Saturday, January 11, 2014

Advanced Treatment For Chronic Pain & Osteoarthritis


The body produces electrical energy to regulate everything from a heartbeat to the way our brains process things. And electromedicine has been used to treat conditions since the first century AD when Roman physicians utilized electric eels to treat conditions like gout. However, like many things about our body it has taken a long time to truly understand how manipulating or enhancing that electrical energy within the human body can assist in the health and well being of that person. Dr. Hansjurgens was a leading researcher in the field of electrotherapy and came to some unique conclusions on how electricity affects the body differently.

In fact Dr. Hansjurgens realized early on that there were some limitations in interferential treatments being used because they focused on just stimulation of the area being treated. As he studied and applied his theories to different cases he discovered that he could classify the electrotherapy treatments into two classes:

  • Stimulatory which increases and decreases intensity over low frequencies (1-1000hz) which is used for treating atrophy, muscle rehab & strengthening, knee joint disorders and spasms

  • Multi-Facilitory which keeps the intensity constant at a higher frequency (1000-100000 hz) which can be used for treating chronic polyarthritis, neuralgia, neuroma, inflamations, sciatica, severe pain and wounds.

This realization led him to create a new technology that treated patients at both the Stimulatory and Multi-Facilitory level and he called this new treatment protocol Horizontal Therapy. Through multiple clinical studies Horizontal Therapy has become the Gold Standard in electrotherapy treatment. By delivering these two classes of treatments to patients not only can clinicians treat the specific condition at the point of the pain but also at the biochemical level to enhance the healing properties of the human body to help provide long term results.

Reactive Arthritis Versus Reiter's Syndrome


What should this disease be called? Should a physician convicted of war crimes against people under his care be honored by calling a disease after him?

Reactive arthritis is also known as Reiter's Syndrome, arthritis urethritica, venereal arthritis and polyarteritis enterica.

It is an autoimmune condition that develops in response to an infection in another part of the body (cross-reactivity). Bacterial infections often trigger the disease.

Reactive arthritis has symptoms similar to various other conditions collectively known as "arthritis". By the time the patient experiences symptoms, oftentimes the "trigger" infection has been cured or is in remission in chronic cases.

The manifestations of reactive arthritis include the following triad of symptoms: an inflammatory arthritis of large joints, commonly including the knee and the back (due to involvement of the sacroiliac joint), inflammation of the eyes in the form of conjunctivitis, which is inflammation of the outer layer of the eye, or uveitis, which is inflammation of the middle layers of the eye, and urethritis in men or cervicitis in women. Patients may also have lesions on the mucus membranes of the skin, as well as psoriasis-like skin lesions. There may also be inflammation where the Achilles tendon attaches to the heal bone, resulting in heel pain. Not all affected persons have all the manifestations (Source: Mayo Clinic ).

The question of what to call this syndrome stems from the fact Hans Conrad Julius Reiter (February 26, 1881 - November 25, 1969), who was a German physician, described the syndrome in 1916. Reiter was not the first person to describe this condition but he was an energetic and long lived self-promoter, and the name Reiter's Syndrome eventually caught on.

Reiter was also an enthusiastic supporter of the Nazi regime. He wrote a well known book on racial hygiene. He designed typhus inoculation experiments that killed more than 250 prisoners at concentration camps, like Buchenwald. He was later convicted of war crimes for his medical experiments at the concentration camp at Buchenwald.

In 1977, appalled by his war crimes, a group of doctors began a campaign for the term "Reiter's Syndrome" to be abandoned and renamed "reactive arthritis." In the last few years, the campaign to change the name to reactive arthritis has met with considerable success.

Personally, I already favored the term reactive arthritis, because I found that it enabled me to get better medical care. Now, having recently learned more about the name change campaign, I have one more reason to favor the name reactive arthritis. Thank you to Don Taylor who recently wrote me about Dr. Reiter's history, of which I was previously unaware.

Osteoarthritis - What Changes Will I Have to Make to My Lifestyle?


If you or someone you love suffers from arthritis, you (or they) are not alone. Chances are if you have arthritis, you may have osteoarthritis, the most common form of arthritis. Osteoarthritis, or OA, is a progressive degenerative disease which may eventually destroys the joints it affects. It affects over 20 million people in the United States, and becomes more common with age.

With osteoarthritis, the cartilage, or padding between the bones in the joint becomes worn and thin. This causes increased friction between the bones, which in turn leads to a loss of mobility in the joint. It may also cause new bone growths, or bone spurs, to form around the joints. The end result is you have a joint which is painful and does not move as well as it should.

The older you get, the greater your risk of osteoarthritis becomes. If you are overweight, you are greatly increasing your risk of being affected by this form of arthritis. Once OA begins, being overweight will accelerate the ravaging effects of this disease on your joints. Osteoarthritis can also be caused by joint injury, joint overuse, as well as chronic inflammation. Most commonly you will find symptoms of osteoarthritis in your hands, feet, spine, hips, knees and ankles.

Preventing Osteoarthritis

Prevention consists first of incorporating moderate, low intensity physical activity in your daily routine. Activities such as walking, biking, and use of home exercise equipment such as elliptical trainers or stair climbers performed throughout your lifetime has been proven to make a significant impact on preventing OA. Secondly, reducing your body weight decreases the risk of developing OA. Lastly, preventing injuries to the joints commonly affected by OA will improve the chances of avoiding it.

Managing Osteoarthritis

If it is too late for prevention, your greatest hope is managing your osteoarthritis, as there are no known cures for this condition. Management is available several different ways, depending on the contributing factors to your situation. If obesity is a contributing factor, reducing your weight will greatly reduce your pain and help slow the progression of damage within your joints.

There is no magic pill or bullet to help you lose weight. The best way for you to reduce your weight is through eating smaller portion sizes and increasing your physical activity level. A simple way to eat less is to eat 2/3 of your normal portion size. When done so regularly, you will decrease your food intake enough to help you decrease weight. The beauty of it is that you won't struggle with still feeling hungry after every meal.

Selecting more fruits and vegetables will also help you eat less, as they are dense foods - foods which contain a large volume of water. Dense foods fill you up faster and cause you to eat less at each sitting. Dark-colored fruits and vegetables, especially those that are blue or purple, have been found to be very rich in agents called phytochemicals, which are greatly beneficial to your health and well-being.

Physical activity doesn't have to mean exercise. Being physically active means movement more so then hitting the gym and "working out". Perhaps one of the best methods you can use to increase your physical activity is to begin using a pedometer. Keep track of the number of steps you make in a regular day over the course of two weeks. Then work to increase your steps by 3000 per day for the next 60-90 days. Once this new level of activity becomes habit, re-evaluate your level of activity and work to increase your steps again by another 3000 per day. If you really want to make this program work for you, get a friend to walk with you. Having someone hold you accountable is a great way to improve your compliance to any physical activity program.

Doing resistive exercises which target the joints affected by osteoarthritis has also been found to slow the progression of this condition. The key is to do one set of many repetitions at a very low amount of weight. Elastic bands or weights can be used, and you can very slowly increase the resistance over time.

Supplements which help protect the cartilage in the joints can also be very beneficial to arthritis sufferers. Glucosamine and Chondroitin Sulfate have been found to benefit the joints. Another supplement, known as SAMe, or S-Adenosyl-methionine, has been found to be a very effective, although more expensive, approach for osteoarthritis.

Relief from the pain of osteoarthritis without the side effects common to prescription medication can be found in topical analgesics that contain menthol, camphor and/or methyl salicylate. There does not appear to be any harm from using these products on a repeated basis, which lends to their strong popularity.

There are over 40 different medications are currently on the market which are commonly prescribed to deal with the effects of arthritis. Finding the one that is right for you can be expensive, frustrating and potentially dangerous. Getting relief from the aching in your joints as well as the muscle soreness that often accompanies stiff, swollen joints can be a daunting challenge.

Summary

Osteoarthritis is a challenging condition to treat. Exercise and topical pain relievers are the best non-prescription approaches to managing this disease.

Friday, January 10, 2014

NSAIDs For Canine Osteoarthritis Prove Effective But Not Without Major Risks


Non-steroidal anti-inflammatory drugs (NSAIDs) are the standard form of treatment for dogs suffering from osteoarthritis. For years, NSAIDs have been prescribed to dogs with this ailment because of their effectiveness in dealing with joint pain.

Over the years, however, more and more studies are emerging that NSAIDs may not be the best treatment for canine osteoarthritis after all. NSAIDs do work by blocking the formation of chemicals in a dogs body which cause inflammation of the joints and joint pain in the affected area. Just like in any disease, the best form of treatment for osteoarthritis should be something that works to repair the source of the disease itself, in this case, degenerating cartilage in the joints. NSAIDs cannot do that. All it can do is to try to stop the inflammation and control the pain. Common names of pain killers used in treatment are Rymadol, Tramadol, and Deramaxx. But take a look at these side effects direct from the Deramaxx web site:

Vomiting, anorexia, diarrhea, melena, inappetence, hematemesis, hematochezia, weight loss, nausea, gastrointestinal ulceration, gastrointestinal perforation, salivation. Hematological: Anemia, thrombocytopenia. Hepatic: Hepatic enzyme elevations, decreased or increased total protein and globulin, decreased albumin, decreased BUN, hyperbilirubinemia, icterus, ascites, pancreatitis. Neurological: Lethargy, weakness, seizure, ataxia, tremor, nystagmus, mydriasis. Sensory: Vestibular signs, glazed eyes, uveitis. Behavioral: Aggression, apprehension. Urinary: Azotemia, polydipsia, polyuria, hematuria, low specific gravity, urinary incontinence, urinary tract infection, renal failure. Cardiovascular: Bradycardia. Respiratory: Tachypnea, coughing. Dermatological/Immunological: Fever, edema, facial/muzzle edema, pruritis, urticaria, moist dermatitis, erythema, dermal ulceration/necrosis.

Half of these symptoms, I have no idea what they are, but I am certain they are of a detrimental nature to the happiness of your pet. Moreover, studies are also stating that NSAIDs may pose even more serious side effects that can lead to permanent damage in dogs. Such damages include ulcers, gastrointestinal bleeding, liver damage and kidney damage which can lead to death. While we will do anything to help our pets feel happy and pain free, this path of powerful drugs for treatment may be more than we bargained for.

Because of these side effects, more dog owners and more veterinarians are looking for alternatives to NSAIDs to help in dealing with canine osteoarthritis. The one that stands out as most effective and with few, if any, side effects, are natural supplements with glucosamine and chondroitin. Studies have concluded that the combination of these two supplements effectively control joint pain better than NSAIDs. Glucosamine treats osteoarthritis right at its source, the degenerated cartilage tissue in the dogs joints. Glucosamine is a building block of cartilage tissue and also acts as a catalyst to the formation of new cartilage tissue. In effect, glucosamine helps treat osteoarthritis by assisting in the repair of damaged and degenerated cartilage tissue.

As for chondroitin, chondroitin works by keeping harmful enzymes that cause inflammation away from the joints. It also aids in the tasks to be done by glucosamine by attracting liquids that will provide lubrication to the joints.

Glucosamine and chondroitin, as clearly stated above, treat osteoarthritis by dealing with the source of the ailment. Pain relief comes from healing, not masking pain.

Do glucosamine and chondroitin display side effects on the same degree as those of NSAIDs? The answer is that none are discovered yet, and most likely, there will be few and not nearly as severe as the side effects of NSAIDs. Glucosamine and chondroitin are natural compounds both found naturally in the dogs body.

Herbs For Arthritis Treatment


Many herbs have been utilized in the treatment of joint pains for centuries. Some of the very commonly used herbs for arthritis are alfalfa, angelica, black snakeroot, black rockweed, burdock, devil's claw, feverfew, ginseng, hawthorn, licorice, meadowsweet, oregano, prickly ash, rosemary, stinging nettle, turmeric, water shamrock, wild cucumber bark, wild yam, willow, wintergreen, yarrow, and yucca.

Alfalfa (Medicago saliva) is a folklore medicine for arthritis. The tea prepared from this plant is rich in nutrient minerals. The tea is believed to fight against arthritis. Angelica (Angelica archangelica) is an herbaceous plant, which has been utilized in the folklore medicine since antiquity in Europe. The Chinese variety (Angelica sinensis) has been widely used in China. Both the species are used in the treatment of arthritis. The root of black snakeroot (Cimicifuga racemosa) is used in the American Indian treatment for arthritis. All the five species of genus Cimicifuga have been used worldwide to treat rheumatism. Besides other anti-inflammatory and antispasmodic elements, the herb also contains aspirin-like components. Devil's claw (Proboscidea louisianica) consists of a good anti-inflammatory factor. Taking one gram twice a day would be effective in reducing arthritis pain.

Feverfew (Tanacetum parthenium) is a bushy aromatic European perennial herb, which is used against arthritis for centuries. Some of the clinical studies have proven that the anti-inflammatory action of this herb is greater than NSAIDs. Ginseng (Panax quinquefolius) contains components called ginsenosides that have numerous pharmacologic activities, especially effective against arthritis. Licorice (Glycyrrhiza glabra) acts as cortisone in the body without the injurious side effects. The plant has considerable anti-inflammatory activity. However, long-term utilization of the plant can induce an elevation of the blood pressure. Oregano (Origanum vulgare) is used as an anti-inflammatory agent. The reactions of free radical are likely involved in the degenerative arthritis. It may help to get rid of osteoarthritis and rheumatoid arthritis.

The tea prepared from rosemary (Rosemarinus officinalis) is used in the United States to treat arthritis. The four anti-inflammatory components of the leaves of the plant are earnosol, oleanolic acid, rosmarinic acid, and ursolic acid. Stinging nettle (Urtica dioica) is an approved remedy in the treatment of rheumatism in Germany. It is also very effective in the treatment of early-onset arthritis. The juice prepared from stinging nettle contains an anti-inflammatory agent, which is similar to steroid drugs. Turmeric (Curcuma longa) has substantial anti-inflammatory activity. It has been proven very effective against certain inflammations. The use of turmeric is quite safe.

According to some herbalists, the bark of wild cucumber, in the form of tea, is described as the best source for treating arthritis and rheumatism. Wild yam (Dioscorea villosa) contains a steroid constituent called diosgenin, which has anti-inflammatory features. The tea prepared from the plant is a famous folklore medicine for muscular rheumatism. Yucca (Yucca spp.) has been used for from ancient period to get rid of arthritic pain. We can list many other herbs, which are used against arthritis!

Foot Arthritis - How To Treat It?


Foot arthritis could be described as one of the more common forms of arthritis. The problem with the foot is that it consists of 28 bones and 30 joints, of which any are susceptible to arthritis. If arthritis develops in any of these joints, its going to affect the way you walk, run and move in general. The joints in the foot which are more commonly affected are: the big toe, the ankle, the mid foot and the hind foot joint.

The most common form of arthritis which develops in the foot is osteoarthritis. Osteoarthritis is the result of getting older, and essentially wear and tear on the joints and cartilage. The cartilage wears down, and the bones rub together resulting in pain and swelling.

Traumatic arthritis is a common form of osteoarthritis that develops in the foot of a patient following some form of severe injury. This can develop in the foot even when the injury was treated correctly, and given time to recover fully. The most common forms of traumatic foot arthritis are a torn ligament, broken bone or severe sprain.

There are various symptoms and indications of foot arthritis, which should alert the sufferer to the condition immediately. These symptoms include swelling, tenderness, pain, stiffness and reduced mobility of the affected joint. All these symptoms will eventually lead to a difficulty in walking.

For a doctor to properly diagnose foot arthritis, a serious of tests and physical examinations will need to be performed. The doctor will also require information about your health and lifestyle to give clues on the complexity of the condition. The next step is to perform a walking analysis. In performing this walking analysis, the doctor will measure your stride and test your ankle and foot strength. Certain diagnostic imaging tests may also be required to further diagnose your condition- theses may include and X-Ray, CT or MRI scan.

After fully evaluating your foot arthritis, your doctor/physician will devise the most suitable treatment plan. There are many non-surgical treatments available, these include:

Taking anti-inflammatory medication

Steroid injection

Foot brace or cane usage

Ankle and foot support usage

Physical therapy

The final treatment option is surgery, and is generally reserved as a 'last resort' when all other treatment methods have failed. The key to effectively treating arthritis is early diagnosis. Don't ignore those sensations of stiffness and soreness; see a doctor as soon as possible, so that you have the best chance of treating your foot arthritis.

Arthritis Treatment: What About the New Oral Medicines for Rheumatoid Arthritis Treatment?


Rheumatoid arthritis (RA) is the most common inflammatory form of arthritis, affecting more than two million Americans.

It is a chronic, systemic, autoimmune disease that affects not only joints but internal organs as well. Among the organ systems that can be affected are the eyes, lungs, skin, bone marrow, peripheral nervous system, heart, spleen, as well as others. Recent evidence suggests that one of the deadlier side effects of RA is the premature development of cardiovascular disease leading to an increased incidence of stroke and heart attack.

Because of the tremendous advances in treatment of RA over the last 50 years, it has been possible to take patients with this disease and put them into remission.

The first milestone came in the 1980's with the use of methotrexate. In the late 1990's biologic therapies came onto the scene. It was with this combination of therapies that talk of remission came to be a common point of discussion among rheumatologists.

Now there is more good news in that oral drugs, called signal transduction inhibitors, are an emerging therapy with a novel mechanism of action. By interfering with the transcription of important proteins inside cells, these drugs block the development of immune cell growth and survival.

By targeting a pathway called "JAK-STAT", these medicines lead to reduced inflammation and therefore less joint destruction.

Efficacy-wise, these new medicines are equivalent in their effectiveness compared to biologic drugs in patients who have failed methotrexate. Measures that have been studied include clinical markers such as the American College of Rheumatology criteria for 20/50/70 response as well as functional measurements such as the Health Assessment Questionnaire, among others.

Another pathway that has been researched with the production of an oral drug is the Syk pathway. This is another signal transduction medicine which has effects on B-cells, macrophages, and synoviocytes (cells that line the joint).

As can be imagined these new oral drugs do have potential side effects that must be more clearly elucidated.

And though available therapies are very effective, they don't lead to remission in all patients. And a significant percentage of patients develop side effects that preclude continuation of the drug, in which case remission will not be achieved.

The bright light is that ongoing research into biomarkers of disease will eventually lead to a more personalized approach so that the "right medicine for the right patient" will permit not only remission but also, possible, cure.