievers combined with regimens of heat, rest, exercise, physical therapy, and controlled application of deep heat to soothe affected joints.

Arthritis Medication

To reduce pain and inflammation in mild cases of rheumatoid arthritis and osteoarthritis, your doctor will probably prescribe aspirin or another nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen. Your doctor may also suggest acetaminophen for osteoarthritis.

In more advanced cases, your doctor may recommend corticosteroid injections -- strong anti-inflammatories -- to ease the pain and stiffness of arthritic joints. Depending on the individual, results range from temporary relief to long-lasting suppression of symptoms. Doctors are also using hyaluronate gel-like solutions in joint injections to further restore the cushion and lubricating properities of normal joint fluid and thereby minimizing pain. Some examples are Hyalgan, Synvisc, Supartz, and Orthovisc.

In the early 1900s, researchers discovered that certain compounds containing gold, given orally or by injection, gave relief to some people who have rheumatoid arthritis and caused total remission in others.
Note, however, that because the side effects of gold treatment can range from minor skin rash to severe blood and kidney disorders, this treatment is generally approached with caution and used rarely.

Newer treatments using low doses of chemotherapy medications (methotrexate) have produced dramatic improvements in severe rheumatoid arthritis, and these treatments show great promise of preserving joint function. Other strong medications that are used with or instead of methotrexate are Arava, Azulfidine, Enbrel, Imuran, Neoral, Plaquenil, Remicade, Humira, Kineret, Rituxan, and Orencia. In general, these drugs work by suppressing the overactive immune system. Apheresis is another treatment for rheumatoid arthritis that removes antibodies from the blood.

Specific arthritis treatment will depend on the nature and seriousness of the underlying condition. The major concern is for healing the affected area before more serious problems or long-lasting damage occur. Treatment of infectious arthritis typically involves large intravenous doses of antibiotics as well as drainage of excess fluid from the joints.

Surgery for Arthritis

Various forms of surgery may be needed to reduce the discomfort of arthritis or to restore mobility or joint function. Synovectomy is the removal of damaged connective tissue lining a joint cavity and it reduces joint swelling, pain, and ongoing damage to the joint. After synovectomy, the body regenerates new, healthy tissue in its place. This operation is most common in the knee. In cases of severe arthritic damage to the neck or foot, bones can be surgically removed or fused. Although movement is limited after such surgery, the operations relieve excruciating pain and help prevent further damage to nerves or blood vessels.

If arthritis pain and inflammation become truly unbearable, or arthritic joints simply refuse to function, the answer may lie in surgical joint replacement. Today, hip and knee joints -- as well as smaller joints in elbows, shoulders, and fingers -- can be replaced with reliable artificial joints made of stainless steel and plastic. This type of surgery can dramatically improve function and mobility.

Arthritis Pain Management

Because one of the most trying aspects of this disease is learning to live with arthritis pain, many doctors recommend training in pain management, including cognitive therapy. Research sponsored by The National Institutes of Health has found that cognitive behavioral therapy, using education and behavior modification alongside relaxation techniques, is better than routine care for relieving arthritis pain. 

Such programs focus on improving patients' emotional and psychological well-being by teaching them how to relax and conduct their daily activities at a realistic pace. Learning to overcome mental stress and anxiety can be the key to coping with the physical limitations that may accompany chronic rheumatoid arthritis and osteoarthritis. Cognitive therapy may include various techniques for activity scheduling, imaging, relaxation, distraction, and creative problem-solving.

Alternative Medicine for Arthritis

A variety of alternative therapies are used for arthritis. Let your doctor know if you're considering them.

Some studies suggest that glucosamine and chondroitin supplements are as effective as NSAIDs for reducing pain, swelling, and stiffness in osteoarthritis. Studies have shown some promise that they may slow the progression of osteoarthritis as well. More studies are underway to further investigate this. Typical doses are 1,500 mg for glucosamine and 1,200 mg for chondroitin daily. Glucosamine can raise blood sugar, so be sure to talk to your doctor before taking it, especially if you have diabetes. The antibiotic doxycycline may also show some potential in delaying the progression of osteoarthritis by inhibiting enzymes that break down cartilage. More research is needed to confirm these results.

The National Institutes of Health considers acupuncture an acceptable alternative treatment for osteoarthritis. Studies have shown that acupuncture helps reduce pain, may significantly lessen the need for painkillers, and can help increase range of motion in affected joints.

Source: WebMD

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