Treatment of Arthritis

Arthritis means pain, inflammation, and stiffness in one or more joints. There are many different types of arthritis. Osteoarthritis is the most common type. Arthritis can affect any joint – most commonly knees, hips, and hands.

Osteoarthritis is rare before the age of 45. But it becomes increasingly common over the age of 60. It is twice as common in females. It can run in families.

What are the risk factors? Any joints subjected to repetitive and strenuous activity are prone to get arthritis. People who are overweight are at higher risk. Injury to a joint can cause arthritis. Often there is no obvious cause.

Many patients with osteoarthritis require regular pain killers to provide comfort and mobility. There are numerous pain killers in the market for arthritis. Some can be bought over the counter, some require prescription. All pain killers have some sort of side effects which affects some people more than others.

Many of the pain killers for arthritis are known as non-steroidal anti-inflammatory drugs (NSAID). NSAIDs commonly cause upset stomach which may result in ulcers and bleeding. Sometimes this can be life threatening – especially in people over the age of 60. Some of these pills can also damage your kidneys and adversely affect your cardiovascular system.

It is estimated that NSAID induced gastric complications in the United States’ arthritic population alone is more than US$4 billion annually.

NSAIDs are the most commonly prescribed drugs in North America. In Canada alone, more than 10 million prescriptions are written for NSAIDs – this does not include the purchase of NSAIDs over the counter.

Is there a safer and effective alternative to taking pills by mouth?

There has been some research going on the local application of NSAIDs. Topical or local application of the NSAIDs, such as diclofenac solution, has been reported to have fewer side effects.

Diclofenac solution contains a substance called dimethyl sulfoxide (DMSO) which enhances the absorption of NSAID through the skin to provide relief of symptoms when applied to a joint with arthritis – most commonly the knees.

A recent study, using diclofenac solution (commercially available as Pennsaid), showed that four weeks of treatment with this topical solution relieved the symptoms of primary knee osteoarthritis significantly better than a placebo.

Systemic side effects were minimal and local reaction was insignificant except for some dryness of the skin. The study, published in the Canadian Medical Association Journal, concludes that given the current practice guidelines, this topical NSAID treatment is a reasonable new option for the management of osteoarthritis of the knee.

The next reasonable question is, should you be using this if you have osteoarthritis? And a reasonable answer is – speak to your family physician first. Your physician should be able to provide you with a reasonable advice.

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Thought for the week:

This is from my friend George: “Don’t let worry kill you, let the church help!” Now this will keep you thinking (or worried) for a long time if you saw this on your church notice board!

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