Non-Surgical Options
Joint pain, caused by osteoarthritis, rheumatoid arthritis or degenerative joint disease can often be treated non- surgically. The main goal of treatment is to reduce pain and slow the progress of the joint deterioration. This can be accomplished through a multifaceted program combining medication, physicial and occupational therapy, exercise and rest.
Nothing will "cure" or reverse joint damage but early, aggressive treatment can achieve good results. Options for non surgical treatment are:
Medications that may be prescribed:
NSAIDs-- are nonsteroidal anti-inflammatory drugs. These medications reduce pain and inflammation but do not slow progression of joint deterioration.
Over-the-counter NSAIDs include ibuprofen (Advil or Motrin) and naproxen sodium (Aleve). Most people with RA require a prescription NSAID as they offer longer lasting results and require fewer doses throughout the day. There are many prescription NSAIDs to choose from.
DMARDs—are disease-modifying antirheumatic drugs. DMARDs help slow to stop progression of RA. The most common DMARD used to treat rheumatoid arthritis is methotrexate. Others include Arava, Azulfidine, Cytoxan, Imuran, Neoral, and Plaquenil.
In rheumatoid arthritis, an overactive immune system targets joints and other areas of the body. DMARDs work to suppress the immune system. However, they aren't selective in their targets. Thus, they decrease the immune system overall and increase the likelihood of catching infections.
DMARDs, particularly methotrexate, have produced dramatic improvements in severe rheumatoid arthritis and can help preserve joint function.
Biologics—are the newest and most effective treatments for rheumatoid arthritis. Biologics are genetically engineered proteins derived from human genes. They are designed to inhibit specific components of the immune system that play a pivotal role in inflammation, a key component in rheumatoid arthritis.
Biologics are usually used when other medications have failed to calm the inflammation of rheumatoid arthritis. They can often slow or stop RA progression when other medications have failed to do so.
TNF blockers help to reduce pain by blocking an inflammatory protein called tumor necrosis factor (TNF). There is some evidence that TNF blockers may stop the progression of rheumatoid arthritis. Recent studies have shown benefits when they are combined with methotrexate. TNF blockers include Enbrel, Humira, and Remicade.
Other biologics suppress different areas of the immune system and include Kineret, Orencia, and Rituxan.
Steroids--For severe RA or when RA symptoms flare, your doctor may recommend steroids to ease the pain and stiffness of affected joints. In most cases, they can be used temporarily to calm a symptom flare. However, in certain people, steroids are needed long term to control the pain and inflammation.
Steroids can be given as injections directly into an inflamed joint or taken as a pill. Potential side effects of long-term steroid use include high blood pressure, osteoporosis, and diabetes. But when used appropriately, steroids are often effective and quickly improve pain and inflammation.
Physical and Occupational Therapy
Physical and occupational therapy are key components of any rheumatoid arthritis treatment plan.
Physical Therapy
Physical therapists are skilled at identifying muscle groups and joints that need improvement. They can assess your level of fitness and ability and design an exercise plan to help you build strength and flexibility where you need it most. Since exercise is key to keeping joints healthy, make sure you don't keep your physical therapist on the sidelines.
Occupational Therapy
Occupational therapists help you keep your independence. If arthritis starts to slow you down, or if daily tasks become difficult, a visit with an occupational therapist will probably help. Occupational therapists have a playbook of "work-arounds" to let you continue to live your own way. They can also provide or recommend an arsenal of supportive devices that will smooth out the rough spots in your daily routine. They can also teach you how to use proper body mechanics when active to relieve stress on your joints.
Self-Management Techniques
Having the appropriate diagnosis and medical treatment from your doctor is important in the success of your life with arthritis. Equally important are the things you can do yourself to limit the impact of arthritis on your life. These include staying healthy and fit by balancing exercise, activity and rest, managing stress, depression and fatigue, avoiding joint pain and injury, and using complementary treatments along with your medications.
Exercise
Exercise is an important component in staying healthy when you have arthritis. Moderate physical activity on a regular basis help decrease fatigue, strengthen muscles and bones, increase flexibility and stamina, and improve your general sense of well-being. Joint flexibility is especially important because stiff joints means inability to do daily tasks, such as buttoning a shirt or starting the car. Learn more about the types of exercise that can help you.
Balancing Activity and Rest
It is important to stay active when you have because you want to keep your joints flexible and healthy. "Use it or lose it, " as the saying goes. However, you don't want to push yourself too hard and end up doing further damage to your joints. Work with your doctor or physical thereapist to achieve the appropriate balance between rest and activity.
Weight Control
Weight control is particularly important for people with arthritis and joint disease. Excess weight directly contributes to the development of osteoarthritis. Weight control not only helps prevent arthritis, it is an important element in your treatment of the disease as well.
Maintaining your recommended weight or losing weight if you are overweight can lessen your pain by reducing stress on your affected joints. Weight loss specifically helps ease pressure on weight-bearing joints such as the hips, knees, back and feet.
If you are overweight, work with your doctor to devise a weight-loss plan that includes eating fewer calories and increasing physical exercise. Make sure you are getting enough nutrients to keep your body healthy and that the activities you choose don't harm your joints.
For more information or to make an appointment please call
1-877-233-WELL (9355).