Arthritis

Pulling up your socks, rising from a chair, opening a jar---the 10 percent of Australians and New Zealanders, with arthritis know just how taxing these simple actions can be. Finding the right treatment can make a dramatic difference in how you feel every day.

What is happening

Experts still aren't sure why cartilage, the shock-absorbing tissue that normally coats the ends of bones, sometimes breaks down, causing those typical arthritis symptoms: stiffness and pain. Once the cartilage has worn down, however your bones start to grate against each other. The roughened ends thicken and may develop knobby out growth called 'spurs'. Bits of cartilage break off in the joint space. At later stage , the joint can block as if a dog has been gnawing at it. The breakdown of cartilage includes inflammation, which alone can make your join hurt; often it's associated with warmth, swelling and stiffness that make symptoms worse. At first, pain may appear only when you move the joint, but later it may hurt even when you're still. It is usually worse by the end of the day and in cold, damp conditions, and gets better with rest.
LIKELY FIRST STEPS

• Paracetamol for discomfort, NSAIDs (including COX-2  inhibitors) or opitates for painful inflammation.
• Application of topical liniments and heat or cold for immediate relief.
• Strengthening exercises to enhance recovery.
• Physical  aids such as shoe wedges, canes and joint protectors (splints, braces) to ease  joint stress.
• Eventually injections or surgery, even a joint replacement, may be necessary.

    Arthritis is a degenerative disease, and its causes are varied. Your family history may bear some responsibility: Your genes set the stage for a defect in the production of collagen, a protein crucial to cartilage. Or perhaps you were injured (even decades ago), or you're overweight, or you use a certain joint repetitively (may be on the job).
   Most people develop pain in just one or two joints, but any joint is vulnerable. Trouble spots include knees, hips, spine and fingers. More than 100 conditions cause join pain, so get a firm  diagnosis before your label yours 'arthritis'. For information on related conditions, see Rheumatoid arthritis on next, Gout on next, Lupus on next also and Fibromyalgia on next also. Discussed here is the most common form of arthritis: Osteoarthritis (OA).

QUESTIONS TO ASK

• Is there anything I can do to prevent my arthritis from getting worse?
• How likely is it that my other joints will start hurting?
• Should I stop playing golf? Tennis? Jogging?
• Am I a candiate for joint injections?
• How will I know if  i need joint replacement surgery?

Treatments

With arthritis, you've probably  discovered you have 'good days' and 'bad days'. If it's the latter, begin by taking a pain killer (paracetamol, a nonprescription' NSAID or COX-2  inhibitor); often you'll feel

better in a couple of hours. Self-care remedies  are also useful: hot or cold packs, liniments, stretching and natural methods of relaxing help control pain. The supplements glucosamine and chondrotin may prevent cartilage deterioration. It's important to appreciate that you can control your situation by making changes in your life style. You can prevent flare-ups, for example, by keeping your weight down, exercising regularly and using doctor-recommended aids (shoe wedges, walking aids). A physiotherapist can provide specialised procedures; ask your doctor for a referral.

                                            Treatment Options 
MEDICATIONS
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Painkillers/NSAIDs                                        Nonprescription/prescription, COX-2s
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 Topical liniments                                          NSAID gels and methyl salicylate can help.
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Opioids                                                           Tramadol or codeine for severe pain.

LIFESTYLE CHANGES
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 Exercise                                                    Stretching, swimming, low-impact, aerobics.
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Special aids                                                 Joint protectors, foot wear, pads, grippers
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Hot & cold treatments                                 Warm for stiffness; cool for inflammation
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Diet                                                               Drop extra kilos; eat fish; get calicum

Procedures
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Injections                                                      Steroids and hyaluronic acid help with pain.
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Surgery                                                           Arthroscopy and osteotomy for certain cases.
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Joint replacement                                             Joint repair, scraping or reshaping

NATURAL METHODS---------------------------------------------------------------------------------------------------------------------------------
 Supplements                                                Glucosamine/Chondroitin for cartilage repair.
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Relaxation techniques                                    Meditation, massage, biofeedback help pain.
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 Acupuncture                                                   Ancient technique for pain relief.