>>>>March 26, 2002 -- When it comes to treating arthritis pain, it is important to "hit early, hit hard," say experts at the American Pain Society. New guidelines call for more aggressive treatment of arthritis pain and earlier use of surgery for those who get no relief from drugs. The guidelines state that a group of anti-inflammatory drugs called Cox-2 inhibitors, such as Celebrex, Vioxx, and Bextra, be the first method of treatment for moderate to severe long-term pain.<<<<<
These guidelines seem somewhat influenced by the pharmaceuticals. In a physician's journal called "Geriatrics" dated in Aug 2000, it mentioned a rather decent sized study in 2000, which showed that exercise was a key factor in not only controlling pain but also in avoiding joint replacements. Participants of the experimental group who exercised in what could be called a very "light" exercise program (basically a couple of times a week) and did some light stretching, had a SIGNIFICANTLY lower percentage of joint replacements (like 5 percent as opposed to 20 percent in the controls who did not exercise).
The new guidelines also call for earlier surgery. People seldom know that when they go into joint replacements, this means that there is basically nothing they can do, exercise-wise, to reduce wear on these and that they need to be surgically replaced every 15 years or so. For instance a friend of mine had knee joints replaced when he was in his forties. He's now 79 and needs replacements again for the THIRD TIME, only the doctors don't want to operate because he had coronary bypass surgery in 1991 and since then, has been in and out of the hospital getting stents inserted and only a few months ago, had an aneurysm so is too high risk. He has to either take a very big risk of surgery or endure the pain. He's starting walking with a cane to ease the discomfort.
This suggests that for many individuals, early surgery may not be appropriate except for increasing the income of the surgeons. I think it's important to try as hard as one can to preserve the joint. For those whose joints are gone, the artificial joints are a Godsend but not something to be taken lightly.
Also, the Cox 2 inhibitors are NOT easier on the stomach than aspirin and the small print on inserts and even the ads do state this.
Here's the deal. Cox 1 and Cox 2 are two enzymes which when suppressed somehow effect the pain centers of the brain causing us to feel less pain and also reduce inflammation. But another "duty" they have is to cause the stomach cells to secrete the protective mucin lining - this lining protects the stomach from being damaged by the low PH (2.2.) in the stomach (very acid) during digestion.
Aspirin is a Cox-1 and Cox-2 inhibitor.
Since Cox-1 is the enzyme which actually causes the secretion of this mucus lining, someone figured that a medication which ONLY inhibited Cox-2 would cause the pain relief and relief of inflammation while allowing Cox-1 to continue producing the protective lining. Hence the birth of the "super aspirin" like Celebrex.
Unfortunately, they found out in studies after the medication was released that people were experiencing bleeding of the stomach while taking Celebrex. This led to the discovery that Cox-1 WILL NOT WORK without the presence of Cox-2.
Therefore, Celebrex is as hard on the stomach as the other NSAIDS. However, they are STILL selling Celebrex and its brothers as 'easy on the stomach' despite a quick disclaimer in the ad that it can cause stomach bleeding and in some cases, can damage the stomach more than aspirin.
Additionally there are other side effects and Celebrex has been associated with some deaths.
I just received a very nice letter from a person thanking me for my article on the super aspirins. This person had experienced one of the side effects, a type of neuropathy. She came across my article, ceased taking the medication and quickly stopped experiencing the symptoms.
If what they mean by narcotic pain killers is tylenol 3, this would be appropriate but these must be used very much in moderation and are best used within the framework of a program including exercise and other lifestyle modifications. Narcotics are addictive - one tylenol-3 pill a day is doable to get off of, if necessary. But even so little as 2 pills a day can take several weeks to cut down or cease, causing cramps and diarrhea, headaches and more until the body adjusts to the lower amount. But true, they are very helpful with pain, far better than the NSAIDS. I have chosen to take 1 tylenol 3 a day. I break it in half - half a pill in the afternoon, half a pill in the evening. With the help I have received from glucosamin chondroitin (see below) I am possibly looking forward to reducing this amount even more. It should be noted that severe arthritis runs in our family - my mother had knee and hip replacements when she was 45 years old. My sister has begun taking glucosamine chondroitin orally and says her arthritis is much improved. Although she has had several arthroscopic surgeries on her knees, she still, to my knowledge has her original joints. She is 52 years old with a BMI in the normal range. And so far, at the age of 57, I am doing well with no surgery, and hopefully if I need joint replacements in the future, I will be able to delay these so that I don't have to have repeat surgery in 15 years.
There is a product called "joint-ritis" which works very well for arthritis management. This is an interesting preparation. It contains glucosamine chondroitin which actually helps (over a longer period) to rebuild the glucosamine-depleted cartilage found in osteoarthritis but also, the product contains several "essential oils" which give immediate pain relief. The product is massaged into the affected joints a couple of times a day, using the skin as the delivery system.
Over a period of a year, this product has SIGNIFICANTLY improved my knee joint (exercise is STILL needed). For example I no longer have the crackling sound in the knees that I used to experience a couple of years ago and also, I've had a major reduction of pain - basically the joint is pretty painfree most of the time unless I do something stupid like run a block. On the other hand, I DID run for a block last week (wearing not real sensible shoes to put it mildly... I was late for an appointment, what's new) and although I fully expected severe repercussions from my knees, those repercussions never happened. I can dig it. :)
What intrigues me about Joint-ritis is that when one takes Glucosamine chondroitin orally, massive amounts are required, probably because some of it is destroyed in the digestive process. But joint-ritis relieves the joint pain while delivering the glusamine to the place where it's needed without straining the digestive process, liver etc. and without introducing large amounts of the substance, systemically.
The product also helps sore muscles. I think no home should be without it. It's easily obtainable at Walgreen's for one. (and no, I'm not making any commission selling the product!) :)
There is a book called "THE ARTHRITIS CURE". It's written by a doctor and well cited, a bit dry in places but very worth reading.
SueW