PAIN RELIEF MEDICATIONS & OTCS (OVER-THE-COUNTER MEDS)

Today, there are a number pain relief medications available for arthritis.  Some are OTCs (over-the-counter) and do not require a doctor’s prescription like some nonsteroidal anti-inflammatory drugs (NSAIDS) while others like acetaminophen and various other topical medications cannot be purchased without a medical prescription.  One needs to be aware though of possible risks from product abuse or long term usage. Always consult your medical advisors before and during use of these drugs.

Ibuprofen, naproxen and aspirin are the most common OTC NSAIDs.  Misuse of some of these can lead to the blockage of an enzyme that helps in protecting the stomach lining and other areas which can result in stomach ulcers and bleeding and problems with the liver and kidney.  This holds true for prescribed NSAIDS too.  Employed correctly, these drugs can provide relief from pain, inflammation and fever.  They can also help prevent blood clot formation.

Some well known products like Excedrin® products, Tylenol®, and Aspirin Free Anacin® contain an active ingredient known as Acetaminophen.  While this does not favorably impact arthritic inflammation and swelling, it does provide some measure of relief from pain in mild cases.  Again, one has to be cautious with the dosage.  Overuse exposes one to the risk of liver damage and even death, especially those who actively drink alcoholic beverages.

Topical painkillers or topical analgesics are useful if arthritic pain is relatively mild and affects only a few joints.  Topical painkillers are available in cream, salve or gel forms.  Active ingredients present in topical painkillers include capsaicin, camphor, eucalyptus oil and/or menthol.

Capsaicin is naturally present in hot peppers and works by blocking a pain-relaying substance, Substance P, to the brain.   Capsaicin is available in pharmacies under the brand names Capzasin-P and Zostrix among others.

Eucalyptus oil, camphor and menthol relieve pain by tricking the body into feeling their heat or coolness as the case may be. They are found in agents like Icy Hot, Arthricare and Eucalyptamint among others.

RELAXATION & COPING TIPS OF MEDICATIONS

Until findings by scientists and doctors showed immensely positive results, relaxation techniques in the treatment of ill-health in general, was normally written-off as a pile of mumbo-jumbo by the medical fraternity. Meditation and other relaxation techniques have proved very effective.  However the general public still does not comprehend their efficacy and implementation of these techniques still lag behind.

Relaxation techniques definitely help in the healing process and greatly benefit arthritis sufferers.  In some forms of arthritis, stress and emotional disposition play a large part in the ailment and relaxation techniques have an increasingly important role in bringing relief.

Prayer and/or meditation for the religious or spiritually inclined are great forms of relaxation.  These provide immense mental and physical support. 

Hypnosis is another option.  The word ‘hypnosis’ normally conjures up visions of a man with a shiny stopwatch, placing you in a trance and then controlling you into divulging information or performing unusual acts. The hypnosis we’re referring to is aimed at pain management and consists of nothing more than simply a guided method of accessing the power of your subconscious through the assisted creation of imagery.  The guiding is conducted by a hypnotist who is normally a trained psychologist, psychiatrist, counselor or social worker. 

Yoga is another relaxation technique that is gaining wide acceptance.  There are different forms of yoga but Bhakta yoga (devotional) and Raja yoga (meditation oriented) are specially suited to providing relief in all forms of arthritis, especially fibromyalgia.  Fibromyalgia is caused by a number of non-physical triggers and normally comes on due to stress, lack of sufficient sleep, depression and other emotional issues and does not involve bone or joint degeneration.  Practicing relaxation techniques is particularly useful here.

SURGICAL SOLUTIONS OF MEDICATIONS

Surgical measures are recommended by doctors only after medications, normally the first course of defense against arthritis related swelling and pain, fail to prove effective.   

The doctor will recommend a procedure he/she considers best suited to the patient’s case and will explain all that the procedure entails.  At this point, the patient should gather all the information and express any concerns he or she may have regarding the procedure, the risks involved and whether there are any alternative measures they can try.

The benefits involved in surgical procedures include stabilization,   replacement or improved alignment of a joint to allow for greater mobility and flexibility, over-all use and range-of-motion.  Some level of pain relief can also be an outcome of going the surgery route.

 The possible risk involved with surgical procedures is formation of blood clots.  Also, if there is an existing health problem that could pose a possible risk, surgery may be ruled out or postponed.  Examples would be sickness or infections that need to be healed first, excess weight that could cause stress and delay recovery, lung or heart problems.

It is important to note that before a surgical procedure, the doctor may prescribe blood thinning agents and advise doing various joint movement activities to increase blood circulation.

In the treatment of arthritis, the following are the most common procedures undertaken:

• Arthrodesis – refers to the joining or fusing together of bones.  Arthrodesis helps end pain by halting the progression of the disease at the point of joint fusion.  While the joint will then be free of pain, be better able to cope with weight and can offer improved general movement,  the procedure may lead to some loss of the joint’s flexibility.  

• Arthroplasty – refers to the rebuilding or replacement of the entire joint.  Meant for those with higher levels of pain and suffering impairment to movement, we will deal with it in greater detail in the coming section with greater focus on hip joint replacement.
• Arthroscopy – refers to the procedure when specialized instruments are inserted into the joint vide tiny incisions.  This procedural form is gaining popularity with the growing improvements in related technology.  The doctor can operate on the joint by looking at it on closed-circuit television while talking through a microphone.  Besides attending to the physical problem, this procedure allows the patient to carry home an audio/video recording of the entire event for insurance and other record purposes.

Arthroscopy is often performed on an ‘outpatient’ basis and recovery time is usually much less than with other surgical procedures.

• Osteotomy – helps with re-alignment and stabilization, pain relief and the delaying of joint replacement for up to 10 years.  This surgical procedure involves actually making a cut in the bone in order to correct youth deformities, normally present in the knee or hip.
• Synovectomy – refers to the removal of diseased synovium or joint tissue lining.  Normally done via arthroscopy, this procedure results in relief from pain, decreased swelling and an improved but not completely healed joint.

Procedures for Joint Replacement Surgery (Hip)

Of all the many options available in orthopedic (bone) surgery for arthritis patients, joint replacement is the most common.  Over 435,000 Americans underwent this surgical procedure last year alone according to figures from the National Joint Replacement Foundation (NJRF).  These figures have pushed joint replacement to being one of the most successful discoveries in the medical field and the most significant surgical procedure in the treatment of arthritis.

So then, what exactly is joint replacement?  The process of removing  an entire joint along with any damaged tissue and replacing it with a metal prosthesis is known as joint replacement. While this procedure is most effective for weight bearing joints such as knees, ankles and hips, it has been used for other joints as well and provides the patient with much needed relief from pain.

The process of removing the entire hip joint and replacing it with artificial components is called Hip Replacement Surgery. The implanted components function as the natural hip would, and allow for the same type of movement.

There is a significant amount of blood loss in the course of this procedure and patients have the option of preparing for this ahead of time.  They can choose to have their own blood taken and stored well before the actual operation so that they can use blood from their own body at the time of transfusion.  This eliminates many of the risks that go with normal transfusions.

In the hip replacement procedure, after making an initial incision, the surgeon removes the entire hip joint including the ball, socket and the top of the femur.  After the joint and all damaged tissue is removed, a metal cup is adhered to the pelvic bone.  Following this, a metal stem is inserted into the femur, leaving several inches exposed at the end.  A ball is then placed on the end of the exposed portion of metal stem and thereafter, all the exposed portions are lined with another antifriction material.  The hip is then reassembled, the ball placed back in the socket and the incision sealed.

Bone fusion or Arthrodesis is another surgical procedure that is an option.  In this procedure, the bones are fused together and prevented from moving independently.  This can be achieved in two ways:

i) Bone grafting:  a method of stimulating fusion between two bones by placing a small piece of bone between them which has been taken from another region in the body. This new piece of bone encourages surrounding bones to grow and fuse together.
 

ii) Metal or ceramic implants:   This is a common procedure and often used in conjunction with joint replacement surgery.   In this procedure a piece of metal or ceramic is adhered to the ends of the bone in the joint by either using screws or special glue.  This prevents movement of the bones.

In a procedure called Ostheo, doctors can eliminate any loose material in the joint with the use of instruments that are inserted through tiny incisions in the skin.  During the procedure, the doctor can observe the joint on closed-circuit TV and rid the joint of any loose growths that could potentially lead to pain.  Ostheo can often be carried out on an outpatient basis and involves shorter recovery periods than the other surgical procedures.

Recovery and rehabilitation from joint replacement surgery varies from patient to patient.  On an average however, it has been seen that it takes around three weeks to regain most functions.  A positive attitude on the part of the patient and in all supporting the patient - family, friends and well-wishers, goes a long way in aiding and speeding up the recovery process.

Whatever surgical procedure has been recommended, it is good to get a second opinion, if not more, before going ahead.  Also, recommended is reading up about the condition and the procedure, by conducting your own research. 

And if surgery is decided upon, forward planning is a good idea.  Prepare to take leave, have someone help in the home, or to run errands.  Call in your support system in the form of family, friends, neighbors, co-workers and get yourself organized so you can go in for the surgery in a relaxed frame of mind.

Hope this article provide you information about medication.

Arthritis

• Arthritis Basic
• Basic Science of Arthritic
• Inflammation
• Types of Arthritis
• Arthritis Diets
• Plan

• Herbal Remedies & Supplements
• Exercise for All Level
• Medication
• Arthritis Prevention
• Arthritis Pain Relief and Prevention