Don't Take Arthritis Lying Down. Fight The Pain With These Simple Strategies
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This article is from the Health Articles series.
Don't Take Arthritis Lying Down. Fight The Pain With These Simple Strategies
More than half of all Americans over the age of 60 have osteoarthritis (OA), a wearing away of the cartilage covering the tips of bones in a joint. OA is a chronic condition, meaning it will never go away entirely, and it tends to worsen over time.
Although researchers still know far too little about the causes of OA-and the more than 100 other types of arthritis that exist-they do know a lot about how to successfully manage arthritis symptoms. The American College of Rheumatology suggests that acetaminophen (such as Tylenol) be the first option for pain relief, in doses of up to 1,000 mg four times a day-especially for OA of the knee or hip. The reason: Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen sodium may irritate the stomach lining, causing gastric distress or even ulcers.
But if acetaminophen doesn't ease pain, an over-the-counter (OTC) NSAID, taken with food to minimize stomach discomfort, can be the next step. If that doesn't help, your doctor may recommend prescription NSAIDs or a new treatment, Arthrotec, which combines two existing drugs-the prescription NSAID diclofenac (for pain) and misoprostol (for stomach protection)-into a single tablet.
Also expected to be approved soon by the Food and Drug Administration (FDA) are Celebrex and Vioxx, two members of a new class of prescription painkillers known as COX-2 inhibitors. These medications are reported to relieve pain without stomach-related side effects.
Two other pain-relief options have recently become available: Synvisc and Hyalgan, liquid medications that replace or supplement the body's natural lubricant for joints. The drugs are injected in a doctor's office in a series of treatments that are spaced one week apart. Afterward, some people experience improvement in pain and joint motion for up to six months.
Topical pain relievers may also be helpful. Unlike drugs that are injected or swallowed, these come in creams, rubs, or sprays and are sold without a prescription. Most contain counterirritants, substances that make the skin feel hot, cold, or itchy. Common ingredients include camphor, capsaicin (from chile peppers), menthol, and salicylates (similar to aspirin).
To use topical pain relievers, simply rub the directed amount into the affected area, avoiding contact with wounds or sores, as well as eyes, mouth, and other mucous membranes. Don't use these medications more often than directed. It's also best to wear gloves when rubbing them in or to wash your hands immediately after use. (If you're treating hand pain, it's fine to wait 30 minutes after using the medication before washing your hands.)
Some osteoarthritis sufferers have also turned to alternative approaches, such as the nutritional supplements glucosamine and chondroitin. Both gluco- samine and chondroitin are substances that occur naturally in the body and help build and maintain cartilage. But so far, neither the American College of Rheumatology nor the Arthritis Foundation recommend the supplements.
In addition to medications, physical therapy and exercise are vital components of any effective treatment program. Physical therapists can explain when it's best to use ice or heat to control discomfort. They can also teach you a range of exercises to help prevent joint stiffness and pain. Appropriate exercise (nothing that involves repeated jarring or pounding) nourishes cartilage and strengthens the muscles around your joints so that they absorb shock better.
If joint pain becomes severe, surgery is an option. Common procedures include arthroscopic surgery, which is the removal of loose cartilage and bone fragments or the smoothing of a rough joint surface, or osteotomy, which is joint realignment or replacement.
Caution: If you have a history of gastrointestinal disease, alcohol abuse, or regularly consume three or more alcoholic drinks per day, consult your doctor before beginning acetaminophen or NSAID treatment. Regular NSAID use increases the chance of stomach bleeding, a risk that rises even more as you get older, if you smoke, drink alcohol, take corticosteroids, or had an ulcer in the past.
For more information, call the Arthritis Foundation at 1-800-283-7800 or check your phone book for a local chapter.
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