The Pain of Arthritis

There are many kinds of arthritis. The most common types are Rheumatoid Arthritis and Osteoarthritis. If you have joint pain, your Health Care Provider can diagnose what type of Arthritis you have.

Osteoarthritis is the most common type of Arthritis. The pain of Osteoarthritis is caused by a gradual decrease of the amount of cartilage between joints and the rubbing of bone against bone. The most common sites of pain are the wrist, hands, hips and knees. Osteoarthritis is a very common ailment for all of us as we age. It can manifest itself as stiffness upon wakening and generally gets better as we move around in the morning. Stiffness usually lasts about 30 minutes and gets better as the day goes on. Osteoarthritis can lead to major joint damage, difficulty in walking, and eventual surgical joint replacement.

Common treatments for Osteoarthritis include:

• Tylenol or Acetaminophen. This is the first treatment recommended by the Arthritis Foundation. The maximum safe dose of Tylenol is two 500 mg capsules 4 times a day, a total of 2 grams/day. It works for many people. The advantage of this drug is that it does not cause stomach upset. The disadvantage is that it should not be taken by people with liver problems.
• Over the counter (OTC) non-steroidal anti-inflammatories (NSAIDS). Ibuprofen and Naproxyn Sodium are the most common OTC medications. Brand names include Motrin-IB, Aleve and Advil. They are very effective. The disadvantages to these drugs are stomach upset and the possibility of causing stomach ulcers. They should not be taken by patients with kidney problems.
• Prescription NSAIDS. These medications are stronger than their OTC counterparts and are very effective. Common names are Motrin, Daypro, Relafen, Votaren, Arthrotec. The disadvantages to these medications are they are more expensive and are more prone to cause stomach problems.
• Prescription pain medications. These medications are traditionally added on if other medications do not relieve pain. Two common medications are Darvocet and Lortab. These medications can provide pain relief. They can cause drug dependence and impaired mental function and decreased coordination. Care should be taken when taking these medications and driving or operating machinery.
• Herbs and Supplements. Glucosamine is a common OTC medication that brings relief to about 40 percent of patients that try them. Rose hips capsules have shown to be more effective than Glucosamine for Osteoarthritis pain.
• Arthritic rubs. Ben Gay has been around for years. Other popular rubs include Bio-Freeze, Capsaisin, Emu Oil, Aspercreme and countless others. These are safe if you are not allergic to the ingredients and give temporary relief to Osteoarthritis pain.
  
• Hot and cold treatment. Many patients say that a hot shower is the best relief for their aches and pains. Heating pads should be used with caution. Thermacare patches produce heat when applied to the skin. Other patients swear by cold packs applied to the painful joints. These treatments are inexpensive, generally safe and effective, but temporary.
  

When medications don't work there are other non-surgical options. There are several medications that can be injected into the knee to improve the viscosity between joints. These are usually given as a series of multiple injections and are more expensive than oral medications. These treatments are often covered by insurance. Injections can be done by your Health Care Provider or an Orthopedic Physician. They are often given under ultrasound or fluoroscopy guidance to make sure the medicine is given in exactly the right place.

Surgery is the last option for Osteoarthritis and performed by an Orthopedic Surgeon. When all the above treatments fail your Health Care Provider may refer you to an Orthopedic specialist.

The best treatments for Osteoarthritis are early treatments. Ask your Health Care Provider for advice about which treatments are best for you and your pain.