Arthritis pain and cures
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
Click here: Second Opinion Arthritis Treatment Kit
Dealing with pain can be the hardest part of having arthritis. The International Association for the Study of Pain defines pain as an unpleasant experience associated with actual or potential tissue damage to a person's body. Specialized cells (neurons) transmit pain signals throughout the body.
The reason it is so difficult to recommend one remedy for arthritis pain is that "arthritis" is a term used to describe more than 100 different conditions. While there is no "cure", there are multiple ways to control the condition.
The first step is knowing which type of arthritis or condition a person has, because that will help determine the course of treatment. Before learning different management techniques, however, it's important to understand some concepts about pain.
Just as there are different types of arthritis, there are also different types of pain. Also, pain tends to wax and wane from day to day.
Each person needs a pain management plan. What works for one person may not work for someone else. Many different treatments may need to be tried until the right one is found.
Pain is the body's alarm system that signalling something is wrong. When the body is injured, nerves in the affected area release chemical signals. Other nerves send these signals to the brain, where they are recognized as pain.
Pain is often a protective mechanism, eg. putting a hand on a hot stove.
Chronic pain, such as occurs with arthritis, is different. While there is something obviously wrong, the pain is not so much a protective mechanism so much as it is a sign there is some sort of problem with the body.
Arthritis pain is caused by several factors:
•Inflammation, the process that causes the redness and swelling in the joints;
•Mechanical abnormalities due to damage to joint tissues, which results from the disease process or from stress, injury or pressure on the joints;
•Fatigue that results from the disease process, which can magnify pain;
•Depression or stress, which can lead to a cycle of pain, disability, and stress and depression that makes managing pain and arthritis more difficult.
An additional type of pain is due to abnormal central nervous system processing of pain. This is the type of pain characteristic of fibromyalgia.
People react differently to pain for several reasons. Some people have high pain tolerance and others relatively low tolerance. Factors that govern how pain is perceived include sensitivity of the central nervous system, severity of arthritis, emotional and social factors, previous experiences with pain, energy level, attitude, the possibility of secondary gain (if people sympathize and make a fuss over the person, there is a reward for having pain.)
Many people with arthritis have found that by learning and practicing pain management skills, they can reduce their pain.
Pain is alleviated by:
• Positive attitude and pleasant thoughts
• Heat and cold treatments
The brain helps combat pain through the production of neurochemicals called endorphins, morphine-like painkilling substances that decrease the pain sensation.
The body also produces endorphins in response to external factors such as exercise, medication, application of heat or cold, and even placebo.
Pain can be acute, sub-acute, or chronic. Acute pain usually responds to cold packs. Cold should only be applied for 15 to 20 minutes at a time.
After an injury is 2 to 3 days old, it is then called a sub-acute injury. If the injury persists over a week, this is called the chronic stage. In the sub-acute and chronic stages of healing, both cold and heat can be of benefit. Cold may continue to be of more benefit when swelling remains in the area. Many times cold used during these stages can be more beneficial in reducing swelling over heat.
Heat should not be used during the first 48 to 72 hours after an injury. This increases blood circulation to the area increasing the swelling and microscopic bleeding causing the injury to worsen and the pain to increase. Heat can be very effective during the sub-acute and chronic stages of an injury. Heat can effectively decrease pain, promote healing by increasing circulation, help tight muscles or muscle spasms to relax, and loosen stiff joints for movement.
Be cautious. Even if the heating pad is set on low, prolonged use can cause burns.
Heat penetrates more deeply if it is moist instead of dry. There are several commercial moist heating pads available on the market today.
Never place heat on an area that is still red from a previous heat application!
Again, heat should not be used in the acute stage of an injury.
Also, heat should not be used by persons who have decreased or impaired sensation. Some common instances where impaired sensation may be present include: diabetes with neuropathies, stroke, head injury, and nerve damage.
Heat should not be used where there is compromised circulation. This could include peripheral vascular disease (PVD), arterial insufficiency, cardiac conditions, and diabetes.
Heat should not be used over malignant tumors. Heat should not be used over open wounds or areas of suspected infection. Heat should not be used over an area that has moderate or severe swelling (edema). Heat should not be used over skin conditions.
Arthritis medicines fall into three broad categories. The first are analgesics. These medicines control pain but do not control inflammation. Examples include acetaminophen, tramadol (Ultram), and other narcotic pain relievers.
The second group consists of non-steroidal anti-inflammatory drugs (NSAIDS). These drugs control inflammation so that symptoms such as swelling, redness, heat, and pain are relieved. Examples of drugs that are in this category include ibuprofen (Advil), naproxen (Aleve, Naprosyn), nabumetone (Relafen), etodolac (Lodine), celecoxib (Celebrex), and meloxicam (Mobic).
The last category of drugs are the anti-rheumatic disease-modifying drugs (DMARDS). These drugs slow down the progression of arthritis and thus reduce pain. Examples of these drugs include hydroxychloroquine (Plaquenil), sulfasalazine (Azulfidine), methotrexate, azathioprine (Imuran), and the newer biologic drugs.
Other pain remedies include drugs such as:
Lyrica is a successor to gabapentin (Neurontin) which itself has been used to treat chronic pain. The FDA approved Lyrica for the management of neuropathic pain – an agonizing and debilitating type of pain caused by nerve damage associated with diabetes and shingles. Lyrica works by restoring the action of overactive nerves to more normal levels. Lyrica is more potent than Neurontin, so it is more effective at lower doses. Side effects seen in clinical trials included dizziness, sleepiness, dry mouth, bloating, blurred vision, weight gain, and difficulty with concentration and attention.
A patch containing an anesthetic- the Lidoderm patch- has been used to treat localized pain. It is relatively safe and easy to use.
In 1998 half of the people in the United States used some form of alternative medicine. There are now more visits to alternative practitioners annually then there are to traditional physicians. Many health care plans are now covering a portion of alternative costs.
Why the turn to alternatives? More often than not, it is for the treatment of chronic pain. Modern medicine has extended the average life expectancy but has failed to cure many painful conditions, such as arthritis. People are living longer with pain. In one study, one third to one half of the people with arthritis surveyed admitted to using some type of alternative therapy.
Does it work? It depends on whom you ask. Ask someone diagnosed with OA whose treatment of glucosamine and chondroitin sulfate was successful and you will hear a resounding "Yes!" Ask a rheumatoid arthritis patient whose experiment with magnet therapy was an expensive failure and you'll likely be told it is a scam. The truth is probably somewhere in the middle.
No one alternative treatment will work for everyone, just as no medication works on all people. Explore alternatives with an open but cautious mind.
Get more information about arthritis pain and cures and related conditions as well as...
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• Ignored remedies that eliminate fibromyalgia symptoms quickly!
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• And much more...
Click here Second Opinion Arthritis Treatment Kit
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