How to Stop The Pain Of Osteoarthritis In Its Tracks
Description
This article is from the Health Articles series.
How to Stop The Pain Of Osteoarthritis In Its Tracks
Osteoarthritis, the most common of all joint disorders, affects more than half the population over the age of 60. The disease occurs when wear-and-tear of the cartilage-the padding between bones-lets bone ends rub against each other, causing irritation, swelling, and eventually the development of bone spurs.
Osteoarthritis, or OA, can also be triggered by a joint injury or be the result of joint deformity. New research suggests that an imbalance in the enzymes and hormones that normally repair and maintain our joints also plays an important role.
OA symptoms can be subtle and easily overlooked until one day fingers may feel too stiff to open a jar, or hip joints ache so much that it's uncomfortable to get out of a chair. In addition to stiffness and achiness, other common signs include difficulty reaching or bending and a grating noise as bones rub together. Though most people first notice the disease in their fingers and knees, OA-which tends to run in the family-can affect any joint, including those of the feet, hips, and back.
Overall, some 40 million Americans of all ages have OA-and at least 7 million have long-term disabilities resulting from it. Still, as common as the condition is, many myths persist about the disease, including the idea that treatment is ineffective. The truth is, there's a lot you can do to fight OA's effects.
Finding Relief
In the past, nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen, were the first choice of treatment for OA pain. Now, the American College of Rheumatology suggests acetaminophen (Tylenol and others) in doses of up to 1,000 mg four times a day-especially for OA of the knee or hip-as a first line of defense.
The reason: Long-term NSAID use may irritate the stomach lining. 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 will most likely prescribe a more potent NSAID, sometimes in combination with a second prescription agent called Cytotec (to prevent stomach problems).
What Are Glucosamine and Chondroitin?
You may have heard that taking glucosamine sulfate and chondroitin sulfate tablets can halt or even reverse OA, without side effects. Both are synthetic versions of substances in the body that help form cartilage. But so far, there is no conclusive proof that they are effective as supplements.
According to the Arthritis Foundation, several small non-U.S. studies have reported beneficial effects with glucosamine and chondroitin, separately. So have many animal studies. In fact, veterinarians use glucosamine to treat animals with arthritis.
But the gold standard of scientific research-large, controlled studies-have yet to be completed. So for now, neither the American College of Rheumatology nor the Arthritis Foundation recommend glucosamine or chondroitin. And the Food and Drug Administration (FDA) has not approved them to treat arthritis. If you want to try these products, it's best to consult your doctor first.
If your arthritis resists even prescription NSAIDs, doctors may prescribe corticosteroids injected into tissues and joints. These drugs are employed sparingly because chronic use can have destructive effects on bones and cartilage. For short-term, intense pain, some doctors may also prescribe narcotics.
Two other pain-relief options have recently become available. The first, Synvisc, is a cushioning fluid approved for use in the knees (though it may be proven beneficial for other joints as well). The drug, which is injected by a doctor directly into the knee joint, prevents the irritation caused by bones rubbing together. The other treatment is injectable Hyalgan (sodium hyaluronate), a version of a chemical that is normally present in high amounts in joints and fluids. In OA sufferers, the quality and quantity of hyaluronate may be deficient.
Topical Pain Relievers
Applying heat-via a heat lamp, hot-water bottle, heating pad, or moist steam pack-may help relax the muscle tension created by sore and rigid joints. Cold packs can numb sore areas temporarily and ease inflammation and swelling. Massaging the skin over the joints can also reduce discomfort.
Another option are topical painkillers. Unlike drugs that are swallowed or injected, these analgesics come in creams, rubs, or sprays and are sold without a prescription. Most of them contain counter-irritants, substances that make the skin feel hot, cold, or itchy. Common ingredients include camphor, capsaicin, menthol, and salicylates (similar to aspirin).
A Prevention Plan
Take steps to help prevent or slow the progression of OA. Your family doctor, rheumatologist, physical therapist, or local chapter of the Arthritis Foundation can help you develop a prevention plan that includes:
- Gentle exercises to put your joints through their range of motion every day.
- Stretches to maintain the length of muscles. This helps keep joints moving properly.
- A light weight-lifting routine daily to prevent muscles from weakening.
- Avoiding injury and overuse, two major causes of OA.
- Shedding excess weight.
To use, rub the directed amount into the sore area, avoiding contact with wounds or sores, as well as eyes, mouth, and other mucous membranes. Don't use these drugs more frequently than the directions suggest and make sure you wear gloves during application or wash your hands immediately after use. (If you're treating hand pain, wait 30 minutes before washing.)
Caution: If you have a history of gastrointestinal disease, alcohol abuse, or regularly consume more than three 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 if you smoke, drink alcohol, take cortico- steroids, or had an ulcer in the past.
Tell your doctor if you have ever had any unusual or allergic reactions to NSAIDs, or if you are allergic to any other substances such as foods, preservatives, or dyes. Notify your doctor if you experience a burning sensation in the stomach while taking NSAIDs.
Possible Drug Interactions
Drugs or foods that may interact with, decrease, or increase the effects of the medication you're taking: Nonsteroidal anti-inflammatory drugs (NSAIDs) may interact with antidiabetic drugs, antipsychotic medications, anti-seizure medications, beta-blockers, blood thinners; gout drugs, heart medications, high blood pressure drugs, other NSAIDs, and sulfa drugs.
Avoid salicylate-containing products if you are taking blood thinners such as warfarin (Coumadin).
Avoid topical products that contain salicylates if you are sensitive to aspirin. Use them with caution if you have asthma or nasal polyps. Don't use a heating pad with a topical analgesic; it can lead to a skin burn.
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