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When joints go bad

Pain

It's not true that arthritic pain is a condition that goes hand-in-hand with aging. It can also affect children and young adults, severely limiting their activities. In these cases, easing the pain is an important part of being able to live life to its fullest.

The term arthritis actually refers to a group of disorders that includes rheumatoid arthritis, osteoarthritis, juvenile rheumatoid arthritis, and others. What they have in common is joint pain. While the causes of the actual pain for the different types of arthritis may be different, some of the same solutions may work. Here are some medications that might help.

Over-the-counter medications
Aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (e.g., Motrin® and Advil®) can be effective in reducing inflammation and pain. If you take aspirin, it's recommended that it be a buffered type (coated) because it can be irritating to the stomach.

Acetaminophen (e.g., Tylenol®) can be effective for reducing pain, but is not effective for reducing inflammation. Therefore, it can be helpful for types of arthritis where there is not much inflammation, such as osteoarthritis. However, types of arthritis with a lot of inflammation will not be helped much by acetaminophen.

All over-the-counter medications should be taken with caution. Always check with your doctor first about which pain relief drug may be best for you, especially if you have any kidney or liver problems. Also, it's important to keep track of all medications you're buying off the shelf in the pharmacy and all medications that are being prescribed for you. These combinations don't always mix, and can be dangerous. Talk to your pharmacist about possible interactions.

Prescription medications
Some medications of a class called disease-modifying anti-rheumatic drugs (DMARDs) are available that might be tried for rheumatoid arthritis if the analgesics (pain relievers) don't work. They include:

  • gold injections
  • antimalarial drugs, such as hydroxychloroquine
  • penicillamine
  • sulfasalazine
  • immunosuppressants, such as methotrexate and azathioprine

A new class of drugs, called biologics, is available to treat rheumatoid arthritis. The first drug to become available in this class is adalimumab (Humira®). It is used for people with moderate to severe rheumatoid arthritis who have already tried one or more DMARDs but did not get adequate relief. Biologics can be used alone or in combination with DMARDs.

Another therapy undergoing research is joint fluid therapy, which replaces the fluids lost as a result of the disease.

For some people, non-medicinal approaches to fighting pain can also offer comfort. For example, a splint attached to the affected joint can protect it from repeated motions. Physiotherapy with active exercise helps others. Lifestyle changes, such as moving to a warmer climate, eliminate the pain for those affected by cool and damp weather. A healthy diet, along with some types of exercise - alternated with lots of rest - can go a long way in easing discomfort and maintaining mobility.


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