HOW IS ARTHRITIS TREATED?

The choice of therapy depends on the type of arthritis and other medical problems that exist at the same time. No single treatment exists for all types.

If you suffer from severe osteoarthritis in a large joint, treatment might include heat applied to the affected area and rest and immobilization, either by remaining in bed or using custom-designed splints. Medications that decrease inflammation, such as aspirin or other antiinflammatory drugs, might be helpful. Very occasionally, injections of cortisone into the joint are valuable, but frequent injections should be avoided. If your hip joint is severely affected and you are incapacitated, surgical replacement might be considered. This operation can result in a dramatic improvement in your symptoms and in your ability to function.

Rheumatoid arthritis is often treated with large doses of aspirin or other antiinflammatory agents. Special drugs such as gold salts by injection might be used in severe cases. This type of treatment should be supervised by a well-trained specialist in arthritic diseases in conjunction with your family physician. It can be useful if your illness does not respond to other treatments.

An episode of acute gout can be treated with a course of colchicine, taken either by mouth or intravenous injection. Non-aspirin-containing antiinflammatory drugs also usually offer fairly rapid relief of symptoms. Depending on the underlying cause, drugs that decrease the amount of uric acid in the blood can prevent further attacks. Small doses of colchicine, or the drug allopurinol, taken on a long-term basis may also help decrease your risk of acute attacks of gout.

Pseudogout is treated with antiinflammatory agents as well as injections of cortisone into the joint. Before the joint is injected, fluid is usually removed to make sure that it is not infected. After treatment of a sudden episode of pseudo-gout, there is usually no need for long-term therapy to prevent further attacks, as opposed to the treatment for gout.

Salicylate, either as plain aspirin or enteric-coated aspirin, is probably the single most valuable medication used to treat the various forms of arthritis. Salicylate relieves pain and also decreases inflammation. It is most effective when taken regularly four or five times a day, not just when pain intensifies; it prevents pain when taken in this fashion.

Some people either cannot tolerate salicylate or do not respond to it. In such cases some antiinflammatory drugs that are different from aspirin and less dangerous than cortisone are available. There are many different types, and no specific drug appears to be more effective universally than the other. In many instances it is a matter of trial and error to see which preparation works for you. These drugs have significant side effects, the most common of which is bleeding from the stomach. If you vomit a coffee-ground-like material or pass blackened stools while taking these medications, seek immediate medical advice.

Gold salts or certain antimalarial drugs have been used in some severe cases of rheumatoid arthritis. Some medications, such as penicillamine, work by interfering with the immunological system that somehow appears to keep the disease active. Some people become more prone to infection when they receive medications that affect the immunological system, however.

Cortisone by mouth is controversial in the treatment of arthritic conditions, especially rheumatoid arthritis. In general, its continued use is avoided because the cumulative side effects, such as weakened bones, bloated appearance, diabetes mellitus, and high blood pressure, can be dangerous. Local injections of cortisone into the painful joint, on the other hand, can be very useful in the treatment of gout, pseudogout, osteoarthritis, and certain cases of rheumatoid arthritis. They can provide immediate relief with few side effects while you begin another medication, or until you begin a program of physical rehabilitation. Injected steroids can only be used infrequently as repeated injections may promote further damage to the joint.

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Tags: General health | Posted in General health