What are your symptoms of arthritis and choices for treatment?

Apr 21, 2020

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

Team by team, reporters baffled, trumped, tethered, cropped. Look at that low plane, fine, then uh oh, overflow, population, common group but it'll do. Save yourself, serve yourself world serves its own needs. Listen to your heart bleed. Tell me with the Rapture and the reverent in the right, right. You vitriolic, patriotic, slam fight, bright light feeling pretty psyched. It's the end of the world as we know it. It's the end of the world as we know it. It's the end of the world as we know it and I feel fine. What's your favorite pandemic song? As you may have guessed, I'm really leaning toward REM's -It's the End of the World as We Know It.

My mom has arthritis in her knees, but like the many other people with arthritis, it doesn't have to be the end of the world. What is arthritis? Arthritis means "inflammation of the joint". As the Arthritis Society points out, arthritis encompasses over 100 conditions ranging from tennis elbow, and gout on the mild end to severe crippling forms of rheumatoid arthritis and arthritis related disease like systemic lupus erythematosus. We are going to talk about the two most common types of arthritis: osteoarthritis and rheumatoid arthritis. Osteoarthritis (OA) is a complicated disease, but at its simplest, it is when the cartilage in a joint wears out and bone rubs on bone. Rheumatoid arthritis (RA) is an autoimmune disease condition in which the body's own immune system attacks the lining of the joints.

If the joint wears out in osteoarthritis, what is a normal joint like? In a normal joint, a tough, smooth, elastic-like material called cartilage lets the two ends of the bones in the joint slide by each other with almost no friction. As cartilage wears down, bits can break off and go into the soft tissue around the joint and cause pain. I was surprised to learn that cartilage itself doesn't have any nerve endings, so it doesn't feel any pain. The pain from OA is from the cords that connect muscle to bone (tendons), bone to bone (ligaments) and the muscles which are forced to work in ways they weren't designed to because of the cartilage break down. When the cartilage breaks down so much that bone rubs on bone, the bone can thicken and form spurs.

What symptoms might I have with osteoarthritis? Pain, stiffness and swelling around a joint that lasts longer than 2 weeks. Unlike rheumatoid arthritis, morning pain and stiffness usually lasts less than 30 minutes. Although there can be swelling around the joint in OA, it is usually less than that expected in rheumatoid arthritis. The joints usually affected are the hips, knees and spine. Finger and thumbs joints may also be involved.

Rheumatoid arthritis (RA) is an autoimmune disease condition in which the body's own immune system attacks the lining of the joints. The first symptom a patient might notice is pain in the hand or foot joints but can also affect other joints. Unlike osteoarthritis, in rheumatoid arthritis, morning stiffness usually lasts longer than 30 minutes. The pain of RA can be in 3 or more joints at the same time. (Often osteoarthritis effects only one joint like a knee.) The pain from RA can last all night long. The pain from RA can be symmetrical on both sides of the body. That means, for example, both your wrists are sore. Other symptoms a person might experience include fatigue, dry eyes, dry mouth, fever and/or chills. RA can cause the immune system to attack other internal organs like the eyes, lungs and heart.

Treatment for both types of arthritis often starts with non-steroidal anti-inflammatory drugs or NSAIDS like ibuprofen, diclofenac or naproxen. These medications can work well for the pain and inflammation but have side effects like stomach upset, risk of ulcers, and risk of increasing blood pressure. In osteoarthritis sometimes synovial fluid replacements can be injected directly into the joint and help lubricate it. It can be effective. It is used most often on knees and it is expensive. In rheumatoid arthritis the body's own immune system is attacking the joints. The most common medication to calm the immune attack in mild RA is hydroxychloroquine and is generally well tolerated. For moderate RA, methotrexate once a week is very common and seems to work very well. Because these drug must modify the immune system, they can take 6 weeks to 6 months to work.

Strange and beautiful are the stars tonight that dance around your head. In your eyes I see that perfect world. I hope that doesn't sound too weird. And I want all the world to know. That your love's all I need. All that I need. And if we're lost. Then we are lost together. Yea, if we're lost. Then we are lost together. You know what? Blue Rodeo's Lost Together is a pretty good pandemic song too. Maybe Al Gaines at CKDM should put together a pandemic playlist for the Parkland. What do you think Al?

The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

For more information visit www.arthritis.ca

As always if you have any questions or concerns about these or other products, ask your pharmacist.

 


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