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>>>>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.<<<<<

  2012: We now know that drugs like Celebrex et al are not only hard on the stomach but also pose a higher risk of heart attack.  They are effective in pain control but are the risks worth it?

Most effective in the treatment of arthritis is non or low impact exercise (elliptical cross trainer, bicycle, swimming), a good healthy diet and glucosamin-Chondroitin.  I have done this through a body cream for 10 years now, which I apply daily.  The one I use now is "JointFlex" available at CVS pharmacies for one.  "Jointritis" unfortunately is no longer made anymore.  I also take small amounts of tylenol (no more than 325 mg at a time because that's all the liver can handle.

Joint replacements do reduce pain but not for all folks and they are not without their side effects as is true of any surgery.  They often "wear out" after a few years and have to be replaced.  Each time they are replaced, it seems that many folks have more problems with them. Some folks do not get a good range of motion of joint replacements.  Americans feel that surgery is always the answer but one might better off waiting until that's the only option.

At the age of 67 (I first wrote the original article when I was 57!), I've found that moving my full body is uncomfortable at times but I sincerely feel a small amount of discomfort now might save a lot of discomfort later. My sister, mentioned in the article below, now has 1 hip replacement and 2 knee replacements.  I still have my original joints (no replacements) and will likely hold out as long as I can with those.

The book, "the Arthritis Cure" by Dr Jason Theodosakis, provides a lot of good information.

Part of my original article, written 10 years ago!

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.

... 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.

The guidelines seem somewhat influenced by the pharmaceuticals. 

It's likely 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.