Pain Relief for Arthritis - 3 Tips for Better Quality of Life

Image via WikipediaArthritis can manifest in many ways and can affect any joint. Rheumatoid arthritis may begin symmetrically on small joints, but may attack virtually all other joints. Osteoarthritis is most frequently occur in the knees, back, hips, and also hands. In about half of the cases, gouty arthritis begins at the proximal joint of the first toe --the infamous podagra--, and may progress with formations of tophi which eventually leads to destructions of the affected joints. In all cases, pain relief is often problematic, especially in advance conditions.

The following are 3 basic tips for you in coping with arthritic pain.

1. Try to study your pain experience.
Pain is mainly a subjective experience, understanding it is a good starting point for you to manage it and eventually gain a better quality of life.

Take notes on what things worsen the pain and what non-medical measures that alleviate the pain. Exhaustive activity, over-training, overuse of one or a group of joints (repetitive movements or too much burden) are some factors that may worsen the pain. Heat pads or cold compress may help in certain situations. Non-burden exercises like swimming may also give relaxing effect to your joints.

2. Make some lifestyle changes
You have to make some lifestyle modification for arthritis pain relief. You may need some consultations with an expert in physical therapy. A physical therapist can give you some practical suggestions tailored specifically to your situation. She/he can also guide you for some types of exercise that you can do to relief a chronic pain, such as strengthening exercises, endurance, or range of motion exercises. If you need some sort of supporting device, a physical therapist is the right person to talk to.

Some simple modification to your daily lifestyle may also help to relief arthritic pain. Pain can also be alleviated by using devices like jar opener and buttoning aids, modified computer keyboard and/or mouse, reduce your body weight, and avoiding stressful repetitive activity involving primarily the affected joints.

3. Know your drugs AND take your medications as prescribed
A thorough understanding about the types of medications you are taking is important, but taking them as prescribed is more important.

Analgesics are the most common drugs prescribed for arthritis relief. There are many types of analgesics. It is a good practice to take a note of the history of your analgetic consumption, including their effectiveness and adverse effects. Make sure your doctor aware about the past history of allergic or side effects from these pain relievers.

Other kind of medications that may be prescribed by a doctor for your arthritis pain relief are the Disease-modifying antirheumatic drugs (DMARDs). This is a category of drugs in rheumatoid arthritis which are used for pain relief and also to slow down disease progression. These kind of drugs are meant to be taken for a long period of time.

In gouty arthritis, allopurinol is an agent to lower the uric acid level in a chronic gout. It is not actually an analgesic, instead its use may worsen the pain when taken during an acute attack. Nevertheless, regular use of allopurinol may reduce the frequency of acute gout attacks.

Related articles

• Pain Relief for Osteoarthritis of the Knee (brighthub.com)
• Arthritis: Surprising Ways to Ease Pain (huffingtonpost.com)
• Home Care Solutions Provide Gout Pain Relief for Painful Feet (arthritis.suite101.com)

Treatment for Gout - Things You May Need To Know

Image via WikipediaMany patients with gout come to their doctor with an acute pain attack. This kind of extremely painful flares usually punctuated after some silent period in a chronic gout. In half of the cases, the very first acute attack involves the first joint of the big toe which famously known as podagra. Untreated or undertreated chronic gout will progress with more frequent attacks, and there will be formation of urate crystal deposits called tophi. The tophi will eventually lead to deformation of the joints.

Normal value for serum urate level is 6.8 mg/dL. Hyperuricemia occurs when the normal level is exceeded. Hyperuricemia does not necessarily mean a gout attack. It is merely a risk factor for developing gout in a long run.

There are certain conditions which co-exist more frequently in patients with gout. Obesity, high cholesterol, diabetes, hypertension, coronary heart disease, stroke, peripheral artery disease, congestive heart failure, and chronic kidney disease are more frequently found in patients with history of gout. It is very important to be aware of these comorbidities, as these conditions are potentially life threatening if left unmanaged.

Gout can be prevented by controlling the modifiable risk factors. There are risk factors that we can not change such as age, gender (male), and race, but serum uric acid level (diet), obesity, moderate to heavy alcohol intake, and hypertension are some of risk factors that ought to be controlable.

The extremely painful attacks of gout can be treated with proper analgetics and/or steroids. Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, and corticosteroids are the main agents used to control pain in a gout flare. A thorough communication with a doctor is essential when using these medications.

After the pain is relieved, it is very important to proceed with urate-lowering treatment. This is necessary to protect against future attack of gout and its potentially destructive complications. The urate-lowering treatment is indicated if you have frequent or disabling gout flares, gout with tophi, gout with impairment of renal function, gout with urolithiasis, uric acid overproduction, or if you are under radiation or chemotherapy for lymphoma or leukemia.

Some urate-lowering agents that you may need to know: Allopurinol (the most common and time-tested urate-lowering agents to date), Probenecid (old one, most potent, used primarily when Allopurinol is contra-indicated), and Febuxostat (new agent). There are a few others that mostly experimental.

Related articles

• Can Gout Spread Throughout the Body? (everydayhealth.com)
• Do I Need Surgery for Gout? (everydayhealth.com)

Sjögren's syndrome and mouse models

Sialography of a patient suspected as Sjögren's syndrome (Image via Wikipedia)Sjögren's syndrome has main manifestations of dry mouth and dry eyes. This is a chronic disease which generally classified as an autoimmune disease. The main target organs of Sjögren's syndrome are the salivary glands and the lacrimal glands, but it actually affects any exocrin glands in human body. So skin, nose, and vaginal dryness might also present. Other organs like kidneys, blood vessels, lungs, liver, pancreas, peripheral nervous system and brain might be suffered as well, bringing many other systemic manifestations of the condition.

It was estimated that the prevalence of primary Sjögren's syndrome in the United States was about 1.3 million of more than 210 million population at 2005. Women are nine times more likely to be suffered from this ailment compared to men.

Sjögren's syndrome may also a part of other autoimmune conditions such as systemic lupus erythematosus, rheumatoid arthritis, scleroderma, or primary biliary cirrhosis. It usually manifest several years after the onset of the primary disease. This is known as secondary Sjögren's syndrome.

The progress in prevention and treatment for Sjögren's syndrome are hindered due to inadequacy of our knowledge in the pathophysiology and clinical progression of the disease. There are several studies involving the development of appropriate mouse models for both primary and secondary Sjögren's syndrome in order to advance knowledge of this disease. Tegan Lavoie and her colleagues have more to say about this in their review about Current Concepts: Mouse Models of Sjögren's Syndrome.

Note: Sjögren syndrome and Sjögren–Larsson syndrome are two different conditions.

Other terminologies: sindrome sjogren, syndrome sjogren.

Related resources:
http://www.sjogrens.org
http://en.wikipedia.org/wiki/Sjögren's_syndrome

New Hope for the Treatment of Osteoarthritis

Image via WikipediaOsteoarthritis is a disease with many underlying backgrounds, it has wide variants of symptoms and variable progression. Despite those confusing triggers, osteoarthritis follows a consistent pathway in its pathogenesis.

In the beginning, the proteoglycans gradual loss will eventually lead to diminishing articular cartilage which can be partial or complete. Thus, articular cartilage is the central focus of our attempt to find treatment for osteoarthritis.

Despite enormous progress in the research of osteoathritis, the mechanisms of the underlying pathogenesis which responsible for osteoarthritis are mostly unknown. Many studies have been conducted to grasp an understanding on the molecular basis for the progression of the degeneration of cartilage that will ultimately cause osteoarthritis, but it seems that we are not there yet.

Ilona Polur and her colleagues from Harvard School of Dental Medicine, hypothesize that

"... excessive mechanical force, due to either overloading on a normal joint or normal loading on a defective joint, can incite chondrocytes, thus resulting in increased chondrocyte activity, such as chondrocyte clustering, during the early stages of the degenerative process."

They further focus their study on the expression of HtrA1 which is a substrate identified as the pericellular matrix component of chondrocytes. It suggests that inhibition of HtrA1 enzymatic activity may slow down the progression of osteoarthritis.

Their study brings a new hope for those in waiting for a good news for the treatment of osteoarthritis, but it seems that we still have to wait a little longer for this study to be implemented as a cure for osteoarthritis in the near future.

Rituxan (rituximab) in rheumatoid arthritis may cause Progressive Multifocal Leukoencephalopathy: FDA Alert

Progressive Multifocal Leukoencephalopathy (Image via Wikipedia)Rituxan was reported to be associated with progressive multifocal leukoencephalopathy (PML). In an alert issued recently by Genentech and FDA, rituximab (Rituxan) was used in a patient with rheumatoid arthritis who has not previously treated with any TNF antagonist. This would be the first case of rituximab-associated PML in rheumatoid arthritis. Previously there have been 2 other rituximab-associated PML cases.
Genentech, the company that produced Rituxan, said that the incident is very low, there were only three cases out 100000. Genentech was trying to expand the use of Rituxan to include earlier stage of rheumatoid arthritis, but FDA has disapproved it due to the recently reported PML.
The FDA said that:
"Physicians should consider PML in any patient being treated with Rituxan who presents with new onset neurologic manifestations. Consultation with a neurologist, brain MRI, and lumbar puncture should be considered as clinically indicated."

Do Psychological Problems Activate the Symptoms of Rheumatoid Arthritis?

Do psychological factors have anything to do with rheumatoid arthritis? In other words, if a patient is having a pyschological problems such as a depression or anxiety, would it it mean that she/he will have her/his symptoms of rheumatoid arthritis activated?

This is not an easy question to answer, because we are seeking causality here. Simply put, does psychological factors activated rheumatoid arthritis? We can easily see that psychological factors may co-exist with an active rheumatoid arthritis, but that should not be necessarily mean that the one causes the other or vice versa; it could simply mean that they are there together without any relation.

That is the challenge that Dr. Kojima and the colleagues from the Department of Medicine, Shinshu University, Asahi Japan, want to answer when they did a research on psychosocial factors, disease status, and quality of life in patients with rheumatoid arthritis.

Dr. Kojima and the colleagues studied 120 outpatients with rheumatoid arthritis. The patients were asked to have a series of health examinations and questionnaires. They want to explore whether there is any relationship between the psychosocial and illness factors which in turn would have something to do with the disease status of patients with rheumatoid arthritis.  Also, they want to know how each factor is associated with the quality of life of those patients.

The study found no significant association between psychosocial factors and disease activity, but yes physical quality of life of the patients depended on current symptoms and their physical functions. To put it in a simple way, may be we can safely say that psychological problems would not cause your rheumatoid arthritis to be activated, but of course the severity of the symptoms and disabilities would compromise your enjoyment of life.

(Source: Journal of Psychosomatic Research, J Psychosom Res 2009 Oct 20; Vol. 67, Issue 5; Page(s) 425-31)

An Overview on the Symptoms of Rheumatoid Arthritis

Rheumatoid arthritis is the second most common form of arthritis after osteoarthritis. Arthritis is a group of diseases which share common symptoms, i.e. joint pain; yet each of them has certain unique characteristics and different underlying etiology.

Rheumatoid arthritis is an autoimmune disease, which means that our immune system mistakenly interpret certain parts of our own organ system as a threat. In rheumatoid arthritis, it is the joint, especially the lining system that is under attack. This odd pathologic mechanism leads to characteristic symptoms of rheumatoid arthritis such as swelling, redness, pain and even disabilities. Due to its systemic nature, the erratic immune system in rheumatoid arthritis not only affects the joints, it also attacks other organs like eyes, lungs, blood vessels and heart. Osteoporosis secondary to rheumatoid arthritis is also a common finding, and treatment with glucocorticoids may further contribute to the worsening of osteoporosis.

The rheumatoid arthritis symptoms is usually begins with insidious vague fatigueness, anorexia, generalized weakness and unobvious muscle pain. The symptoms may persist for weeks or months, and can be viewed as prodromal symptoms of rheumatoid arthritis. This prodromal state usually end after the joints inflammation become apparent.

Morning stiffness is a famous feature of arthritic diseases. It is a generalized joint stiffness which usually last not more than an hour in the morning and disappear when the patient begins her/his daily activites.

The joints pain in rheumatoid arthritis most usually takes a symmetrical pattern. It typically affects multiple little joints in both hands and/or feet. It can also damage bigger joints such as the ankles, knees and elbows. About one out of three patients who suffered from rheumatoid arthritis will develop subcutaneous rheumatoid nodules which usually found near the joints structure but can also grow in hidden places such as in the pleura (a thin lining at the surface of the lungs) and the meninges that covers our brain.

The symptoms of rheumatoid arthritis usually take a chronic course with remissions and acute phases. During remission periods, the symptoms of rheumatoid arthritis usually disappear but will return once the disease becomes active again. Joint damage takes a long course to finally debilitate the patient. This course can be slowed down with the use of modern medications known as disease modifying anti-rheumatic drugs (DMARDs).