The Pros and Cons of Arthritis Injections

In the treatment of musculoskeletal problems, cortisone injections may be extremely effective. Also called corticosteroid injections, they provide a focused anti-inflammatory effect aimed at providing pain relief for patients that is coming from a joint problem, such as osteoarthritis, or a soft tissue problem, such as lateral epicondylitis (tennis elbow).

The medication in a steroid shot contains some of the same hormones that the human adrenal glands produce. These hormones, corticosteroids, perform vital functions in the body, such as being released and providing anti-inflammation when stress is experienced.

These injections into either joints or soft tissues provide pain relief, but it is not permanent. The effects wear off after a few weeks to months, and it may actually take a few days for the pain relief to kick in. Typically some numbing medicine is included with the steroid to give immediate relief.

Patients frequently ask if the cortisone will help with cartilage restoration. Steroid injections are not disease altering treatments, they are simply symptom altering and meant to decrease pain.

So what are the benefits of a steroid injection?

1. Pain relief - This is the main benefit, as the injection of steroid doesn't alter the course of arthritis. But it does make life more tolerable by decreasing pain for what may be quite a few months.

2. Low Risk - Compared with surgery for a musculoskeletal condition, an injection maintains a much lower risk profile.

3. Low Cost - Also compared with surgery, an injection cost exponentially less.

4. Focused Injection - The steroid is injected into either a joint which is a confined space or into a soft tissue area where the medication stays predominantly local.

5. Outpatient - The injections are done either in the doctor's office or as an outpatient procedure. No overnight stays necessary.

6. Can delay the need for surgery - If a patient is in his 50's and has terrible osteoarthritis, doing a knee replacement may only last for 15 years. This may lead to the need for a revision surgery which typically has a less satisfactory result. So the injections may provide an impressively tolerable delay for years.

7. Can be placed in multiple joints - If a patient has pain and arthritis in multiple joints, such as the knees, shoulders, and spine, steroid injections may be placed in a few joints (with appropriate care not too many at once)

What are the risks of a steroid injection?

1. Temporary blood sugar elevation - this is most common in diabetics and may raise blood sugars temporarily for 24-48 hours. It would be unusual for this to be an actual clinical problem, but people should be aware of the potential temporary issue, especially diabetics.

2. Cartilage damage - It's unclear in humans if this is clinically relevant. In animal studies there has been shown cartilage alterations with repetitive injections. The key here is moderation with the amount of injections administered to each joint.

3. Adrenal gland suppression - this type of complication may occur with oral steroid medication on a repetitive basis, it would be extremely unusual for a focal steroid injection to end up with this complication.

4. Infection - with appropriate sterile technique obtaining an infection after a steroid injection is rare, much less than 1%. Prophylactic antibiotics are not necessary.

For most individuals, cortisone injections represent an excellent pain relief option for musculoskeletal conditions. The key is moderation.

Is Arthritis Hip Pain Grinding You Into Submission? Discover What's Behind it and End Your Pain Now

Do you know if you are experiencing arthritis hip pain? Many people don't understand the very symptoms of arthritis hip pain; consequently, they may blow the symptoms off as "just some nagging injury that will heal up" or "I must have twisted my hip a little, I'll be alright in a few days".

But if you really are experiencing arthritis hip pain, not the effects of an injury, you can't treat that pain in your hip the way you might have always treated it before. If you've got pain in your hip due to arthritis, it is probably a form of rheumatoid arthritis. And while men can and do certainly get rheumatoid arthritis in their hips and elsewhere in their bodies, it is a fact that about 75% of "rheumatism" sufferers are women--especially when it comes to the hips. Why this is so is essentially a mystery, but we know that it's a fact. Therefore, the first hint that the pain in your hips might be arthritis is your being female.

Rheumatoid arthritis, as doctors will tell you, is possibly a conglomeration of several diseases all at once, for while it is based in inflammation it also directly affects the immune system--and affects it for worse, not better. When you get this disease in your joints, such as your hip joints, you may experience limitations on your hips' range of mobility as well as tenderness and the obvious pain caused by inflammation. If you suspect that you are experiencing arthritis hip pain, you should go to your doctor immediately. X-rays can determine if there is wear and tear on the joints because of damage done in that area to tendons, cartilage, ligaments, and bone. Once this damage is done, arthritis hip pain can arise because of circumstances similar to what happens when the break pads on your car wear out and suddenly the metal bar is pressing directly against the inner part of your tires. Your pain is like that "squeal" sound or, if things get really bad, just like your breaking bar pressing metal-to-metal--wearing out your tires quickly and causing you to be unable to stop properly. This is why your range of motion is compromised--and, it's the source of the intense pain that you feel.

Rheumatoid arthritis is so sinister because it can come on without any warning. There are people suffering from arthritis who have gone to bed fine one night and woken up in the morning with sudden aches and pains, loss of mobility in the joints, low-level fevers (a possible arthritic symptom), and fatigue (another possible symptom). Arthritis in the hips can cause the hip joints to become destabilized and even deformed. This could clearly lead to loss of walking speed, diminished ability to balance which could be especially dangerous in certain places such as when taking a shower, and perhaps, eventually, the need to use a cane or be in a wheelchair.

If you have pain or tenderness in your hips and you suddenly cannot move your hips as you usually could, first consider if you've done something to injure yourself. But, if you cannot rationally figure out how you did this, then you must get to your doctor right away and check for it being arthritis hip pain. Remember, this condition can come on literally overnight, although of course it has built up to that point over time. There are steps you can take to diminish the pain and perhaps even keep it at bay. But arthritis hip pain is nothing to be taken lightly or ignored

Arthritis - Hidden Enemy Inside Us

Arthritis can be a nasty disease to have to deal with and can cripple you at times making it difficult just to get out of bed. There are over 100 different types of the disease and it may affect many different parts of the body. The most common strains are osteoarthritis, rheumatoid arthritis, gout arthritis, and lupus. Many people have arthritis in hands, elbow arthritis, arthritis in feet, arthritis in spine along with knees, shoulders, fingers, hips and most other joints. Arthritis causes intense joint pain and inflammation. Some of the symptoms may include joint pain and stiffness, painful swelling and inflammation, tenderness, fever, chills, loss of appetite, weight loss, anemia, and rash. Some of these symptoms only pertain to a certain strain of the disease. Arthritis joint pain can be described in many different ways. Some describe the pain as aching and deep in the joint, while others describe the pain as sharp and persistent.

There are many available arthritis treatments including pain medication and anti-inflammatory drugs that help reduce the inflammation in the joints as well as reduce the pain. Some times over the counter pain medications can factor greatly in arthritis relief. Another common treatment is physically therapy. There are many arthritis remedies, but always make sure you are well informed of the risks of the type of remedies you are trying. It is always best to consult your doctor if you are unsure if something is safe for you to take. There are also certain arthritis diets that are circulating. Sometimes diet can effect the disease depending on the type of arthritis you have. Ask your doctor if you should try to change your diet to help with your disease.

It is very important to keep the joints active to prevent them from getting stiff. Some arthritis causes are: genetics, age, weight, injury, occupation, and illness or infection. It is hard to determine how much or how little these factor into the arthritis diagnosis. Many people claim to have an arthritis cure, and while there are many claims most types of the disease do not yet have a cure. Early detection and proper treatment is the best way to control your ailment.

There is a lot of information on arthritis and many programs to help suffers deal with the disease. The Arthritis Foundation which was founded in 1948 is a charitable not-for-profit organization whose aim is to help prevent, control, and cure the disease, and to make living with the disease easier. The foundation provides public education, research, and even create an action plan to help attack the disease. This disease is the leading cause of disability in the United States. The foundation produces books and a magazine. They also organize many events including wine tasting, galas, and walk/run events.

The Dangers of Chronic Inflammation

What would you consider a serious danger to your health? You were probably thinking about Heart attacks, strokes and cancer; right? Would it surprise you to know that one of the greatest threats to our health is chronic inflammation? All of us experience inflammation of one kind or another at some point in our lives; surely it cannot be very dangerous. Well, there are times where inflammation can be beneficial, and there are times that it can be harmful.

Inflammation is one of the bodies first responses to any kind of damage. If you were to cut your finger, bump your head or break an arm, within minutes that whole area starts to swell and become a red. This is a process where the body's white blood cells, oxygen and chemicals are pumped to the wound, and the active inflammation protects us from infection and foreign substances such as bacteria. Once the white blood cells have done what was needed and the wound starts to heal, the swelling then subsides. In some cases, the body's defense system triggers the inflammatory system's response when there are no foreign substances to fight off. Certain diseases can cause this to happen and they are called autoimmune diseases. In this case, the body's immune system, which is meant to protect it, causes damage to healthy tissue.

Arthritis is a disease that is most commonly linked to chronic inflammation. The term arthritis is a general description of inflammation of the joints. However, not all types of arthritis are a result of inflammation. Inflammation of the joints can occur when an increased number of cells and inflammatory substances from within the joint cause irritation and wearing down of the cartilage. When enough damage has been caused, swelling occurs in the lining of the joints. The types of arthritis caused by inflammation include rheumatoid arthritis, shoulder tendinitis, gouty arthritis and Polymyalgia rheumatic.

Chronic inflammation can also have a detrimental impact on internal organs. Inflammation of the heart is known as myocarditis and can cause shortness of breath or swelling of one or both legs. Inflammation of the bronchial tubes located in the lungs, disrupt the absorption of oxygen and can lead to an asthma attack. Inflammation of the kidneys sustained over a period of time can lead to high blood pressure and eventually kidney failure.

A growing number of medical practitioners are starting to understand the consequences of chronic inflammation and the risk that it poses to human health. If doctors are now getting concerned, then surely we need to as well. We need to ask ourselves why we develop chronic inflammation and how we can prevent it. Did you know that information can cause premature aging? No amount of anti-aging creams or plastic surgeries will help if you cannot keep inflammation under control. The only way to do this is to take control of our health and ensure that we detoxify ourselves on a regular basis. It is only by keeping toxicity levels low that we can avoid chronic inflammation and premature aging.

What's New for Osteoarthritis Treatment?

The American College of Rheumatology meeting, held in Atlanta, Georgia, from November 7 through November 11, 2010 provided some new modest advances in the understanding of osteoarthritis.

Osteoarthritis is characterized by the gradual wearing away of articular cartilage the gristle that caps the ends of long bones. Osteoarthritis primarily affected weight-bearing regions such as the neck, low back, hips, and knees.

Osteoarthritis is the most common form of arthritis and affects more than 20 million Americans and is expected to increase in frequency as Baby Boomers continue to age.

The aim of treatment in osteoarthritis is to provide pain relief and improve function. However, the ultimate goal has always been to restore articular cartilage.

Some important highlights from this year's meetings were:

1. The demonstration that genetic markers called "SNPs" may provide clues as to why some people develop osteoarthritis more readily than others. So, in addition to trauma to the cartilage, which is a known risk factor for the development of osteoarthritis, there also appears to be a genetic predilection for the disease. Perhaps, in the future, patients who are at higher risk for contracting osteoarthritis might be identified and treated more aggressively.

2. Cymbalta (duloxetine), a drug already approved by the FDA for treatment of major depressive disorder, fibromyalgia, and diabetic peripheral neuropathy, was approved by the FDA for treatment of chronic musculoskeletal pain, including pain resulting from osteoarthritis and chronic lower back pain. The efficacy of Cymbalta for chronic lower back pain and osteoarthritis were assessed in four double-blind, placebo-controlled, randomized clinical trials. Patients taking Cymbalta in these trials experienced significantly greater pain reduction compared with placebo.

3. Data on Naproxcinod, a unique non-steroidal anti-inflammatory drug was presented. Naproxinod is the first cyclooxygenase inhibiting nitric oxide donator (CINOD) in development for the treatment of osteoarthritis. It was found to be comparable to naproxen in its ability to relieve the pain of hip osteoarthritis, while causing fewer adverse effects on blood pressure.

4. The popular "new kid on the block", vitamin D, suffered a blow to its reputation. Supplementation with vitamin D was unsuccessful in helping patients with osteoarthritis of the knee overcome pain in one study presented from Tufts University.

5. The use of ultrasound to guide knee injections for osteoarthritis treatment led to a 42 percent reduction in pain, a doubled response rate to therapy and a 15 percent reduction in cost to patients, compared with conventional injections guided by "feel."

6. Pennsaid, a relatively new topical agent which combines the anti-inflammatory effects of diclofenac with the penetrating power of DMSO presented some encouraging data on pain relief for osteoarthritis of the knee.

7. Another study showed that Lidoderm patches provide another possible options for knee osteoarthritis pain relief and were superior to placebo.

8. Researchers from Rush Medical School in Chicago recently studied the gaits of 16 adults who, through x-rays and reported symptoms, were diagnosed with osteoarthritis of the knees. The researchers found that special shoes can ease knee pain and slow the progression of knee pain and arthritis.

9. A study from the Netherlands showed that distraction of the knee ( using pins to open the knee joint) actually led to cartilage growth and improvement of symptoms as well as avoidance of the need for knee replacement.

10. Two presentations on mesenchymal stem cells provided hope that in the near future, the ability to regenerate cartilage to treat osteoarthritis is a possibility. The first was a talk given by Dr. Nathan Wei, from the Arthritis Treatment Center in Maryland, who presented data on 22 patients treated with mesenchymal stem cells for osteoarthritis of the knee. At six months and at one year following treatment with autologous stem cells (a patient's own stem cells), patients showed improvements in both subjective measures as well as objective measures of cartilage growth. The second talk given by Dr. Rocky Tuan from the University of Pittsburgh, demonstrated that transformation of adult mesenchymal stem cells into human articular cartilage was not only possible but relatively easy.

Gluten Free Might Help Your Arthritis Condition

For some people it is hard to believe that gluten can cause so much destruction. When we tell people that in order to treat a serious condition like arthritis, inflammation and pain, a few serious dietary measures are needed. Giving up gluten might be one of them.

When someone first hears they have to give up gluten which mean mainly wheat (but also includes rye, barley and oats), you can hear the panic in their voices "there is nothing left for me to eat". Most people find it unbelievable and unacceptable that their diet has made them ill often refusing to consider giving up anything you suggest especially wheat, at first. Yet the scientific evidence and our experience with dealing with patients with auto-immune disease it makes a huge difference. After a little while people come around to the idea of gluten-free might be worth it in order to become pain-free or at the very least drastically reduce their suffering.

There are several things this outburst reveals. We already know that wheat is addictive, and most people are addicted to it. The fact that someone says 'but there is nothing left for me to eat' means they are not eating enough variety in their diet, this is typical.

I'll give you an example - we all know pineapple is good for you, so I recommend you eat it 7 days a week 3 or 4 times a day, you would think I was crazy. Of course I would never suggest such a thing. Yet, people do this with wheat 7 days a week 3 to 4 times a day! And patients think I am mad? What do I mean - breakfast cereals, sandwiches, toasties, pasta, pizza, biscuits, cookies, crackers, pastry, dumplings, pancakes, muffins, cakes, dough-nuts, pretzels etc. This list is almost endless, as there are also products that contain some gluten - like sauces, gravy, sausages, fish in batter or chicken coated in bread crumbs, how did we end up drowning in wheat?

The other reaction I get from patients "but I don't have celiac disease also known a spurs!" You don't have to have full blown CD to have a problem with gluten. CD was once thought of as rare and only suspected in children, today it is considered more common and is most often undiagnosed or misdiagnosed, whereas gluten sensitivity is very common indeed, causing all sorts of havoc and destruction. We have seen, as have other practitioners, patients vastly improve on a 'gluten-free diet' that have had the tests and were told they did not have CD. Yet they vastly improved, because you can have intolerance to gluten a Non-Celiac Gluten Sensitivity, setting up the same symptoms as CD.

I discovered about 7 years ago I had celiac disease, as naturopath I had been eating ultra well for years many, giving up wheat completely at least 10 years earlier. I did eat oats and rye sometimes. I became very tired which was a surprise as I ate really well and always felt good. A very rare visit to the doctor revealed anemia, that surprised even more as I did eat lamb and plenty of green vegetables. I then was diagnosed as having celiac disease, I immediately gave up all gluten and in no time without iron tablets my hemoglobin levels were high again.

For those people who are gluten sensitive and it is much more common than you realize, by continuing to eat gluten is putting yourself at higher risk of auto-immune diseases, and if you have a form of arthritis I suggest you consider sooner than later, going gluten-free.

The Paleo Diet: Arthritis, Inflammation, and Food Allergies, Help, or Hype?

Everywhere you look there is a "new" weight loss, health promoting, or performance enhancing diet. "The Paleo Diet," (Paleo: being before the agricultural revolution) created by Dr. Loren Cordain is gaining a lot of buzz. It is promoted as an anti-arthritis diet.

In this diet, Dr. Cordain outlines a "hunter-gatherer" diet plan, claiming to help people optimize health, minimize risk of chronic disease, reduce inflammation, and lose weight. It is based upon common, modern foods, which mimic the food groups of our (pre-agricultural) ancestors. The concept is, "If the cavemen didn't eat it, you shouldn't either."

This is due to the high correlation between inflammation of the gut and joints. Autoimmune problems are thought to result from lectins, a protein often found in grains. When consumed in large quantities, these lectins could lead to increased inflammation. Wheat contains both gluten and lectins, and intolerance to both gluten and dairy lectins have been connected to arthritis.

A diet too high in omega-6 fatty acids and too low in omega-3 fatty acids can also promote inflammation. Omega-3 fats are known to reduce inflammation, while overconsumption of Omega-6 fats has been linked to arthritis inflammation. Processed oils such as corn, soybean, and vegetable oils contain high levels of Omega-6's, unlike butter, olive oil, or coconut oil. Both fats are necessary, but in a proper ratio. Creating a smart balance can help improve health.

While interesting in theory, it is not a magic bullet. Eating and exercise patterns have changed dramatically since prehistoric time. Because our lifestyles are different from our Paleolithic ancestors, so are our nutritional needs.

(Pros) The Paleo Diet:

1. Promotes eating natural foods, needed to maintain health. The body and brain work in harmony, and all-natural foods promote functioning, whereas highly processed foods can cause dysfunction.


2. Uses protein as the mainstay of the diet, and decreases carbohydrates and processed foods. This ratio of protein to carbs, was seen more in our earlier ancestors.


3. Lowers the chance of health problems due to food intolerance. For people with arthritis, food allergies or sensitivities, (especially to gluten, nuts, additives, dairy, artificial preservatives, or refined carbs) such restriction can create a noted health advantage.


4. Encourages lower carbohydrate intake and lower glycemicfoods. Foods low on the glycemic scale are digested and absorbed more slowly, so they do not spike blood sugar.


5. Creates a high fiber intake, which is essential for good health. Whole grains, fruits, and non-starchy vegetables are excellent options to increase fiber; they promote intestinal health and reduce inflammation.


6. Does not demonize healthy fats. Encouraging and allowing monounsaturated and polyunsaturated fats with balancedOmega-3 and Omega-6 fats, offers a cardiovascular benefit.


7. Promotes a net dietary alkaline load, tobalance dietary acid.This offers a range of health benefits such as stronger bones and muscle, lower blood pressure, and a decreased risk for kidney stones.


8. Increases potassium intake and decreases sodium intake. Unprocessed, fresh foods contain 5 to 10 times more potassium than sodium, (a ratio to which Stone Age bodies were adapted).

(Cons) The Paleo Diet:

1. Demonizes Dairy (a healthy food group). Unless you have a true sensitivity, there is no need to exclude dairy, which serves a distinct purpose in the diet. It provides essential nutrients the body needs to function properly.


2. Excludes potatoes, legumes, and peanuts. While higher in glycemic value, potatoes are a natural starchy vegetable. All natural foods should have a place in healthy diets. Learning when, and how to place them in your diet, would provide more benefit than excluding them.


3. Is restrictive. It provides a list of off-limits foods (many of which are natural and healthy). Not everyone is willing, or able to withstand this, making adherence a problem. Processed foods, sugars, and starches are not allowed. For some this would be a deal breaker.


4. Does not emphasize the role of exercise and leading an active lifestyle. Diet is only one component of living a healthy lifestyle. Any plan that does not include the role of movement, in one's life, should be looked at with skepticism.


5. Does not address or take into consideration, the mental component of eating. While a scientific approach is taken, the mental attachment to food can often override what we understand to be beneficial. By not offering support or accountability, this plan leaves room for a high drop out rate.

The bottom line is, if you are looking for a different approach to eating, have some food sensitivities or arthritis, need structure, and would be willing to restrict your food options, this plan could provide the health benefits claimed by the creators.

However, a half-hearted attempt could lead to more frustration and perhaps additional pounds. Keep in mind, healthy eating is not something you do TO yourself, but FOR yourself. Finding a method that works in your lifestyle, makes that possible. Here is a general checklist for evaluating any healthy living plan. Does it:

1. Increase healthy, natural, and unprocessed foods choices (not restricting any one food or group).

2. Decrease highly processed foods, sweets, and calorie dense food options.

3. Guide you to stay mentally engaged to what and why you eat, along with providing support and a means for accountability.

4. Encourage you to create, and stick to a plan to move more daily.

5. Allow you to make wise choices 80% of the time and allow 20% of the time for indulgences.