You have squeaky, achy joints, some kind of pain in your knee, or a serious shooting pain from the shoulder to the elbow. There’s no big deal, right?
Unfortunately, you are wrong. Far too frequently we assume that any kind of joint pain is an integral part of aging, and we just need to learn to live with. According to specialists, it is nonsense. Experts are constantly suggesting a wide variety of treatment options, starting from physical activity and alternative supplements to medicines and joint replacement surgery.
We should be aware of the fact that it is a grave problem, due to the fact that pain may influence negatively each aspect of your life. "What is pain? It is not only the experience of hurting… it influences your way of dealing with your life, your livelihood, your relations with relatives and colleagues," says Raymond Gaeta, MD, director of pain management services at Stanford Hospital & Clinic at Stanford University.
Lately, Gaeta has published an all over the country telephone survey with the striking results. It appeared that almost twenty per cent of respondents suffered from serious pain like that caused by arthritis. However, almost fifty per cent admitted that they didn’t know the cause of their pain. The substantial majority (84 per cent) were taking over-the-counter medications to alleviate their pain.
"The trouble is that we are used to the thought that the body heals itself naturally, and therefore we always expect that to happen," Gaeta explains to WebMD. "With chronic pain, we put up with it, we try various painkillers, however we never visit our healthcare provider. That’s the trouble - people have to consult their physicians. There is a variety of techniques for pain management available, however it begins with asking the question - what’s wrong?"
"The typical person may be unable to say if it’s the joint, a torn tendon, or pain in the area of the joint," explains Shannon Whetstone Mescher, vice president of programs and services at the Arthritis Foundation. "A doctor has to examine you to be sure that you really suffer from joint pain and why."
Getting the Right Diagnosis
Arthritis is a catch-all term describing inflammation of the joints - however it’s not easy to diagnose. "We are now able to distinguish over one hundred different forms of arthritis," according to Robert Hoffman, MD, chief of rheumatology at the University of Miami Miller School of Medicine. "That’s why placing the proper diagnosis is essential. You require the right treatment."
There is one more very good reason to visit a healthcare provider: "A lot of people have other diseases that can aggravate arthritis," claims Jason Theodoskais, MD, MS, MPH, FACPM, author of The Arthritis Cure and a preventive and sports medicine expert at the University of Arizona Medical Center.
For instance, gout is a form of arthritis that may result in osteoarthritis; hemochromatosis is an inherited illness involving unusually high iron storage in the organism, which brings about heart disease, diabetes, and also arthritis. He adds that joint pain may also constitute result of cancer that has spread to joints. "If we do not address the origin of the problem, patients will not receive the appropriate treatment or pain relief," Theodoskais explains to WebMD.
Common pain-related diseases:
Osteoarthritis: This is frequently called degenerative joint disease. It constitutes the most widespread kind of arthritis in the people over fifty years of age. As we become older, the rubbery cartilage that serves as a shock absorber to our joints becomes stiff, loses its elasticity, and becomes more vulnerable to breakages. As the cartilage wears down, tendons and ligaments stretch, causing pain. It may appear in almost any joint in the body - most frequently in the fingers, hips, knees, and spine.
Among other symptoms are: joint aching and soreness, pain, and bony knots in the finger joints. Medicines, pain relievers, and alternative supplements (like glucosamine and chondroitin) may be helpful in relieving the pain. However, significant changes in lifestyle, such as weight loss can also be needed in order to lower the level of stress on weight-bearing joints.
Rheumatoid Arthritis: This form of arthritis is completely different from degenerative joint disease. This kind of inflammation happens in joints on both sides of the body - symmetry that helps differentiate it from other kinds of arthritis. On the other hand, though, a lot of the symptoms seem to be familiar - joint pain and swelling, joint stiffness, and tiredness. Scientists are convinced that an external organism – such as a virus or bacteria, for instance- may modify the immune system, causing it to attack the joints and sometimes several other organs.
"Rheumatoid arthritis is not only a benign joint ailment," Hoffman explains to WebMD. "It may result in early death. With rheumatoid arthritis, there is pretty good evidence that early diagnosis and forceful treatment can help to preserve function, prevent disability, and improve survival."
Polymyalgia Rheumatica (PMR) and Temporal Arteritis (TA): Both of these inflammatory diseases frequently take place at the same time and are believed to be correlated. PMR is a condition that involves the bigger joints of the body like the hip and shoulders. TA is an inflammation of the blood vessels to the head, including the eyes. Both these diseases result from the body’s immune system reacting against itself.
The most common symptoms of PMR include: ache and stiffness in shoulder and hip joints, fever, weight loss, and tiredness. Frequently it happens that the only symptom is the inability to get out of a chair easily or raising the arms to brush one’s hair. Among the most widespread symptom of TA is a severe headache - and if it is not treated, TA may lead to irreversible blindness, stroke, or transient ischemic attacks (ministrokes.)
The scientists still do not know the cause of these disorders, however they seem to happen most often in people of Scandinavian or Northern European descent. "Yet once it has been diagnosed, the treatment is really uncomplicated - prednisone, a steroid," claims Gaeta. "However, the vast majority of people have never heard of this form of arthritis. It points to the necessity to consult your healthcare provider."
Fibromyalgia: This is a chronic disorder that brings about pain and tenderness at several points all over the body, leading to serious sleep problems and tiredness. The cause of this condition is feebly understood, however is not connected with any muscle, nerve, or joint injury. According to one theory, the condition can be connected with oversensitive nerve cells in the spinal cord and brain. Another theory says that it may be caused by an imbalance in brain chemicals that control mood, reduces a person’s tolerance for pain, probably triggering a cycle of restless sleep, exhaustion, inactivity, sensitivity, and pain.
Although there is no cure for fibromyalgia, treatment is concentrated on managing pain, tiredness depression, and many other symptoms in an effort to break the cycle of sensitivity, pain, and reduced physical activity.
Low doses of antidepressant drugs taken before going to sleep can provide more restful sleep. Other sorts of sleeping tablets are not helpful enough for people who suffer from fibromyalgia. Nonsteroidal anti-inflammatory medications (NSAIDs) – such as ibuprofen and naproxen - may help lower pain, however they ought to be used long-term only under the care of a physician.
Depression: Unhappiness is not the exclusive hallmark of depression. According to research, there also may appear physical symptoms such as mysterious aches and pains. The most regularly mentioned symptoms include: frequent headaches, back pain, joint pain, and abdominal pain - all of which are able to cover the depression. The physical symptoms mentioned above may be connected with or provoked by the depression and may remain longer than the emotional symptoms.
Some healthcare providers, for instance Hoffman, are convinced that these physical symptoms are genuine signs of fibromyalgia. "These two conditions really seem to commonly coexist," he explains to WebMD. "Moreover, depression may cause a heightened awareness of pain. Treating the depression is essential."
Ask your healthcare provider for a referral to a specialist dealing with the kind of pain you are experiencing, advises Charles Weiss, MD, chairman emeritus of the department of orthopaedics and rehabilitation at Mt. Sinai Medical Center in Miami Beach, Fla.
Changes in Lifestyle
Specialists claim that although there is no available cure for joint pain, you can find significant relief. Treatments vary from lifestyle changes to medicines to surgery - and normally ought to be tried in that order.
Lose weight: If you are overweight, the first step is to discard those extra pounds. Whetstone Mescher points to recent research demonstrating that losing as little as eleven pounds may decrease the risk of osteoarthritis of the knee by 50 per cent.
Start practicing sports: The next step can be to work with a physical therapist in order to create an program of exercise that is appropriate for you. All too often, victims of serious pain get trapped in a vicious cycle: Their painful joints stop them from practicing sports, which makes their joints to become weaker further and their condition to get worse, Whetstone Mescher tells to WebMD.
"A physical therapist constitutes a solution, particularly if you have no idea where to begin," she explains. "They will be able to tell you which exercises are the best for your purposes - normally those that improve strength, stamina, and range of motion - and suggest precise joint exercises designed particularly to relieve pain."
Getting forty minutes of physical activity at a time - three or four days per week - is normally recommended.
Here are some suggestions:
* If you have access to a swimming pool, water workouts are frequently suggested. The buoyancy of water supports the weight of the body, taking the stress off stiff and achy joints and making it much easier to exercise.
* Riding a bike, walking, and other low-impact exercises that never put pounding pressure on the joints can also be useful. However, high-impact exercises including jogging should normally be evaded, and never subscribe to the "No pain, no gain" mantra, Whetstone Mescher states.
Wear appropriate shoes. "Buy soft cushiony shoes providing an extra layer of protective padding," suggests Letha Griffin, MD, bone expert and team doctor at Georgia State University in Atlanta.
If you are a smoker, give up this habit. It’s been proven that smoking cigarettes affects both bone health and response to treatment.
Pain relievers Can Spell Relief
If changes in your lifestyle don’t alleviate your pain, medicines are frequently prescribed. For soft pain, a simple pain reliever is usually helpful, such as acetaminophen (Tylenol), aspirin, ibuprofen, or other nonsteroidal anti-inflammatory medications (NSAIDs). A newer class of NSAIDs also called Cox-2 inhibitors includes Vioxx, Celebrex, and Bextra.
In September 2004, Vioxx was voluntarily withdrawn from the markets all over the world by Merck, the medication’s manufacturer. The decision was made after relieving the information that a clinical trial proved greater risk of heart attack and stroke.
In April 2005, the FDA asked Celebrex to carry new warnings concerning the potential risk of heart attacks and strokes as well as potential risk of stomach ulcer bleeding. Simultaneously, the FDA asked to remove Bextra from the market, due to the fact that its risks of heart, stomach, and skin problems outweighed its benefits.
Also in April 2005, the FDA asked that over-the-counter anti-inflammatory medications – with the exception of aspirin - revise their labels in order to comprise information about possible risk of heart and stomach ulcer bleeding.
For people, especially elderly patients, who are taking multiple medicines for other diseases such as high blood pressure, the healthcare provider may eventually decide which pain reliever to prescribe based on which is the most secure for you. High doses of acetaminophen, for instance, may lead to the liver damage, therefore they almost certainly wouldn’t be suggested for a person suffering from liver problems.
And due to this, it is so relevant that a senior never self-medicate, Weiss emphasizes. "Always consult your physician before taking some medications, even if they are sold over-the-counter, without any prescription. Tell your doctor what other medications have been prescribed to you by other healthcare providers. And make sure to ask about the proper dosage, which can vary depending on your age."
Weiss claims that no matter what kind of painkiller is prescribed, seniors ought to be tested for liver and kidney conditions; any loss of blood; and any change in blood pressure.
Other Ways to Alleviate Pain
Heat or cold therapy may frequently offer temporary pain relief, Whetstone Mescher explains. "Some people prefer heat packs, others ice packs," she claims, "therefore try both of them, and decide which is more effective for you." Neither of them should be kept on the joints for more than twenty minutes at a time, she adds.
For other patients, "such creams as Ben-Gay that are connected with a warm, peppery feeling that can help," Weiss explains. "Rubbing the cream encourages the skin around the joint, lowering pain."
Joint fluid supplements. For people who haven’t been provided with relief by changes in lifestyle and pain medicines, the latest approach known as joint fluid supplements - called visco-supplements by physicians - may also be suggested.
One of the elements of the supplements us a synthetic form of hyaluronic acid, a natural chemical substance acting as a lubricant and shock absorber in the joint. Not all physicians agree with this form of treatment: Some of them claim that the benefits are negligible mostly and may not be worth the discomfort of the injections.
Steroid shots. Corticosteroids constitute one more option. Shots of steroids - artificial versions of the body’s natural hormones - into the joint may lower inflammation, and as a result decrease pain, Weiss claims. But although injections are all right as a short-term fix, long-term use is normally not suggested due to possible side effects.
Alternative supplements. In the past few years, various studies have proven that glucosamine and chondroitin sulfate can help alleviate pain resulting from osteoarthritis. Furthermore, some research has discovered that these supplements, mainly glucosamine, can slow, or even stop, progression of osteoarthritis. The vast majority of studies have been carried out on knee osteoarthritis, however specialists suspect that other joints would also benefit.
Glucosamine supplements derive from crustacean shells. They are believed to replace missing fluid and promote the growth of cartilage, therefore helping to restore joints, Weiss explains. Chondroitin sulfate, frequently taken together with glucosamine, may help cartilage from breaking down. Both of these supplements are absolutely secure and successful but are slow-acting, and need a few weeks to months of treatment to get relief.
Joint replacement. If everything else fails to alleviate your pain and disability, your physicians may suggest surgery, in which an arthritic or injured joint is removed and replaced with an artificial joint known as a prosthesis. These artificial joints, made of metal and plastic, may be as good as the real ones, restoring both movement and function.
"Joint replacement is extremely effective, lasting over twenty years for more than 90 per cent of all patients," Weiss claims. However, there is some risk: Some patients may experience some complications; a small percentage may even die. Obviously, the elderly are particularly vulnerable. "But new sophisticated software helps healthcare providers to navigate the area of the joint more effectively; we can achieve maximum benefit with negligible risk."
