Treatment for arthritis

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

The comprehensive treatment of arthritis depends on obtaining an accurate diagnosis. The treatment for the more than 100 different types of arthritis can vary.

Short-term relief for pain and inflammation may include pain relievers (analgesics) such as acetaminophen or non-steroidal anti-inflammatory drugs.

Heat and cold
Whether to use hot or cold applications on affected joints depends on the type of arthritis present and the recommendation of your physician. Pain relief may be obtained temporarily by using moist heat (warm bath or shower) or dry heat (heating pad) on the joint. Pain relief may also be obtained by placing an ice pack wrapped in a towel on the joint. Cold applications help reduce swelling, as well. However, people who have poor circulation should not use ice packs. Consult your physician regarding the type of application and application time before use. Generally, cold is more effective for acute situations while warmth is better for chronic. One exception might be osteoarthritis where cold does help.

Joint immobilization
The use of a splint or brace can help a joint rest and protect it from further injury. Walking devices, such as canes, crutches, and assistive devices with extra large or longer handles help keep stress off certain joints.

Light stroking and/or kneading of painful muscles may increase blood flow and bring warmth to the muscle.

Transcutaneous electrical nerve stimulation (TENS)
Pain may be temporarily relieved with the use of a small TENS unit that directs mild, electrical pulses to nerve endings in the skin. TENS blocks pain messages to the brain and modifies pain perception.

Physical Therapy and Occupational Therapy
A cornerstone of therapy of any form of arthritis is physical therapy and occupational therapy to maintain joint mobility and range of motion. The proper kind and amount of this therapy will vary depending upon the underlying cause and upon individual factors that your physician will discuss with you.

Performed by a licensed acupuncture therapist, acupuncture is the use of thin needles that are inserted at specific points in the body. Acupuncture seems to stimulate the release of natural, pain-relieving chemicals produced by the brain or nervous system.

Maintaining ideal weight is critical. Not only is the mechanical effect of excess weight detrimental but new research has indicated that leptins, proinflammatory cytokines, are produced by fat cells. Also, more research into the role of foods and their role in improving or worsening arthritis is being conducted.

The use of various herbal remedies is exciting. While the work is preliminary, there may be some important developments on the horizon. These include the use of bromelain, boswellia, curcumin, ginger, and garlic, to name a few. Meanwhile, nutritional supplements such as glucosamine and chondroitin are effective in osteoarthritis. The issue here is potency and purity. Only get the supplements from reputable manufacturers.

Many rheumatic diseases are chronic, making long-term management of the disease very important.

There are several types of medications that may be used long-term to reduce pain and symptoms, including the following:

Nonsteroidal anti-inflammatory medications
As mentioned above, these medications, such as aspirin and ibuprofen, help to reduce pain and inflammation.

Disease-modifying anti-rheumatic medications
These prescription medications may affect the course of the disease, by slowing down its progress and influence, and/or by correcting immune system abnormalities that are linked to the disease. Examples of disease-modifying anti-rheumatic medications include methotrexate, hydroxychloroquine, leflunomide, azathioprine, and cyclosporine.

More recently, biologic agents aimed at blocking tumor necrosis factor (TNF)- examples of which are Enbrel, Humira, Remicade, Cimzia, and Simponi. OTher bioilogics withj different modes of action also are effective. These include Actemra, OPrencia, Rituxan, and Xeljanz.

Corticosteroids are hormones used to treat rheumatic diseases. These medications, an example of which is prednisone, can be taken orally or as an injection.

Pacing yourself
To conserve energy and reduce stress on your joint(s), pacing yourself (alternating periods of activity with periods of rest) can help protect your joints and minimize symptoms of arthritis.

Weight reduction
Extra weight puts more stress on weight-bearing joints, such as the hips and knees. Weight loss in overweight people has shown to reduce the chance of developing certain types of rheumatic disease, including osteoarthritis. And don't forget those pesky leptins!

Certain exercises, such as swimming, walking, low-impact aerobic exercise, and range-of-motion exercises, may help reduce joint pain and stiffness. Stretching exercises may be helpful in keeping the joints flexible. Strengthening may also be of benefit.

In severe cases of rheumatic disease, surgery may be necessary to repair or replace a joint. There are two main types of surgery for arthritis and other rheumatic diseases, including the following:

• repair - surgery to repair a damaged joint may include removing debris in the joint, fusing bones, or correcting a bone deformity.

• replace - if a joint is too damaged for repair, it may need to be replaced with an artificial joint.

More recently, the use of tissue engineering and regenerative medicine techniques has been found to be effective for both soft tissue degenerative problems such tendinopathies and ligament problems as well as osteoarthritis. Platelet-rich plasma , various growth factors, and mesenchymal stem cells have been able to regenerate and heal damaged tendon tissue and cartilage. This has enabled patients to avoid surgery and joint replacement.

For more information:

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Click here Second Opinion Arthritis Treatment Kit

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