TAKING CONTROL
Medications
No medicine can yet cure yours arthritis, but many can ease pain and stiffness, actually making life comfortable again. Reach first for paracetamol (Panamax, panadol). If you're just a little achy and stiff, it might well do the trick, and it's very safe. But paracetamol can't calm inflammtion, so if discomfort persists or there's actual swelling, add a nonsteroidal anit-inflammatory during (NSAID), such as aspirin, ibuprofen (Nurofen, Actiprofen) or naproxen (Naprogesic). NSAIDs, available by prescription in stronger versions (familiar brands include Voltaren, Clinoril, Naprosyn, Brufen,
TACKLING NSAID TROUBLES
NSAIDs taken more often or at higher does than recommended can damage your stomach, kidneys or liver. Stomach problems (nausea, heartburn, potentially serious bleeding ulcers) develop because NSAIDs knock out chemicals called prostaglandins that protect stomach tissues.
Alternatives
Ask your doctor about taking an NSAID with histamine blocker (H2 blocker) such as Tagamet or Zantac. These drugs suppress the production of damaging stomach acid. Another option for relief is to add an anti-ucler medication called a proton pump inhibitor (Somac, Losec or Nexium). If you're already at risk for developing a stomach ulcer, your doctor might prescribe a COX-2 inhibitor such as Vioxx or Celebrex, which is less likely to cause gastrointestinal complications.
Interactions
Other reasons to talk over your NSAID use with your doctor are that many interact negatively with common medications such as diuretis, anticoagulants, Corticosterioids and ACE inhibitors. You should be particularly cautions about taking an NSAID if you have a history of certain medical conditions such as ulcers, stomach bleeding, asthma, hypertension, epilepsy, liver or kidney problems or Parkinson's disease. Age also matters: If you're over the age of 60, you are four times more likely than younger adults to experience NSAID-related gastrointestinal bleeding or ulceration.
Feldene), block the body's creation of prostaglandins, substances that trigger inflammation. If your arthrits is a constant problem, you might experience some digestive side effects from these drugs. Although generally quite safe, NSAIDs can irritate your stomach lining, causing queasiness, adodminal pain and even bleeding (see box above). Along with NSAIDs, try a liniment (pain-relieving cream, rub or spray). Many NSAIDs are also available in gel from which can be effective, especially if you have a single arthritic joint.
If you've had side effects from some NSAIDs or are at risk for an ulcer, consider going straight from paracetamol to one of the prescription NSAIDs, COX-2 inhibitors, introduced in the late 1990s. Celeoxib (Celebrex) and rofecoxib (vioxx) are now very popular fro the treatment of osteoarthritis. Unlike traditional NSAIDs, COX-2s target inflammation-causing prostaglandsins without affecting the lining of the stomach. They're much easier on the digestive tract, but provides the same anti-inflammatory effects. On the downside, COX-2s may slightly increase your risk of heart-related problems (heartattack, stroke). Experts disagree about COX-2 risks, but the known side effects such as salt retention and sweelling may be hazardous if you have a heart problem.
If your pain's severe, opiods such as tramadol (Tramal) or codeine are worth considering. with your doctor, aim for the lowest effective dose so that you can minimise the risk (especially with codeine) of becoming dependent or suffering side effects such as constipation, nausea ro drowsiness.
Could I be doing something that's making my arthritis worse?
First, make sure you truly have osteoarthritis. Lots of conditions can give you joint pain and stiffness (tendonitis, pinched nerve, lupus). So get a fimr diagnosis before embarking on any treatment plan. Also, the wrong exercise or a poorly fitting brace or other joint aid can cause more harm than good. Check with your doctor or physisotherapist.
Does it matter when or where I do my exercise?
Yes, both matter. Unless your joint inflammation is severe, do your exercises every day, when your muscles are loose after a hot shower or bath and your medicine is at its peak. If possible, exercise in a class setting rather than at home. Research from Britain indicates that because classes tend to be more rigorous and you have the support of others in the same situation, such sessions are the best way to promote pain relief.
Lifestyle Changes
When your joints are creaky and aching, it certainly seems counterintutitive to exercise, but this is one of the best arthritis remedies around. Done properly (good form is crucial), exercise can keep your pain and stiffness from veering out of control. You'll get the biggest payoff by doing resistance
training with weights designed to strengthen and tone muscles.
- Go to a class. Studies show that being actively involved in managing your own OA can dramatically lessen. your pain. Contact the arthritis foundations of Australia and New Zealand for information on the self-management programs that are avialable for arthritis sufferers (see finding support)
- Toss the heels. Twice as many women as men suffer from knee OA, and Harvard reseachers have a clue as to why. When walking in heels higher than 5 cm, the torque--the rotational force--applied around the inside of the knee is 23% greater than when barefoot. This is enough torque to destroy cartilage and cause arthritis. So opt for low-heeled or flat shoes, and keep the high heels for (brief!) special occasions.
- Get on the ball. Try squeezing a tennis ball to relieve stiffness and strenghten your forearms and hands. Make a cut of 5-7 cm in the ball for light resistance, and a 2.5 cm cut for moderate resistance.
Medications
No medicine can yet cure yours arthritis, but many can ease pain and stiffness, actually making life comfortable again. Reach first for paracetamol (Panamax, panadol). If you're just a little achy and stiff, it might well do the trick, and it's very safe. But paracetamol can't calm inflammtion, so if discomfort persists or there's actual swelling, add a nonsteroidal anit-inflammatory during (NSAID), such as aspirin, ibuprofen (Nurofen, Actiprofen) or naproxen (Naprogesic). NSAIDs, available by prescription in stronger versions (familiar brands include Voltaren, Clinoril, Naprosyn, Brufen,
TACKLING NSAID TROUBLES
NSAIDs taken more often or at higher does than recommended can damage your stomach, kidneys or liver. Stomach problems (nausea, heartburn, potentially serious bleeding ulcers) develop because NSAIDs knock out chemicals called prostaglandins that protect stomach tissues.
Alternatives
Ask your doctor about taking an NSAID with histamine blocker (H2 blocker) such as Tagamet or Zantac. These drugs suppress the production of damaging stomach acid. Another option for relief is to add an anti-ucler medication called a proton pump inhibitor (Somac, Losec or Nexium). If you're already at risk for developing a stomach ulcer, your doctor might prescribe a COX-2 inhibitor such as Vioxx or Celebrex, which is less likely to cause gastrointestinal complications.
Interactions
Other reasons to talk over your NSAID use with your doctor are that many interact negatively with common medications such as diuretis, anticoagulants, Corticosterioids and ACE inhibitors. You should be particularly cautions about taking an NSAID if you have a history of certain medical conditions such as ulcers, stomach bleeding, asthma, hypertension, epilepsy, liver or kidney problems or Parkinson's disease. Age also matters: If you're over the age of 60, you are four times more likely than younger adults to experience NSAID-related gastrointestinal bleeding or ulceration.
Feldene), block the body's creation of prostaglandins, substances that trigger inflammation. If your arthrits is a constant problem, you might experience some digestive side effects from these drugs. Although generally quite safe, NSAIDs can irritate your stomach lining, causing queasiness, adodminal pain and even bleeding (see box above). Along with NSAIDs, try a liniment (pain-relieving cream, rub or spray). Many NSAIDs are also available in gel from which can be effective, especially if you have a single arthritic joint.
If you've had side effects from some NSAIDs or are at risk for an ulcer, consider going straight from paracetamol to one of the prescription NSAIDs, COX-2 inhibitors, introduced in the late 1990s. Celeoxib (Celebrex) and rofecoxib (vioxx) are now very popular fro the treatment of osteoarthritis. Unlike traditional NSAIDs, COX-2s target inflammation-causing prostaglandsins without affecting the lining of the stomach. They're much easier on the digestive tract, but provides the same anti-inflammatory effects. On the downside, COX-2s may slightly increase your risk of heart-related problems (heartattack, stroke). Experts disagree about COX-2 risks, but the known side effects such as salt retention and sweelling may be hazardous if you have a heart problem.
If your pain's severe, opiods such as tramadol (Tramal) or codeine are worth considering. with your doctor, aim for the lowest effective dose so that you can minimise the risk (especially with codeine) of becoming dependent or suffering side effects such as constipation, nausea ro drowsiness.
Could I be doing something that's making my arthritis worse?
First, make sure you truly have osteoarthritis. Lots of conditions can give you joint pain and stiffness (tendonitis, pinched nerve, lupus). So get a fimr diagnosis before embarking on any treatment plan. Also, the wrong exercise or a poorly fitting brace or other joint aid can cause more harm than good. Check with your doctor or physisotherapist.
Does it matter when or where I do my exercise?
Yes, both matter. Unless your joint inflammation is severe, do your exercises every day, when your muscles are loose after a hot shower or bath and your medicine is at its peak. If possible, exercise in a class setting rather than at home. Research from Britain indicates that because classes tend to be more rigorous and you have the support of others in the same situation, such sessions are the best way to promote pain relief.
Lifestyle Changes
When your joints are creaky and aching, it certainly seems counterintutitive to exercise, but this is one of the best arthritis remedies around. Done properly (good form is crucial), exercise can keep your pain and stiffness from veering out of control. You'll get the biggest payoff by doing resistance
training with weights designed to strengthen and tone muscles.
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