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Alternative Treatments for Arthritis

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Inflammatory conditions like rheumatoid arthritis are currently treated with drugs — painkillers, steroids and what are known as biologics, or genetically engineered proteins. But such medicines are often expensive, hard to administer, variable in their efficacy and sometimes accompanied by lethal side effects. Which is why, physicians are now leaning toward a measured use in combination with an array of alternative therapies – from electrical stimulation to pain pumps – for arthritis pain relief.

Here’s a list of current innovative therapies that look promising:

Topical Medications: Gels, creams and patches that are applied to the skin supply sodium channel blockers, such as lidocaine or prilocaine. They work by numbing nerve endings close to the skin. Topical NSAIDs work by reaching the joint fluid and decreasing inflammatory proteins like prostaglandins, providing a direct anti-inflammatory effect.

Transcutaneous electrical nerve stimulation (TENS): As pain is carried on small fibers called C fibers,and other sensations are carried by larger fibers, the current is transmitted through the larger fibers, which supersedes the smaller fibers, essentially shutting out the pain. The electrical current also stimulates the nervous system, possibly stimulating the brain to release endorphins and enkephalins, opiate-like substances that relieve pain.

Steroid Injection: Steroids, or corticosteroids, such as cortisone, hydrocortisone and prednisone, are synthetic versions of the hormone cortisol, which reduces inflammation. Steroid injections provide long-term relief for those suffering from inflammatory joint pain. Steroid injections work for anyone with inflammatory arthritis and can also be used for juvenile arthritis (JA).
Hyaluronic acid injection: Hyaluronic acid (Synvisc, Hyalgan, Supartz) is a slippery, viscous fluid that is a component of natural cartilage. Hyaluronic acid injection may help damaged cartilage by increasing its nutrition and overall health. It can help cartilage regenerate, but the effectiveness [of the injections] varies from patient to patient.

Exercise/physical therapy: Physical therapy is a treatment that uses exercises designed to improve posture, strength, function, range of motion and to reduce pain. It boosts energy and mood as well. A patient who is new to exercise might begin a program of strengthening, stretching and aerobics by seeing a physical therapist twice a week for 12 weeks. Exercise works for any kind of arthritis, including OA, rheumatoid arthritis (RA) and ankylosing spondylitis.

Heat/cold: As muscle spasms can cause basic constriction of blood flow, heat works by increasing the blood flow to the [painful] area, relaxing the muscles. Cold sensations travel along large nerve fibers, superseding pain sensations that travel along smaller fibers. Cold also reduces swelling and inflammation by constricting the blood vessels. Heat works better than cold for osteoarthritis pain. Heated paraffin wax baths can be helpful for patients with RA, especially their hands – as long as they’re not having a flare. Cold works best for inflammation caused by injuries like sprains, strains and pulled muscles and ligaments.

Trigger point injection: In this therapy, a physician injects anesthesia such as lidocaine, or anesthesia plus a corticosteroid, into muscle. As trigger points are bundles of muscle that are painful, putting a needle into the trigger point allows the muscle tissue to go back to its normal structure. An injection can relieve pain for weeks or months. Stretching and exercising the muscle afterward helps the injection’s effect last longer. It can work for any kind of muscle pain caused by arthritis, except fibromyalgia.

Nerve block: Nerve blocks are used to block pain and also to help physicians pinpoint where certain pain is coming from. A doctor injects a local anesthetic, or a mixture of local anesthetic plus a steroid, into a nerve. The anesthetic stops the conduction [of signals] along the nerve, and the steroids help [calm] the inflammatory tissue.

Acupuncture: An ancient Chinese therapy that involves placing tiny needles along meridians in the body to release trapped energy or chi. Placing the needles increases the production of endorphins, morphine-like substances that are natural pain relievers. It also increases the blood flow to the area, and helps get rid of by-products like lactic acid that cause pain. Acupuncture is appropriate for any kind of arthritis pain – almost any kind of pain.

Peripheral nerve stimulation: A physician implants a trial electrode just under the skin along a painful peripheral nerve (any nerve outside the brain and spinal cord) that receives electrical signals from a small battery-operated generator. If the pain is relieved after a week-long trial, the electrode as well as a small generator are permanently placed.

Pain Pump: A doctor implants a small pump programmed to deliver varying amounts of pain medication, such as morphine or baclofen (a muscle relaxant), through a catheter threaded into a space around the spinal cord. The pump delivers narcotic medication directly to a painful area so that a patient has fewer systemwide side effects than she would with oral narcotics. It’s used increasingly for low-back pain that could be caused by osteoarthritis or spinal arthritis

Facet joint denervation: A physician uses radiofrequency heat energy to destroy painful nerves that supply the facet joints, or the paired joints at the back of the spine. This therapy is very useful for patients with OA in the facet joints, and can be used for multiple kinds of arthritis. It’s typically used for back pain.

Deep brain stimulation: This invasive therapy is used only when all else fails. A neurosurgeon implants an electrode in a part of the brain such as the thalamus. A wire from the electrode is placed under the skin of the head, neck and shoulder, connecting to a generator, which is usually implanted under the skin on the chest. The continual impulses disrupt pain messages that the thalamus would otherwise send to the cortex to be interpreted as pain.

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This web site is run by an Arthritis Specialist based in Dubai, United Arab Emirates. On this site you will find news about the latest in arthritis, information about research results in the field, tips and information and diet and exercise, and much more.

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This web site is run by an Arthritis Specialist based in Dubai, United Arab Emirates. On this site you will find news about the latest in arthritis, information about research results in the field, tips and information and diet and exercise, and much more.

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