If joint pain
swelling, stiffness, redness, loss of motion or deformity occurs, medical
evaluation by a health-care professional is warranted. Even minor joint symptoms
that persist unexplained for over one week should be evaluated. For many forms
of arthritis, it is essential that patients have an early evaluation as it is
clear that this can both prevent damage and disability as well as make optimal
Treatment may not be necessary for arthritis
with minimal or no symptoms. When symptoms are troubling and persist, however,
treatment might include pain and antiinflammatory medications as below.
applications and topical pain creams can be helpful.
As a first step, rest, heat/cold applications, and topical pain creams can be
helpful. For osteoarthritis
, the over-the-counter food supplements glucosamine and chondroitin have been
helpful for some, though their benefits are still controversial according to
national research studies. These supplements are available in pharmacies and
health-food stores without a prescription. If patients do not benefit after a
two-month trial, I tell them that they may discontinue these supplements. The
manufacturers sometimes make claims that these supplements "rebuild" cartilage.
This claim has not been adequately verified by scientific studies to date.
For another type of dietary supplementation, it should be noted that fish oils
have been shown to have some anti-inflammation properties. Moreover, increasing
the dietary fish intake and/or fish oil capsules (omega-3 capsules) can
sometimes reduce the inflammation of arthritis. Obesity
has long been known to be a risk factor for
osteoarthritis of the knee. Weight reduction is recommended for patients who
are overweight and have early signs of
osteoarthritis of the hands, because they are at a risk for also developing
osteoarthritis of their
knees. Of note, even modest
weight reduction can be helpful.
medications that are available over the counter, such as
acetaminophen (Tylenol), can be very helpful in relieving the pain symptoms
osteoarthritis and are often recommended as the first
medication treatment. Since
has fewer gastrointestinal side effects than nonsteroidal antiinflammatory drugs
(NSAIDS), especially in elderly patients,
acetaminophen is generally the preferred initial drug given to patients with
Some patients get significant relief of pain symptoms by dipping their hands in
hot wax (paraffin) dips in the morning. Hot wax can often be obtained at local
pharmacies or medical supply stores. It can be prepared in a Crock-Pot and be
reused after it hardens as a warm covering over the hands by peeling it off and
replacing it into the melted wax. Warm water soaks and wearing nighttime cotton
gloves (to keep the hands warm during
sleep) can also help ease hand symptoms. Gentle range of motion
performed regularly can help to preserve function of the joints. These
are easiest to perform after early morning hand warming.
Pain-relieving creams that are applied to the skin over the joints can provide
relief of daytime minor
arthritis pain. Examples include capsaicin (Arthricare, Zostrix), diclofenac
cream, salycin (Aspercreme), methyl salicylate (Bengay, Icy Hot), and menthol
(Flexall). For additional relief of mild symptoms, local ice application can
sometimes be helpful, especially toward the end of the day. Occupational
therapists can assess daily activities and determine which additional techniques
may help patients at work or home.
There are a few forms of arthritis, such as gout
, that can be impacted by dietary changes.
Finally, when arthritis symptoms persist, it is best
to seek the advice of a doctor who can properly guide the optimal management for
each individual patient.
Click below to see more videos....