As a rheumatologist, I work with all kinds of people living with different types of arthritis. I’ve noticed that I’m asked the same questions time after time. I hope these common questions and my answers will be helpful for anyone living with arthritis. Here are some of the most common questions that patients ask me. 1. Isn’t There Only One Type of Arthritis? The answer is a big NO. There are many different types of arthritis. The great majority of us envision our elderly grandparents, the fragrant aroma of Bengay radiating from them and how they looked like a slow motion movie, while attempting to rise from a chair. That’s the very common type of “wear-and-tear” arthritis, known as osteoarthritis. As many as 27 million Americans are afflicted with osteoarthritis, according to the Centers for Disease Control and Prevention. There are many other types of arthritis, including autoimmune mediated diseases which cause the body to attack its own joints. Common examples of the latter are rheumatoid arthritis and psoriatic arthritis. 2. Can I Be Cured of Arthritis? There is no cure for any type of arthritis. The goal with osteoarthritis is pain management to maximize quality of life and joint protection from trauma, which can predispose the person to accelerated degeneration. The goal for an autoimmune disease-related arthritis is remission, which thanks to rapidly advancing medical research, is achievable today. If you have an inflammatory arthritis such as rheumatoid arthritis, time can be your best friend or foe. The more time that passes from the onset of inflammation, the more irreversible joint damage can accrue. Therefore, it is imperative that appropriate disease modifying medications be started right away, by your rheumatologist. 3. What Can You Offer Me Other Than Pain Relievers or Joint Replacement? Often, people are tired of taking so many over-the-counter pain relievers that they want something different, but they don’t necessarily want joint replacement surgery. There may be options depending on which type of arthritis you have. Hand arthritis. Based on American College of Rheumatology (ACR) recommendations, in addition to oral medications, you can try an over-the-counter topical capsaicin cream for hand arthritis. If that doesn’t help, ask your rheumatologist to prescribe a topical nonsteroidal anti-inflammatory cream. Warm paraffin baths and splinting may also provide surprising relief. Knee arthritis. Weight loss, tai chi programs, water therapy, and transcutaneous electrical stimulation (TENS) are all non-pharmacologic ACR-approved treatment for knee arthritis. Steroid injections into the knees and hips can also provide relief from arthritis pain, as they help calm down inflammation in the joints. If more conservative measures aren’t adequate, there is some data that an injection of hyaluronic acid (viscosupplementation) — a thick gel-like material that helps lubricate joints — into the knees, may be helpful. In fact, a recent study has showed that while steroid injections certainly do a good job with more immediate pain relief, viscosupplementation is showing better long-term pain relief. 4. What Should I Eat (or Avoid) to Help My Arthritis? By eating an anti-inflammatory diet, you will not only look better and feel better, you may also be helping your joints. The friendly omegas in fish and walnuts, for example, can start a riot against inflammation. Don’t forget spices such as ginger and turmeric, which are touted for their anti-inflammatory properties. Limit processed foods and saturated and trans fats; obesity increases leptin levels, which have been linked to an increased risk of osteoarthritis. If you have a diagnosis of Celiac disease, avoiding gluten will not only improve your gastrointestinal health and enhance nutrient absorption, it will also help resolve celiac-related arthritis. Patients who develop arthritis due to chronic gout flares will fare best by avoiding foods with a high uric acid content. Meats, seafood, shellfish, high fructose corn syrup, and beer are among the most widely recognized and notorious offenders. The list of foods high uric-acid is long, and a person with chronic gout will do their body good if they search for a list of these foods, so they know what to avoid. 5. Will Glucosamine/Chondroitin Help My Joints? This is a very widely debated topic in medicine, and in rheumatology in particular. We read, do studies, read some more, yet we can’t seem to agree on one unanimous answer. There is basic science data revealing a synergistic effect when glucosamine and chondroitin are combined, and at least experimentally in animals, the duo seems to reduce excessive bone resorption. This means that the glucosamine-chondroitin combo may potentially help keep bones stronger, at least according to animal-related data. Another study, published in Journal of American Medical Association, found that although studies revealing a significant benefit for glucosamine and chondroitin may have been biased, they may still be somewhat helpful. Other research showed that across the board, the glucosamine-chondroitin combination is really no different than a “dummy” drug (placebo). However, in a subgroup with moderate to severe arthritis, patients did experience pain relief from these supplements. The ACR specifically does not recommend the use of chondroitin sulfate or glucosamine in hip and knee arthritis. So what is a person with arthritis to do? It really comes down to preference. Rheumatology guidelines do not support the use of glucosamine/chondroitin. However, results are mixed. For some people with chronic arthritis who are dependent on multiple pain medications daily, even if they take one less pain reliever, that’s victorious. Mahsa Tehrani, MD, is a board certified rheumatologist with certification in musculoskeletal ultrasound, and is co-founder of Arthritis & Rheumatology Clinical Center of Northern Virginia. Dr. Tehrani is also board certified in Internal Medicine, and holds a Master’s degree in Complementary and Alternative Medicine from Georgetown University. In addition, she has performed a year of oncology research at the National Institutes of Health. Dr. Tehrani has been published in numerous peer reviewed medical journals, including Blood and the International Journal of Rheumatology. PHOTO CREDIT: Henrik Sorensen/Getty Images Original article and pictures take http://www.everydayhealth.com/rheumatoid-arthritis/living-with/questions-ask-your-doctor-arthritis/ site
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