Arthritis natural remedies and arthritis medications

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Arthritis natural remedies and arthritis medications a hard nut to crack

When we are talking about arthritis natural remedies and arthritis medications we must know what is arthritis. Arthritis means inflammation of one or more joints. Diseases those fall in this group are rheumatoid arthritis , seronegative arthritis ( Reactive arthritis , psoriatic arthritis , ankylosing spondylitis ), crystal arthopathy like gout, vasculitis , traumatic arthritis, collagen diseases like SLE, DLE , arthritis with systemic diseases like haemolytic diseases etc.

Arthritis remedies fall in three categories

  1. Natural remedies for arthritis
  2. Arthritis medications
  3. surgery

The general aims of management are to:

  • educate the patient
  • control pain
  • optimise function
  • modify the disease process where this is possible
  • identify and treat related comorbidity.

Simple  and  safe  interventions  should  be  tried  first. Symptoms and signs will change with time, so the plan  requires  regular  review  and  re­adjustment.  Effective  management  may  require  the  expertise  of  a  variety  of health  professionals,  with  a  coordinated  multidisciplinary team approach.

Natural remedies of arthritis

Remedies that need no drug ingestion are considered as natural remedies . Wide range of natural remedies are available .

Education

Education of patient about the nature of disease ,investigation, treatment , possible outcome can be useful to improve patients  compliance to therapy thereby improve outcome. A physical therapist can help a patient to be educated and have an appropriate designed therapy.

Exercise

Aerobic fitness training can reduce pain and long term disabilities. This exercise includes walking , swimming etc. This is beneficial for sleep and reduction of co morbidities like obesity .

Local strengthening  exercise of muscles can improve muscle strength ,improve proprioception , reduce pain, disabilities for over compromised joints .

Joint protection

We should not let our compromised joint to do a lot of works. Or after initial impact we should be careful not to get same impact again. We should perform our works using other joints or at least work of the joint should be divided to other joints or appliances. Use of shock absorbing footwear with thick soft soles , walking stick etc can be

Weight loss

Obesity  aggravates  pain  at  most  sites  of  the  body  through increased mechanical strain and is a risk factor  for more rapid progression of joint damage in patients  with arthritis. This should be explained to obese patients. And appropriate measure to reduce weight should be taken.

Personal life changing

The person is asked to reduce excessive alcohol  intake,  especially  beer. In case gout Thiazide  diuretics should be stopped if possible and substituted with angiotensin converting  enzyme  (ACE)  inhibitors,  as these have a uricosuric effect.

Diets

Right food choice can aid reduction of pain. In case of osteoporosis patient should be asked to take foods containing calcium like milk , phytoestrogen containing soya protein , flurides.  In gout patients should be advised to avoid large amounts of seafood and offal, which have a high purine content, but a highly restrictive diet is not necessary.

Hot and cold therapies

Hot water bag can be used for application of heat therapy. It can reduce pain and inflammetory edema. You can also use cold bath , ice compression to apply cold therapy . This also serves same purpose.

 Acupuncture

Acupuncture is an oldest way to get relief from arthritis pain.

Infrared therapy and short wave ultrasonography

This two also can reduce arthritis pain.

Hydrotherapy

Hydrotherapy  induces  muscle  relaxation  and  facilitates  enhanced  movement in  a  warm, pain relieving environment  without  the  restraints  of  gravity  and normal  load­bearing.

Meditation

Relaxation therapies are also proved to reduce arthritis pain.

Rest

Then provide rest of joint by cast , back slab, slings etc. Elevation of limbs can be helpful to reduce the inflammetory edema , reduce hematoma. Wrist splints, knee orthoses, and iron and T straps etc can help rest affected joint.

Self-help and coping strategies

The  aim  is  to  increase  self­management  through  self assessment  and  problem solving,  so  that  patients  can recognize negative but potentially remediable aspects of their mood (stress, frustration, anger or low self esteem) and  their  situation  (physical,  social,  financial).  These may  then  be  addressed  by  changes  in  attitude  and behavior.

Herbal medicines

It may be hard to believe but it is true that those can’t relieve patients arthritis pain.

Others

A raised toilet seat, raised chair height, extended handles on taps, a shower instead of  a  bath,  thick handled  cutlery,  and  extended  ‘hands’ to pull on tights and socks. Full assessment and advice from  an  occupational  therapist  maximize  the  benefits  of these.

Know more about natural remedies of arthritis.

Arthritis medications

Analgesics

Paracetamol (1 g up to 4 times daily) is the oral analgesic  of first choice . If it is successful, it is the preferred long term  oral analgesic. If  paracetamol  fails  to  achieve  an  adequate  response,  it  can  be  used  in  combination  with opioids  such  as  codeine  and  dihydrocodeine  in  compound analgesic preparations like co­codamol (codeine and paracetamol) or co­dydramol (dihydrocodeine and  paracetamol).  The  non­opioid  analgesic nefopam  (30–90 mg  3 times  daily)  can  help  moderate pain.  Patients  with  severe  or  intractable pain may require stronger opioid analgesics such as oxy-codon and morphine.

Non-steroidal anti-inflammatory drugs

These are among the most widely used drugs. Oral NSAIDs are particularly useful in the management of  pain  that  has  an  inflammatory  component,  and  a long acting  NSAID  taken  in  the  evening  may  help reduce  early  morning  stiffness.  There  is  marked  variability  in  individual  tolerance  and  response;  patients who  do  not  respond  to  one  NSAID  may  still  gain relief  from  another.  Traditional NSAIDs,  such  as  ibuprofen,  diclofenac  and  naproxen and newer  NSAIDs, such  as  celecoxib  and  etoricoxib are mostly used.

Commonly used NSAIDs and their relative risk of gastrointestinal bleeding and perforation:

  • Very low risk(Selective COX-2 inhibitor):Celecoxib Etoricoxib
  • Low risk(Weak anti inflammatory effect ):Ibuprofen, Etodolac, Meloxicam, Nabumetone
  • Medium risk: Ibuprofen, Naproxen, Diclofenac
  • High risk: Indometacin, Ketoprofen
  • Highest risk(Restricted use in those >60 yrs):Piroxicam, Azapropazone

Topical agents

Topical  NSAID  creams  and  gels  and  capsaicin  (chilli extract; 0.025%) cream can help in the relieve of arthritis pain affecting  hands, elbows and knees.

Disease-modifying anti-rheumatic drugs (DMARDs)


When all measure fails to control pain these agents are used. These also prevent the complications and deformities. Here are some commonly used DMARDs : Hydroxychloroquine,Cyclophosphamide ,Ciclosporin ,mycophenolate mofetil, Methotrexate, Sulfasalazine, Hydroxychloroquine , Leflunomide, D-Penicillamine ,Gold, Ciclosporin

Corticosteroids

Systemic  corticosteroids  have  disease modifying  activity. But their primary role is in the induction of remission in many diseases particularly in collagen diseases, rheumatoid arthritis, vasculitis and seronegative arthritis . They act by inhibiting prostaglandin synthesis. Prednisolone and triamcinolone are used as intra muscular or intra articular injections or orally. Side effects are GIT ulcers , cushing syndrome, glaucoma , weight gain, osteoporosis, high blood pressure , cataract etc

Biological therapies

The use of biological agents (often abbreviated to ‘biologics’)  is  reserved  for  the  treatment  of  patients  who have  high  disease  activity  despite  having  had  an  adequate  trial  of  traditional DMARDs.  These  agents  are targeted  towards  specific  cytokines  and  other  cell surface  molecules  regulating  the  immune  response. Although  generally  well  tolerated,  biological  therapies increase the risk of serious infections due to suppression of the immune response.

Some biological agents are : Rituximab, Abatacept, Anakinra, Tocilizumab, Infliximab, Etanercept, Adalimumab.

Know more about arthritis medications

Surgery

A variety of surgical interventions can relieve pain and conserve or restore function arthritis . Soft tissue release and tenosynovectomy may reduce inflammatory symptoms,  improve  function  and  prevent  or  retard  tendon damage  for  variable  periods,  sometimes  indefinitely. Synovectomy of joints does not prevent disease progression  but  may  be  indicated  for  pain  relief  when  drugs, physical  therapy  and  intra­articular  injections  have provided  insufficient  relief.  For damaged joints following procedures done:

osteotomy (cutting bone to alter joint mechanics and load transmission),

excision arthroplasty (removing  part  or  all  of  the  joint),

joint  replacement (insertion of prosthesis in place of the excised joint)

arthrodesis (joint fusion).

If  surgery  is successful,  the operation should be integrated with  rehabilitation,  by multidisciplinary  teams  of  surgeons,  allied  health  professionals and physicians.

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