In my last article I tried to explain what arthritis is. In this article, I would like to talk about the signs, symptoms and some treatments for arthritis. The two most common symptoms associated with arthritis are pain and stiffness in a joint. Other common symptoms include stiffness, swelling, cracking, snapping, popping, locking and giving way.
The typical scenario involves a patient, usually in their 50s or 60s, who starts to develop a dull ache in a joint. Sometimes the pain will become sharper if the person moves the joint in just the “right” way. Most patients who have arthritis describe stiffness in the morning but after they get going, the stiffness goes away until the end of the day when the joint starts to get sore again from the forces put on it during the day.
They may also describe swelling. The dull pain can become sharper. Eventually the joint becomes stiffer and loses more range of motion. It becomes more painful. There is more grinding, popping, snapping, etc. The patient will usually then present to a physician for this problem. There are many treatments physicians can offer their patients who suffer from arthritis.
Probably the most common, but not necessarily the best, is pain medication, and there are many different types. The safest, but probably also the least effective is Tylenol/ Acetaminophen. This is strictly a pain medication. Tylenol has no anti-inflammatory effect.
The most commonly prescribed medications are anti-inflammatories. These are broken up into non steroid anti-inflammatories NSAIDs and steroid type anti-inflammatories.
The most common NSAID is Aspirin, which can be very effective for arthritic pain but that comes with a price in that Aspirin can cause a lot of inflammation in the stomach and digestive system leading to the possibility of ulcers. Aspirin also “thins the blood,” which can lead to bleeding problems. There are traditional anti-inflammatories such as Ibuprofen (Advil, Motrin) and Naprosyn (Aleve). There are many other traditional NSAIDs but these are the most common.
They are very effective in relieving arthritic pain and inflammation but they also can have an adverse effect on the GI tract. They can also potentially lead to problems with thinning of the blood, liver and kidney problems with long-term use. There are the Cox2 inhibitors such as Celebrex. Bextra and Vioxx were also in this category of medication and had a higher rate of heart attacks and heart complications especially in patients who had pre-existing heart disease. Cox2 inhibitors are usually much safer on the GI tract and have a lower incidence of ulcers than the traditional NSAIDs. Vioxx and Bextra were pulled from the market. Celebrex, at this stage, seems to still be a safe medication if used properly but as with any medication, it still needs to be used with caution and should be used under your own doctor's advice and supervision.
Steroid type anti-inflammatories such as Prednisone, which is an oral form of a corticosteroid, can be an effective anti-inflammatory. It has to be taken by mouth so it ends up going through the whole body before it gets to the affected area. This can sometimes cause adverse effects on other parts of the body.
Narcotics are very effective at relieving pain but unfortunately have sedative and addictive side effects which are undesirable.
Although these are used commonly, they can be dangerous for the above reasons.
There are also many supplements that claim to cure or improve arthritic symptoms. The most common would be glucosamine/chondroitin sulfate. Glucosamine and chondroitin sulfate are normal components of articular cartilage so the theory behind the use of them is that by eating them it will grow back new cartilage. Despite the claims, no one has actually proven that in humans, although there is some evidence that it does protect the cartilage that you still have left. There also appears to be at least some form of anti-inflammatory effect because there are many, many patients who do claim the use of glucosamine/chondroitin sulfate helps their arthritic symptoms.
A word of caution regarding supplements is that they are not regulated by the FDA so you never 100 percent know what you are getting when you buy a supplement. I usually advise my patients to ask their pharmacist what their pharmacist thinks is a reputable brand and then go ahead and try it. It does seem to be fairly safe.
There are some risks, just like taking any medication, and you have to take it for at least two or three months to see if it will actually work. Usually if it is not working after three months, it is not worth the money that you are spending on it.
Other options for treating the pain and inflammation of arthritis include cortisone injections. I will talk about those more in next month's article.
Dr. Marc P. Pietropaoli is a sports medicine specialist and is president of Victory Sports Medicine & Orthopedics in Skaneateles.
They may also describe swelling. The dull pain can become sharper. Eventually the joint becomes stiffer and loses more range of motion. It becomes more painful. There is more grinding, popping, snapping, etc. The patient will usually then present to a physician for this problem. There are many treatments physicians can offer their patients who suffer from arthritis.
Probably the most common, but not necessarily the best, is pain medication, and there are many different types. The safest, but probably also the least effective is Tylenol/ Acetaminophen. This is strictly a pain medication. Tylenol has no anti-inflammatory effect.
The most commonly prescribed medications are anti-inflammatories. These are broken up into non steroid anti-inflammatories NSAIDs and steroid type anti-inflammatories.
The most common NSAID is Aspirin, which can be very effective for arthritic pain but that comes with a price in that Aspirin can cause a lot of inflammation in the stomach and digestive system leading to the possibility of ulcers. Aspirin also “thins the blood,” which can lead to bleeding problems. There are traditional anti-inflammatories such as Ibuprofen (Advil, Motrin) and Naprosyn (Aleve). There are many other traditional NSAIDs but these are the most common.
They are very effective in relieving arthritic pain and inflammation but they also can have an adverse effect on the GI tract. They can also potentially lead to problems with thinning of the blood, liver and kidney problems with long-term use. There are the Cox2 inhibitors such as Celebrex. Bextra and Vioxx were also in this category of medication and had a higher rate of heart attacks and heart complications especially in patients who had pre-existing heart disease. Cox2 inhibitors are usually much safer on the GI tract and have a lower incidence of ulcers than the traditional NSAIDs. Vioxx and Bextra were pulled from the market. Celebrex, at this stage, seems to still be a safe medication if used properly but as with any medication, it still needs to be used with caution and should be used under your own doctor's advice and supervision.
Steroid type anti-inflammatories such as Prednisone, which is an oral form of a corticosteroid, can be an effective anti-inflammatory. It has to be taken by mouth so it ends up going through the whole body before it gets to the affected area. This can sometimes cause adverse effects on other parts of the body.
Narcotics are very effective at relieving pain but unfortunately have sedative and addictive side effects which are undesirable.
Although these are used commonly, they can be dangerous for the above reasons.
There are also many supplements that claim to cure or improve arthritic symptoms. The most common would be glucosamine/chondroitin sulfate. Glucosamine and chondroitin sulfate are normal components of articular cartilage so the theory behind the use of them is that by eating them it will grow back new cartilage. Despite the claims, no one has actually proven that in humans, although there is some evidence that it does protect the cartilage that you still have left. There also appears to be at least some form of anti-inflammatory effect because there are many, many patients who do claim the use of glucosamine/chondroitin sulfate helps their arthritic symptoms.
A word of caution regarding supplements is that they are not regulated by the FDA so you never 100 percent know what you are getting when you buy a supplement. I usually advise my patients to ask their pharmacist what their pharmacist thinks is a reputable brand and then go ahead and try it. It does seem to be fairly safe.
There are some risks, just like taking any medication, and you have to take it for at least two or three months to see if it will actually work. Usually if it is not working after three months, it is not worth the money that you are spending on it.
Other options for treating the pain and inflammation of arthritis include cortisone injections. I will talk about those more in next month's article.
Dr. Marc P. Pietropaoli is a sports medicine specialist and is president of Victory Sports Medicine & Orthopedics in Skaneateles.
