•A New Test to Detect Osteoarthritis Early… Will it Help?
Osteoarthritis is the most common form of arthritis. It affects more than 20 million Americans according to some estimates. Because osteoarthritis (OA) is primarily a degenerative process, the incidence and prevalence of this disorder is expected to rise with the surge in Baby Boomers.
OA affects weight-bearing joints such as the knee and hip. It is a disease of articular cartilage, the tough, elastic material that cushions moving parts of joints. OA is the most common reason for eventual...
•Actemra, The New Rheumatoid Arthritis Drug... What Makes it so Special?
Biological response modifiers (BRMS) are drugs that target inflammatory pathways in rheumatoid arthritis (RA) and represent a relatively new approach to the treatment of RA.
Medications that block tumor necrosis factor alpha (TNF-a), a pro-inflammatory cytokine important in the pathogenesis of RA, were among the first to be developed and approved for the treatment of RA. Several anti-TNF-a medications including Enbrel, Humira, and Remicade are currently marketed for the treatment of...
•Are Anti-Inflammatory Drugs Safe? I’m Confused About The American Heart Association Comments.?
The use of non-steroidal anti-inflammatory drugs to treat musculoskeletal problems has come under intense fire from the cardiology community. It is their position that these drugs often pose an unacceptably high risk of cardiovascular events.
A recent paper from the American Heart Association presents their position. Obviously, the thoughts of a practicing rheumatologist are going to be at loggerheads with that of cardiologists. Their ten-point program along with my comments in parentheses...
•Can Not Having Enough Vitamin D Make My Rheumatoid Arthritis Worse?
In addition to the other health problems associated with vitamin D deficiency, there is another one. Not having enough vitamin D can make rheumatoid arthritis (and other inflammatory arthritis, possibly) symptoms worse. These findings were reported recently by researchers in the United Kingdom.
In the July issue of Arthritis and Rheumatism, Dr. Sanjeev Patel of St. Helier University Hospital, Carsholton, and colleagues note that there is evidence that vitamin D and its metabolite...
•Can Rooster Comb Injections Prevent Knee Replacement?
Osteoarthritis (OA) of the knee is one of the most common problems seen by both rheumatologists as well as orthopedists in the office. The standard forms of therapy include maintenance of proper weight, exercise, application of cold, bracing, analgesics (pain killers), anti-inflammatory medicines, steroid injections, and viscosupplementation. This latter type of treatment involves the injection of a lubricant directly into the knee.
These lubricants consist of a purified form of a protein...
•Chronic Tendonitis - What’s New In Treatment?
So, you’ve been diagnosed with tendonitis and you’ve gone through the usual types of treatment programs like physical therapy, anti-inflammatory drugs, and even cortisone shots.
What else is available?
Before we discuss the exciting new ways of managing chronic tendonitis, let’s talk about what tendonitis is… and what it isn’t.
Tendons are thick cords of fibrous tissue that connect muscles to bones. It is this connection that allows joint motion. When muscles contract, they pull on the...
•Do Lateral Wedge Insoles Relieve Pain Due To Osteoarthritis Of The Knee?
Osteoarthritis (OA) is the most common form of arthritis and affects approximately 30 million Americans. The underlying pathology is altered biochemical changes in cartilage- the gristle that caps the ends of long bones. Cartilage consists of cells called chondrocytes that produce a matrix. The chondrocytes sit inside this matrix, much like grapes inside gelatin.
With the development of OA, the chondrocytes no longer function properly. In addition, inflammatory changes occur within the joint....
•Do You Recommend Exercise For Your Patients With Osteoarthritis Of The Knee?
Osteoarthritis (OA) is the most common form of arthritis and affects roughly 30-40 million Americans. The condition is due to a metabolic disorder of cartilage, the gristle that caps the ends of long bones. Cartilage functions to cushion the joint against impact and also to allow gliding of the joint with movement.
Cartilage consists of cells called chondrocytes that sit inside a matrix- much like grapes inside of gelatin. Normally, chondrocytes produce substances that build up and nourish...
•Doctor Wei... What Types Of Bursitis Are There?
In a previous article I discussed what bursitis is and why it develops. In this article I'll talk about some of the more common types of arthritis. Let's start from the top and work down.
In the shoulder there is a large bursa called the subdeltoid bursa. This sits underneath the deltoid muscle which lies on the side of the upper arm at the shoulder. This is also called the subacromial bursa. Bursitis in this area presents with aching soreness in the shoulder that is aggravated by movement....
•Doctor, When Should Muscle Relaxants be Used For Arthritis?
One question that comes up repeatedly is, “Where do muscle relaxants fall into the treatment approach for different musculoskeletal conditions”?
Patients will sometimes ask about them and physicians who see these patients sometimes wonder if these drugs should be considered.
Skeletal muscle relaxants are the most widely prescribed drug class in the United States for non-specific low back pain.
In addition, this class of drugs is used for neck pain, muscle spasms, fibromyalgia, and myofascial...
•Doctor... Does Ultram Help With Arthritis?
Non-steroidal anti-inflammatory drugs (NSAIDS) have been the mainstay of treatment for arthritis symptoms. Physicians often advise patients to use over-the-counter preparations... or also use prescription NSAIDS for more severe problems.
Unfortunately, NSAIDS do have many potential side-effects including the potential for creating stomach and small bowel ulceration, kidney dysfunction, liver damage, fluid retention and a small but real increased incidence of cardiovascular events.
So... a...
•Doctor... I Have Rheumatoid Arthritis... But I’m Afraid Of The New Biologic Drugs... What Do I Do??
Up until the mid 1990's the best we, as rheumatologists could do with patients with rheumatoid arthritis (RA), was to relieve their pain, suppress their disease a bit, and maybe slow it down some.
With the advent of biologic therapies, specifically tumor necrosis inhibitors (anti-TNF drugs), it is now possible to get the disease into complete remission. And, it is not out of the realm of possibility that if treated early enough and aggressively enough, some patients with RA can actually be...
•Doctor… I Don’t Want a Joint Replacement For my Arthritis. What Are my Options?
Arthritis is a growing health concern. The most common form of arthritis-osteoarthritis (OA)- is increasing in prevalence coincident with the Baby Boomer surge into late middle age. It is estimated that OA affects more than 20-30 million Americans. By the year 2030, that number will probably double.
This form of arthritis is also prevalent among the overweight—which describes nearly 65 percent of our nation's adult population.
While the treatment of end-stage OA of weight-bearing joints such...
•Doctor… My Shoulder Really Hurts. What Do You Recommend?
Patients with inflammatory types of arthritis such as rheumatoid arthritis and psoriatic arthritis often have shoulder problems. However, more often than not, a patient presenting with shoulder pain to the rheumatologist will have another reason besides the arthritis for the discomfort they are feeling.
The shoulder is a complicated and complex joint consisting of the interaction of two major bones forming the glenohumeral joint- the joint that joins the upper arm bone to the shoulder blade....
•Doctor… Tell me About How I Can Get Into a Research Trial For my Arthritis?
Research trials are conducted for all pharmaceutical drugs for arthritis that eventually reach the market.
A clinical research trial may be the only way you can get early access to a breakthrough arthritis treatment; however, there are pluses and minuses so it’s important to understand the questions that need to be asked and answered.
It should be emphasized that a clinical trial is just another component of standard arthritis treatment. It should be considered as an option for patients...
•Fibromyalgia 2008- What’s New... And How Do You Get Relief If You Suffer From This Disease??
The American College of Rheumatology meeting held in Boston from November 6-12 provided a platform for experts in the field of fibromyalgia (FM) to present information that updates our notions as to what this disorder really is.
Legitimacy as a medical condition has been supported by the FDA approval of a drug, pregabalin (Lyrica), for the treatment of fibromyalgia.
Unfortunately there are still skeptics including many physicians. Dr. Daniel Clauw, of the University of Michigan in Ann...
•For Rheumatoid Arthritis Sufferers... Some Info About Methotrexate
Rheumatoid arthritis is the most common inflammatory form of arthritis. It affects more than 2 million Americans. Because it is a systemic disease capable of damaging internal organs, it must be and usually is treated very aggressively.
The most widely prescribed disease-modifying anti-rheumatic drug (DMARD) for rheumatoid arthritis is methotrexate.
It has been in use since the early 1980’s and is the “gold standard” by which rheumatologists judge all other DMARDS. It is also the drug upon...
•Got Knee Pain From Arthritis? Stop Smoking!
Osteoarthritis (OA) is the most common form of arthritis. It is due to premature wearing away of cartilage, the gristle that cushions the ends of long bones in the joint.
Known risk factors for knee OA include a history of trauma, a family history of the disease, certain metabolic conditions, and obesity.
A recent study has confirmed the suspicion that smoking has another detrimental effect on health. It can worsen the prognosis of men who have osteoarthritis of the knee. The study,...
•Got Osteoarthritis? Here Are A Few Tips That Might Help…
Osteoarthritis is the most common form of arthritis, affecting about 40 million Americans. It is also the most common cause of disability.
While more than half of patients older than 65 years of age have osteoarthritis changes in the their knees on x-ray, osteoarthritis is not considered a “normal” part of aging.
Certain activities and occupations increase the likelihood of osteoarthritis. For instance baseball players have an increased incidence of osteoarthritis in the elbows and...
•Hidden Danger...Who Else With Rheumatoid Arthritis Has Anemia?
Rheumatoid arthritis (RA) is a chronic, inflammatory, systemic, autoimmune disease for which there is no known cure. It is a common disorder and affects more than 2.1 million Americans.
Because it is a systemic condition, it affects more than joints. Like other inflammatory conditions, RA causes anemia. The anemia is not the result of bleeding (although some patients treated with non-steroidal anti-inflammatory drugs can develop gastrointestinal bleeding), or deficiency of vitamin B12,...
•How Dangerous Are COX-2 Drugs For Arthritis?
Ever since the voluntary withdrawal of rofecoxib (Vioxx) from the market, debate has raged regarding the risks of COX-2 drugs. Another casualty of the COX-2 "wars" was valdecoxib (Bextra), for an unrelated reason (rashes).
The debate has been fueled, in part, by hysteria, rather than data. What do we know about COX-2 drugs right now? For one, we know that they cause many fewer severe side effects in the gastrointestinal tract than traditional non-steroidal anti-inflammatory drugs (NSAIDS)....
•How Do Arthritis Experts Treat Osteoarthritis?
Osteoarthritis (OA) is the most common form of arthritis and affects more than 20 million Americans. Commonly associated with aging, OA affects weight-bearing areas of the musculoskeletal system such as the neck, low back, hips, and knees. It also affects joints that are highly mobile such as the base of the thumb and the big toe joint.
While OA was considered to be primarily a condition affecting the elderly, it is now believed that OA can begin early- within the second decade of life. OA is...
•How Does My Rheumatologist Know When I Need A Treatment Change For My Rheumatoid Arthritis?
Rheumatoid arthritis (RA) is a systemic, progressive, autoimmune inflammatory disease that has as its main targets, the joints. It affects more than 2 million Americans.
In recent years, tremendous strides in understanding how RA develops has led to the development of targeted therapies.
The aggressive use of disease-modifying anti-rheumatic drugs (DMARDS) such as methotrexate, in combination with biologic therapies has resulted in sustained effectiveness, improved tolerability, and better...
•How Early Should Rheumatoid Arthritis Be Diagnosed And Why Is That Important?
Rheumatoid arthritis (RA) is a common inflammatory, chronic, systemic, autoimmune disease for which there is no known cure. It affects approximately 2.1 million Americans.
RA is one of the leading causes of disability.
And, because it is a systemic disease it can cause significant damage to other organ systems besides the joints including the eyes, heart, lungs, and blood.
The prognosis for this condition has improved dramatically in recent years because of the advent of new drug therapies...
•How Experts Treat Ankle Sprains
The most common type of ankle sprain is an inversion injury. The ankle turns in. Inversion sprains are common complications that may occur after casual strolls, "trips", falls, and sports.
Most sprains are minor but the severe ones can result in ligament strain or rupture and cartilage injury to the bones within the ankle joint.
The most important risk factor for a new sprain is a previous sprain so comprehensive attention to a first sprain is critical.
A patient presenting with a sprain...
•How Old is Too Old to Get a Joint Replaced if You Have Arthritis?
Osteoarthritis (OA) is the most common form of arthritis. It affects approximately 40 million Americans and that number is predicted to rise with the change of demographics occurring as the Baby Boomers age.
OA is a disease of articular cartilage, the gristle that caps the ends of long bones and is most common in weight-bearing joints such as the hips, knees, neck, low back, base of the thumbs, and great toe joints.
The treatment regimen for this condition has not changed appreciably for...
•How Old Is Too Old To Get Joint Replacement Surgery?
Arthroplasty (joint replacement surgery) involving the hip and knee is one of the most common orthopedic procedures performed in the United States.
The technology has improved so that a good to excellent outcome is the usual result. Complications and side effects such as postoperative infection, thrombophlebitis (blood clots), loosening of the joint replacement, and persistent pain still occur but fortunately aren't common.
Patients younger than 50 still are operated on with some reluctance...
•How Quickly Should Rheumatoid Arthritis Be Treated?
Much has been written about the need for early treatment of rheumatoid arthritis. But how early? How aggressively?
New research has demonstrated that rheumatoid arthritis (RA) treatment, if given within 15 days of initial presentation compared with four months after diagnosis can lead to remarkable improvement in outcome measures.
Most studies have demonstrated that a narrow window of opportunity exists between the onset of rheumatoid arthritis and when treatment can make a difference in...
•How To Get Rid Of Neck Pain Simply And Easily
Almost 70 per cent of 10 Americans experience neck pain at some point in their lives. Stretching and strengthening exercises have long been considered a key component for keeping the neck strong and healthy.
A Danish study published in 2007 demonstrated that women with neck pain who practiced specific strength training (SST) exercises for the neck and shoulder muscles experienced substantial pain relief.
Neck pain is usually triggered by repetitive use or holding the neck and shoulders, in a...
•I Have Achilles Tendonitis... Could it Be Caused by the Antibiotic I Took?
Tendons are ropes of tissue that connect muscles to bones and allow joint motion. When a muscle contracts, the tendon is pulled and the bone that the tendon is connected to moves.
Tendons consist of collagen (mostly type I collagen) and elastin that sit inside a matrix (framework) with collagen accounting for 65-80% and elastin approximately 1-2% of the mass of the tendon.
Collagen and elastin are produced by special cells called tenoblasts and tenocytes. Crosslinks strengthen the collagen...
•I Have Failed Enbrel And Humira. My Doctor Wants To Start Rituxan... Tell Me More
Rituximab (Rituxan) is a biologic agent used to treat patients with rheumatoid arthritis (RA) who have failed at least one TNF inhibitor such as Enbrel, Humira, and Remicade.
It is an antibody which combines protein parts from a mouse and protein parts from a human. This antibody is directed against certain types of cells called B cells. Not all B cells are affected. Only B cells that have a marker called CD 20 are targeted. When Rituxan is given B cells with the CD 20 marker are removed from...
•I Have Fibromyalgia And Have Heard About Gabapentin... Tell Me More...
Fibromyalgia is a chronic disorder characterized by chronic, widespread muscle pain and tenderness, and is frequently accompanied by fatigue, insomnia, depression, and anxiety. It affects three million to six million Americans, mostly women, and can be disabling.
The precise cause of fibromyalgia in not known, but research suggests it is related to a problem with the central nervous system's processing of pain. As with some other chronic pain conditions, people with fibromyalgia often develop...
•I Have Just Been Diagnosed With Rheumatoid Arthritis. My Doctor Wants To Wait To Treat. What Should I Do?
Twenty five years ago, the therapeutic options for rheumatoid arthritis (RA) were greatly limited. High doses of corticosteroids were often administered over a prolonged period of time. And gold salts were still being injected for people with severe disease.
Likewise, drugs such as penicillamine and hydroxychloroquine (Plaquenil) were still being used for many patients despite the presence of severe disease. Strong immunosuppressive drugs such as cyclophosphamide (Cytoxan), azathioprine...
•I Have Rheumatoid Arthritis And Am Worried About Heart Attack Risk...
If you have rheumatoid arthritis, you should be worried about risk from cardiovascular events. That includes both heart attacks and strokes.
Women with rheumatoid arthritis (RA) have high rates of non fatal heart attacks. This occurs even without traditional risk factors being present. (Solomon, et al. Circulation 2003; 107: 1303-1307). The same is probably true for men with RA as well.
In addition multiple studies have demonstrated the increased risk of stroke occurring in patients with...
•I Have Rheumatoid Arthritis And Heard About Actemra In The News... What Is It?
Rheumatoid arthritis (RA) is a progressive, systemic autoimmune disease characterized by inflammation of the lining of the joint (synovial membrane). This inflammation causes pain, stiffness and swelling. More disturbing is that, over a short period of time, the inflammation leads to irreversible joint destruction and disability. RA affects more than 21 million people worldwide with approximately 2.5 million people affected in the United States.
RA also shortens life expectancy by affecting...
•I Have Rheumatoid Arthritis And I’ve Heard Il-6 Is Bad. What Is It??
Rheumatoid arthritis (RA) is a chronic systemic disease characterized by inflammation and multiplication of inflammation causing cells within the lining of the joints. This leads to progressive and bone destruction. In addition, because it is systemic disease, the same type of inflammatory changes are seen in other organ systems of the body.
It is the consensus of most researchers that RA is driven by chemical messengers called cytokines. These cytokines activate immune cells to attack the...
•I Have Rheumatoid Arthritis. What Are My Chances For Becoming Disabled And Can I Do Anything About It?
Rheumatoid arthritis (RA) is a chronic, progressive, autoimmune, inflammatory disease that affects more than 2 million Americans. It is a condition that is associated with increased mortality (rate of death) as a result of malignancy (lymphoma), cardiovascular events (heart attack and stroke), and significant disability.
The purpose of this article is to discuss the state of the art as it relates to disability.
It is clear that persistent disease activity leads to joint damage which leads to...
•I Have Rheumatoid Arthritis. What Is My Prognosis?
This article discusses some of the prognostic factors used to guide arthritis specialists when they treat patients with rheumatoid arthritis.
Evidence suggests there is a narrow window of opportunity, perhaps as slim as 3 months, in which aggressive treatment with disease-modifying anti-rheumatic drugs can reduce x-ray damage and subsequent disability.
Once a diagnosis of rheumatoid arthritis has been made, it is important to recognize those patients who are at high risk for rapidly...
•I Have Rheumatoid Arthritis... I’ve Heard That Something Called Cathepsin G Is Important ... What Is It??
Rheumatoid arthritis is the most common inflammatory form of arthritis. It is a chronic, systemic, autoimmune process that affects more than 2 million Americans. While it typically affects both small (hands, wrists, ankles, feet) and large joints (shoulders, elbows, knees, hips), leading to a potentially disabling and crippling situation, it also causes internal organ damage and can affect the eyes, skin, heart, and lungs and other organs as well.
The thrust of much research has been in the...
•I Take Methotrexate For My Rheumatoid Arthritis... I’m Worried About My Liver...?
Methotrexate is the most commonly used disease-modifying anti-rheumatic drug (DMARD) used in the treatment of rheumatoid arthritis (RA). While it is extremely effective, it has potential side effects. Among them are reductions in blood cell counts (particularly white blood cells and platelets), mouth sores, skin rashes, fatigue, gastrointestinal upset, and liver toxicity.
When methotrexate was first introduced in the early 1980's, concern about the potential for liver toxicity prompted many...
•I Want To Try Acupuncture For The Osteoarthritis In My Knee... Does It Work?
The role of many complementary and alternative therapies for arthritis have come under careful scrutiny recently. Some therapies seem to work while others are a short step from snake oil. The difficult problem is separating the truly effective therapies from the ones that really don't work.
In arthritis this is more of a problem than many other conditions because the placebo response in clinical trials involving drugs used to treat arthritis can be as high as 40 per cent! What that means is...
•Is Arthritis Becoming More Common?
Arthritis is the most common chronic disease affecting joints and is also the most common cause of disability in the United States. Many forms of arthritis are also life-threatening. While it has been tempting to speculate that arthritis will become more common as the Baby Boom generation continues to age, there has been a relative lack of hard data to support that notion.
The National Arthritis Data Workgroup is a consortium of epidemiologic experts who have collected and analyzed...
•Is Fibromyalgia A Real Disease?
This article is being written in late 2007. It is surprising that even now, many physicians have the notion that fibromyalgia (FM) is a "wastebasket disorder", that it is due to psychological problems, or it is a condition that indicates the patient is "crazy."
There is abundant and overwhelming data to support the concept that fibromyalgia is a real clinical disorder. What's more there is valid biology and neurobiology that supports the reasons why patients with FM have the pain they...
•Is Fibromyalgia Real?... My Doctors Make Me Feel Like I’m Crazy...?
Fibromyalgia (FM) is a condition characterized by chronic, widespread pain in muscles and soft tissues accompanied by fatigue. It is an extremely common condition that is often underdiagnosed or misdiagnosed because it does not cause any structural damage in an organ and there are no specific laboratory tests that point towards its presence.
Fibromyalgia, affects approximately 2% of the US population. It is considered the prime example of a group of diseases that are called central...
•Is My Rheumatoid Arthritis Treatment Going To Give Me Cancer?
The link between rheumatoid arthritis (RA), a chronic, systemic, inflammatory, autoimmune disease and the incidence of cancer is still murky. Multiple epidemiologic studies have shown that hematopoietic (blood), lung, and skin cancers are increased in incidence in RA patients, while breast and colon cancers are decreased.
Whether these cancer rates are caused by RA itself, the immunosuppressive chemotherapeutic agents used to treat RA, or by newer biologic therapies is an issue of ongoing...
•Is Rheumatoid Arthritis A Genetic Disease?
Rheumatoid arthritis (RA) is the most common inflammatory type of arthritis. It affects more than 2 million Americans and is still a leading cause of both disability as well as days lost from work. RA is more common in women than men, and typical onset for the disease is between 25 and 50 years of age. Symptoms of rheumatoid arthritis include swelling, loss of movement, stiffness, and pain in joints, most commonly, the fingers and wrists.
RA is to be feared and respected because it is a...
•Is There Any Evidence That Meditation Helps Rheumatoid Arthritis?
Today, arthritis patients are not only more receptive to complementary therapies- what has been called alternative therapy- but actually prefer it to conventional medicines.
There are many reasons for this. These reasons include the adverse publicity surrounding the side effects of medicines such as Vioxx and Bextra, cost of pharmaceutical agents, insurance restrictions that make it difficult for patients to get the types of medicines they need, and the widely held concept that "natural"...
•Is Your Doctor Making These Mistakes With Your Rheumatoid Arthritis Treatment?
The treatment of rheumatoid arthritis (RA) has come a long way in the last 20 years. It used to be that if you could reduce pain and swelling, you were doing your job as a specialist in arthritis. That is not good enough anymore.
Rheumatoid arthritis presents with either the acute onset or slow onset of pain and stiffness with functional impairment; if not treated aggressively, it can result in irreversible joint damage. Irreversible joint damage may occur within three to six months of...
•I’m Confused... Are Arthritis Medicines Good For Me Or Bad For Me??
Non-steroidal anti-inflammatory drugs (NSAIDS) are a mainstay of arthritis treatment. However, recent concerns regarding their cardiovascular safety make their routine use in arthritis therapy problematic.
NSAIDs possess a certain risk for kidney toxicity which contributes to fluid retention and edema while also promoting the aggravation of hypertension.
However, often underappreciated are the blood pressure and kidney effects of NSAIDs. It has long been noted that a potential risk of NSAIDs...
•Knee Replacement Surgery May Be A Thing Of The Past For Many Baby Boomers
Today, Baby Boomers (defined as those people born between the years 1946 to 1964) are living longer, staying more active, and very interested in continuing to maintain a vigorous lifestyle.
Multiple research studies have demonstrated the benefit of regular exercise in forestalling the complications related to such degenerative conditions as diabetes and Alzheimer’s disease.
Exercise is also important in maintaining the health of joints by strengthening muscles, improving blood flow, and...
•My Shoulder Hurts And I’ve Been Diagnosed With Tendonitis… What Is It?
When patients go to their rheumatologist or orthopedist with aches or pains, they are often told they have tendonitis.
The term “tendonitis” means inflammation of a tendon. Tendons are tough fibrous cords of tissue that connect muscles to bones. When muscles contract (tighten) the tendon attachment makes the bone the tendon is attached to move in the direction of the contracted muscle. When the muscle relaxes the bone moves back to its original position.
To picture this, imagine tying a rope...
•My Shoulder Hurts. My Doctor Told Me I Have A “Rotor Cuff” Problem… What’s That?
The term “rotor” cuff, actually- the rotator cuff- refers to a group of muscles and associated tendons that connect the scapula (shoulder blade) to the humerus (upper arm bone). The rotator cuff tendons sit on top of the humerus and permit movement in all directions. In fact, the shoulder is the most mobile joint in the body. Because of the wide range of motion that the shoulder joint has… plus the amount of work that the shoulder has to do doing activities of daily living, the rotator cuff...
•New Arthritis Drug Guidelines... Do They Help... Or Do They Hurt?
Non-steroidal anti-inflammatory drugs (NSAIDS) have been the mainstay of arthritis treatment for more than 50 years. Over this time multiple drugs have reached the market and have been used by millions of people. In most cases, the safety profile has been one that has been predictable. In a few unusual cases, safety has been problematic leading to the withdrawal from the market of at least three drugs- Oraflex, Vioxx, and Bextra.
NSAIDS provide both analgesic (pain-relieving) as well as...
•Rheumatoid Arthritis? Go Fish!
Rheumatoid arthritis is the most common inflammatory form of arthritis, affecting more than 2.1 million Americans. It is a chronic, systemic, autoimmune disorder that can potentially lead to crippling, deformity, disability, and early death.
The clinical approach to diagnosis and treatment of rheumatoid arthritis (RA) has dramatically shifted in the last 5-10 years. Most rheumatologists recognize the need for early intervention and aggressive management.
As a result, early institution of...
•Stem Cell Therapy For Arthritis: Is It Possible To Wind The Aging Clocks Of The Cartilage Cells In Your Joints Backwards?
Research on stem cells is leading scientists to investigate the possibility of cell-based therapies to treat disease, which is often referred to as regenerative medicine.
Stem cells have two important characteristics that distinguish them from other types of cells. First, they are unspecialized cells that renew themselves for long periods of time through cell division. The second is that under certain physiologic or experimental conditions, they can be induced to become cells with special...
•Stem Cell Treatment For Osteoarthritis Of The Knees And Hips…can It Work?
Osteoarthritis (OA) is the most common form of arthritis in adults and affects roughly 40 million Americans. It is a disease that affects articular cartilage, the gristle that caps the ends of long bones.
OA is a disease of weight-bearing joints such as the neck, low back, hips, and knees.
Because the ability to ambulate depends entirely on properly functioning legs, the impact of OA on the hips and knees cannot be discounted. In fact, it has been estimated that more than 100,000 Americans...
•Stretching And Aerobic Workouts In Warm Water May Help Relieve Pain And Improve Function In People Suffering With Osteoarthritis
Osteoarthritis (OA) is the most common form of arthritis and affects approximately 30 million Americans. OA develops as a result of breakdown of joint cartilage, the gristle that caps the ends of long bones. This cartilage loss then causes the bones to rub against each other, leading to stiffness, pain and loss of movement in the joint. The symptoms develop due to a combination of mechanical factors as well as local inflammation.
OA is a disease of weight-bearing joints and as a result causes...
•Tarsal Tunnel Syndrome: Carpal Tunnel Syndrome of the Foot?
Tarsal tunnel syndrome is condition where the posterior tibial nerve in the ankle is compressed. In many ways, this condition is analogous to carpal tunnel syndrome in the hand where the median nerve is compressed.
With tarsal tunnel syndrome, compression of the tibial nerve occurs within a tunnel created by a floor consisting of the calcaneus (heel bone) and bounded by the medial malleolus- the bump on the inside part of the ankle- and the far corner of the heel bone. The roof of the tarsal...
•The Ultimate Betrayal Of The Knee Arthritis Lambs
About 20% of the 900,000 arthroscopic knee surgeries performed annually in North America are done as treatment for osteoarthritis (Time, 2008). A knee arthroscopy is a procedure where a small telescope is inserted into a joint and debris is removed. The vast majority are done by orthopedic surgeons.
It turns out that knee arthroscopy may be no more effective over two years than non-surgical treatment using physical therapy and medications, according to a recent study published in the New...
•What Are The Pitfalls Of Current Treatment For Rheumatoid Arthritis?
Rheumatoid arthritis (RA) is a chronic, systemic, autoimmune inflammatory disease that affects more than 2 million Americans.
It is the subject of intense interest since it is so common and the lessons learned from it may help in the management of other forms of inflammatory arthritis.
Currently, the initial step upon diagnosis of RA is to start the patient on disease- modifying anti-rheumatic drugs (DMARDS) like methotrexate. It is one of the most effective and best tolerated DMARDS. Other...
•What Do I Look For In Alternative Therapies For Arthritis?
Of all the medical conditions that exist, arthritis is the one that is most often treated with alternative types of therapies. That is because it is a chronic condition for which there is no cure yet. In addition, people with arthritis are in pain and therefore need relief. And, quite frankly, there is mistrust and fear when it comes to conventional treatments, particularly pharmaceuticals.
Yet, it is a mistake to assume that because a remedy is touted as being "natural" or "organic" or "an...
•What Is “Inflammatory Arthritis?”?
There is an old joke. It goes like this: "Neurologists diagnose the untreatable while rheumatologists treat the undiagnosable." Nothing could be truer than when it comes to what is termed "inflammatory arthritis."
Most rheumatologists tend to divide arthritis into two major categories: inflammatory and non-inflammatory. The latter category is also termed "degenerative" arthritis.
The major distinction is that inflammatory types of arthritis have a significant amount of inflammatory cells...
•What Kinds Of Physical And Occupational Therapy Will Help My Rheumatoid Arthritis?
Rheumatoid arthritis (RA) is a chronic, progressive disease which may lead to considerable disability. While there are no cures for RA, recent developments in biologic therapy make it possible to place many patients into remission.
In addition to medications though, it is important to add adjunctive treatments such as physical therapy and rehabilitation which help to increase functional capacity, provide pain relief, and also provide patient education.
Before starting therapy, physical...
•What Kinds Of Physical Therapy Work For Arthritis?
Patients with arthritis in our practice are often referred to physical therapists during the course of their management. One question I often hear from patients when I suggest physical therapy is, "But, why can't I do exercises at home?"
So the big misconception here is that physical therapy is just a bunch of glorified exercise instruction. Nothing could be further from the truth. Physical therapy plays an extremely important role in the management of the patient with arthritis.
Before we...
•What You Can Do If You Have Arthritis Knee Pain... Information From An Expert
The most common type of arthritis is osteoarthritis (OA). This article discusses the diagnosis and management of this common problem.
Osteoarthritis (OA) of the knee is one of the most common causes of knee pain in people over the age of 30. The cause is progressive wearing away of the cartilage cushion that covers the ends of the long bones that make up the knee joint. The inflammation that accompanies this process leads to swelling and pain.
Risk factors include family history of...
•What’s New For Carpal Tunnel Syndrome Treatment? Will I Need Surgery??
Carpal tunnel syndrome (CTS) is one of the most common problems affecting nerves.
I will discuss what carpal tunnel syndrome is and what the examination of a carpal tunnel patient is like. At the end of the article is a description of a new method for releasing the carpal tunnel that doesn't involve an operating room or scalpel or endoscope.
The carpal tunnel is located on the palm side of the wrist.
It is called the carpal tunnel because the tendons, nerves, and blood vessels that enter...
•What’s New For Osteoarthritis Of The Hip And Knee? Orthokine And Other Treatments... Do They Work?
The most common form of arthritis, osteoarthritis, remains a therapeutic challenge.
This is a generally felt to be a disease of cartilage. However, osteoarthritis is a complex disease that appears to involve a complex series of pathways that include degradation of cartilage, inflammation of the lining of the joint (synovium), and stimulation of pain pathways through different chemical messenger systems.
While traditional methods including patient education, rest, exercise, anti-inflammatory...
•When Are Antibiotics Used To Treat Arthritis?
Research has pointed to a possible benefit of using antibiotics for the treatment of some types of arthritis. This article discusses some of the data.
The role of antibiotic therapy for the treatment of arthritis is controversial. However there is at least some evidence for effectiveness in two examples. Minocycline, a member of the tetracycline family, appears to suppress enzymes involved in the inflammatory process. Doxycycline is an antibiotic that also belongs to the tetracycline group...
•Why Do Rheumatoid Arthritis Patients Hate Prednisone?
One drug that is often used in the early treatment of rheumatoid arthritis is prednisone. Prednisone is a glucocorticoid. Glucocorticoids are drugs that have biologic activity similar to the hormones made in the adrenal glands.
These drugs are chemically synthesized and are used to treat a variety of inflammatory disorders.
Glucocorticoids, while very effective for treating inflammation, have many potential side effects including thinning of the skin, acne, weight gain, fluid retention,...
•Why Is The Thyroid Gland So Important In Rheumatoid Arthritis?
Rheumatoid arthritis (RA) is the most common inflammatory form of arthritis, affecting more than 2 million Americans. It is a chronic, systemic, progressive autoimmune process for which there is no cure, currently. However, there are medications available that can put this disease into remission.
Prior to treating rheumatoid arthritis, it is important than any patient suspected of having the disease undergo a thorough and complete examination. This will include an in-depth history, careful...
•“Three Weeks Ago, I Had Excruciating Neck Pain... Now It’s Gone!”: A New Device To Help With Chronic Neck Pain... Is It For You??
More than one-third of all adults will have significant neck pain at some point in their life. And often it becomes chronic. Neck pain is generally due to irritation of nerve roots coming from trauma, herniated disc, or arthritis. The nerves become inflamed and cause muscle spasm.
Neck pain is usually treated with drugs and physical therapy, and all too often people undergo surgery. But a unique new device relieves neck pain by gently reducing the muscle spasm that is often the root cause of...
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