Browsing: Arthritis

New Findings on the Link Between Rheumatoid Arthritis and Exercise

Many rheumatoid arthritis patients suffer from so much stiffness, pain and (among other symptoms) fatigue, that they tend to avoid exercise and movement. Sooner or later they may tend to avoid stairs and even avoid walking altogether, becoming increasingly sedentary and immobile. This may be thought as inevitable and even necessary: ​​although, a new, reputable January 2012 study has found that lack of physical activity is an extremely detrimental attitude for those who suffer from this joint disease. Thus, appropriate forms of exercise may well spare your body from further damage or at least contribute to postponing health crises due to this self-attacking illness.

Even though in the past doctors used to recommend plenty of rest to rheumatoid arthritis sufferers, it is now becoming clear that physical activity is in fact much more important, even essential; Unfortunately this new study has also found that almost half of those affected tend to be very sedentary, to the point of risking dire consequences.

Unlike common belief, it has now been shown that being physically active is key to maintaining joint flexibility, joint movement, joint strength and even to keep stiffness and pain at bay, and that this is true for all ages. Whilst it may be wise to rest your joint during a flare up (the acute, temporary forms of rheumatoid arthritis), as soon as symptoms are back to being 'chronic rather than acute', sufferers must resume or start appropriate physical activity on a daily basis. Appropriate exercise is generally understood to be moderate but regular, such as cycling, swimming (the best activity for those whose rheumatoid arthritis is severe) and brisk walking.

It is understanding that, while one toes pain and stiffness (and often fatigue), the most desirable choice of action is rest and the minimization of physical activity; however, resuming or beginning a regular of moderate exercise, to be instituted daily for one hour (or at least for about 10 minutes several times a day) is essential for joint health. Moreover, since rheumatoid arthritis often affects your heart health, keeping oneself physically active, undertaking regular exercise, is essential to minimize the already present risk of heart disease.

So, if you can, it is important to put your wheelchair as and start physical activity: this will not only help your joints but also increase the chances of having better cardiovascular health, now and in the long term. The key is to find the appropriate type of exercises for you ..

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Arthritis Treatment: Nerve-Related Knee Pain and How to Treat It

One of the most perplexing problems a rheumatologist faces is making the diagnosis in a patient who presents with knee pain. There are multiple causes of knee pain including arthritis, bursitis, tendonitis, as well as a host of other conditions.

One very common problem that is often overlooked is knee pain occurring as a result of nerve-related pain.

There are three nerves that can be associated with knee pain. The first is the femoral nerve. This is a nerve that runs down the front of the thigh. While rarely a cause of knee pain per se, it can cause pain in the front of the thigh.

The second nerve that sometimes causes pain in the back of the knee is the sciatic nerve. Patients with degenerative arthritis or degenerative disc problems can develop pain that runs from the low back down the back of the leg. What is interesting is that sometimes a patient will have leg pain but no back pain.

The final nerve that can be associated with knee pain is the peroneal nerve. This is a branch of the sciatic nerve and runs along the outside of the leg. Where this nerve becomes an issue is in a patient with a knee replacement. While this situation does not occur now very often, in the earlier days of knee replacement surgery, women would sometimes receive knee replacement hardware for men.

These replacements would be a bit too large for the joint and what would happen is that the peroneal nerve that runs along the outside of the knee joint would get irritated.

When that happened the patient would have severe pain. The typical scenario is of a woman patient who continues to have knee pain after the joint replacement surgery. She goes to see the orthopedic surgeon who takes x-rays, puts the films up on the view box, and pronounces, “The knee replacement looks perfect!” And the patient would say, “But my knee still hurts …” And the orthopedic surgeon would shr his his shoulders and say, “I do not know why.”

The treatment of nerve-related knee pain is dependent on making a correct diagnosis. Usually femoral and sciatic nerve root pain are spine related. So the treatment is aimed at relieving whatever is causing nerve root irritation in the low back.

Peroneal nerve related knee pain, if it's due to irritation from a knee replacement appliance, can be treated with ultrasound guided hydrodissection of the peroneal nerve. What this involves is using a small needle to inject a large amount of fluid in the nerve sheath and moving the peroneal nerve away from the appliance. This often affords long term relief.

In patients where peroneal nerve compression continues and gets worse, there is progressive numbness, tingling, and weakness in the leg. The diagnosis can be confirmed by electrical studies such as electromyography. Patients who do not respond to hydrodissection may require neurosurgical consultation.

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Ayurvedic Remedies For Arthritis


Herbs can be very effectively used in the treatment of arthritis. Some of the most commonly used herbs in the treatment of arthritis are,
1. Cayenne pepper.
2. Licorice
3. Alfalfa
4. Ginger
5. Buchu
6. Chaparral.

Cayenne pepper: Cayenne pepper contains capsaicin, the active ingredient which helps to relieve pain by inhibiting the transmission of pain signals from nerves in the muscles and joints when applied to the skin. Topical application of cayenne pepper four times daily on the affected area can give effective result. Prepare the mixture of cayenne pepper by adding 1 oz of cayenne pepper to the 1 quart of rubbing alcohol. Allow the mixture to infuse for three weeks, agitating the bottle each day. Apply this infusion in to affected area for 10 to 20 minutes and wipe away after use.

Licorice: Licorice offers significant anti-inflammatory effect by blocking the inflammation receptors. It has been used effectively in the treatment of arthritis, allergies and other inflammatory disease that put excess stress on the adrenal gland. Long time use of licorice can cause hypertension in some people. Taking two capsules of licorice is recommended in the treatment of arthritis.

Alfalfa: This is a nutrient rich remedy useful in the treatment of arthritis symptoms, nourishes joints and alleviates the inflammation. It is better to use alfalfa tea rather than powder or capsules because it is the pure form and more easily assimilated to the body. Prepare the tea by placing 1oz of alfalfa in a pot and cover with 1 quart of water. Boil the decoction for 30 minutes. Strain and consume the decoction through the day. Use the remedy for approximately three weeks and suspend for one week and begin the regimen again as needed.

Ginger: Ginger is primarily known as culinary herb. It contains gingerol the active ingredient can relive the muscle and connective tissue infection associated with the arthritis. Sometimes ginger can cause heartburn.

Buchu: This is a herb native of south Africa, Africans are using the leaves of this herb for the treatment of water retention and in kidney problems. The oil contained in the buchu leaves can reduce the pain and inflammation of both rheumatoid arthritis and osteoarthritis. This herb may lower the potassium, a mineral that helps maintain muscles tone and strength.

Chaparral: This is also known as stink weeds. This herbs contain chemicals that offer anti-inflammatory benefits, reduces the pain and stiffness. However the scientific studies are only done in the animals so there is no evidence that chaparral helps relieve arthritis symptoms in human.

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Arthritis Treatment: Newer Treatments For Gouty Arthritis – Pegloticase

Gout is a common form of arthritis that is due to the excessive accumulation of uric acid (UA) in the body. This event leads to deposits of UA in multiple areas including the joints and kidneys.

This over accumulation of UA is due to abnormal metabolism of purines, a common building block of many foods. In patients with gout, the conversion of purines to UA outpaces the body's ability to excrete it.

Gouty arthritis is characterized by acute attacks of extremely painful debilitating attacks of joint swelling and inflammation.

Over time if gout is not treated the attacks become more frequent and can lead to crippling and disability.
Drugs used to treat gout are divided into two groups. Those that are aimed at striking the acute attack and those aimed at lowering serum UA.

Among the drugs that are used for the acute attack are colchicine, non-steroidal anti-inflammatory drugs, and steroids. Drugs that are used to lower serum UA are probenecid, allopurinol, and febuxostat (Uloric).

A more recent addition to the treatment arsenal is a drug called pegloticase (Krystexxa).

Pegloticase was approved by the FDA for the treatment of chronic gout unresponsive to conventional therapy. Unlike other gout drugs, it is given intravenously. In clinical trials, it was noted that antibodies to pegloticase were common in patients receiving pegloticase, and that high levels of antibodies were associated with loss of response and increased risk of infusion reactions and anaphylactic shock.

One clue to this problem is the measurement of serum UA levels before infusion. When elevated, they indicate reduced efficiency of the drug and the potential for infusion reactions.

Measurement of serum UA levels before each infusion is recommended. Treatment should be discontinued in patients with a pre-treatment serum UA of more than 6 mg / dL.

Pegloticase was used as a single agent in clinical trials. However, pegloticase has been used in clinical practice with other UA lowering therapies, such as allopurinol and febuxostat.

While serious side effects have not occurred, there is concern that use of combination therapies could mask UA elevation due to loss of efficiency from antibodies to pegloticase. This would potentially hide those patients at higher risk for infusion reactions. It's recommended that other UA lowering drugs should not be used in combination with pegloticase.

Other caveats with pegloticase are it should not be used in patients with congestive heart failure nor in patients with G6PD deficiency. This is a metabolic problem that could lead to severe reactions. Patients receiving pegloticase should be premedicated with antihistamines and steroids.

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Natural Treatment for the Common Condition of Osteoarthritis

Osteoarthritis, or degenerative joint disease, is the most common form of arthritis. When cartilage is damaged, bones will grind against each other causing severe pain and restrictions in movement. This can occur over the span of many years or immediately after an infection or injury in a joint.

There are numerous different types of arthritis; therefore, the treatment varies for each type and each individual. When the body's joints encounter repetitive trauma the end result is osteoarthritis, or degenerative joint disease, which is more common as we progress in age. Joint deformity and abnormal anatomy can sometimes result from arthritis. Other factors that contribute to degenerative joint disease are poor blood supply, immobilization, and poor nutrition.

Movement is vital and highly beneficial to the maintenance of arthritic joints. Joints are self-lubricating through a lot of movement which coats and protects the cartilage. If the body places idle and does not move then there's missing protection for the cartilage.

All of the causes for osteoarthritis revolve around the expertise of chiropractors. Putting ice on the joints will definitely help the inflammation, but chiropractors assist in restoring full function back to the joint and relieving the patient of their pain. During a spinal manipulation, the ends of the joint are folded apart allowing the lubricating fluids to flow and re-coat the cartilage.

Preventative measures can be assessed for arthritis starting with regular chiropractic adjustments. All of the joints in the body need to move, they must to remain healthy. There is not a better way to do this in a quick way other than spinal manipulations. Move around and stretch every single day. When muscles tighten it leads to joints compressing. Stay on a healthy diet and maintain a healthy weight because excess weight tends to break down joints in the body.

Depending on the severity of the condition, chiropractic treatment is primarily the way to help patients with arthritis because they are trained to tackle the underlying cause of the problem. Rather than offering medications that temporarily mask the pain, chiropractic treatment gets to the core of the condition causing arthritis, or degenerative joint disease.

Although chiropractors can not reverse the joints from degenerating, they can rid the spinal of stiffness and allow the joints to move more freely. Osteoarthritis can cause a person tremendous pain, but with the right care and preventative measures it can be a way of life rather than dreaded pain that hinders daily activities.

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Arthritis Treatment: Tibiofemoral Osteoarthritis, Diagnosis and Treatment

The most common presentation of osteoarthritis of the knee (OAK) is involvement of the tibiofemoral joint, the space between the femur (upper leg bone) and the tibia (the larger of the two lower leg bones.)

These are the two surface areas that contain the largest amount of hyaline cartilage inside the knee.

As mentioned earlier, hyaline cartilage is the “harder” of the two type of cartilage within the knee. Hyaline cartilage caps the ends of the long bones inside the joint while fibrocartilage, a softer more pliable cartilage is represented by the medial and lateral menisci of the knee. These are semicircular piece of cartilage that give added protection to the hyaline cartilage when it comes to shock absorption, gliding, and rotation.

Symptoms of OAK typically consist of stiffness, swelling, buildup of joint fluid, and tenderness along the joint line. Over time the ability to bend and straighten the knee will be compromised as well. While one compartment, either the medial (inside) or lateral (outside) compartment of the knee may be affected more than the other, often both compartments are affected. This causes diffuse pain.

The diagnosis can be suspected clinically by history and physical examination. It can be confirmed by positive changes seen on standing knee x-rays. Magnetic resonance imaging (MRI) is much more sensitive to changes of OAK which will consist of cartilage defects, bone edema (swelling), and fluid.

The typical treatment regimen is aimed at pain relief and maintenance of function.

If the patient is overweight, weight loss is a must. Regular exercise contracting of low impact aerobic exercise, resistance exercise, and stretching are components of a common-sense program for a patient with OAK.

Addition of non-steroidal-anti-inflammatory drugs taken either orally or given as a topical agent may also be used.

Removal of excess joint fluid followed by injections of glucocorticoids (“cortisone”) are helpful for symptomatic relief. Glucocorticoids have a deleterious effect on articular cartilage and should be used sparingly, no more often than three times per year in a given joint.

The patient may also benefit from viscosupplement injections. These are substances consisting of hyaluronic acid which mimics the characteristics of normal joint fluid. These injections can also help provide symptomatic relief.

All injections need to be administered using ultrasound guidance to ensure accuracy.

Surgery is defined as being cartilage sparing or cartilage sacrificing. Cartilage sparing procedures involve osteotomy- removing a wedge of bone in order to line the knee joint straighter. This is used in young active adults to buy time. Cartilage sacrificing procedures refer top joint replacement. The trend recently has been for patients to get these operations done at a younger age. The downside is that these surgeries are associated with a small but real risk of severe complications including infection, blood clots, and death.

An option that is being proved to be an alternative is the use of autologous stem cells, a patient's own stem cells to help sustain and possibly regrow cartilage in an osteoarthritis knee.

(Wei N, et al. Guided Mesenchymal Stem Cell Layering Technique for Treatment of Osteoarthritis of the Knee. J Applied Res. 2011; 11: 44-48)

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Arthritis Treatment: Conventional Approach to Osteoarthritis Treatment

Osteoarthritis (OA) is, without question, the most common form of arthritis. It is a disease of articular cartilage, the gristle that caps the ends of long bones. Cartilage consists of a mixture of proteins and sugars (proteoglycans), and collagen. Interspersed in this matrix of substations are chondrocytes, cartilage cells. The purpose of the chondrocytes is to manufacture new healthy matrix and keep it healthy.

With the onset of OA, the chondrocytes begin to eradicate destructive enzymes. In addition, there is a complex interplay of events that leads to hardening of the underlying bone along with bone spur formation and inflammation of the synovium (the lining of the joint), which causes further joint destruction.

OA is typically a disease of weight-bearing joints. However, other joints can be affected and cause debilitating symptoms and loss of function.

The conventional approach to osteoarthritis has not changed for more than fifty years.

The three aims of treatment are to relieve symptoms, improve function, and restore cartilage. While the former two goals are sometimes reached, the latter has remained elusive.

OA treatment begins with non-medical interventions such as weight loss, physical therapy, exercise, patient education, and sometimes assistive devices. Assistive devices are things such as braces and canes that might help a patient perform activities of daily living more efficiently.

Many doctors advocate the use of analgesics (pain relievers) instead of traditional non-steroidal anti-inflammatory drugs (NSAIDs). This is because of the side effect profile of the latter group of medicines in light of data relating to cardiovascular events and gastrointestinal events associated with the use of these drugs.

One way of getting around this is to use NSAID in topical form. There are two preparations, Voltaren gel, and Pennsaid which are topical medicines containing the anti-inflammatory drug, diclofenac.

Nutriceuticals, such as glucosamine and chondroitin have their advocates. In addition various studies touting the benefits of dietary fish oil, and herbal remedies indicate these are also an option for people with mild OA. Glucocorticoid injections can be employed for patients with significant symptoms. They should be administrated using ultrasound guidance and no more frequently than three times per year in an individual joint.

Viscosupplements, lubricants, can also be used although they are indicated so far for OA of the knee only. As with glucocorticoids, they should be administered using ultrasound guidance to ensure proper placement.

There is a huge void between these conservative therapies and surgery.

Recent experiences using autologous growth factors such as platelet-rich plasma (PRP) as well as autologous stem cells (a patient's own stem cells) may hold the promise of cartilage protection and cartilage regeneration.

(Wei N, Beard S, Delauter S, Bitner C, Gillis R, Rau L, Miller C, Clark T. Guided Mesenchymal Stem Cell Layering Technique for Treatment of Osteoarthritis of the Knee J. Applied Res., 2011; 11: 44-48 )

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Arthritis Treatment: How Does Being Obese Potentially Affect Arthritis Treatment?

Osteoarthritis (OA) is the most common form of arthritis. It is a condition due to the disruption of hyaline cartilage, the gristle that caps the ends of long bones. Hyaline cartilage consists of a matrix of collagen and proteoglycans (combinations of sugars and proteins). Within this matrix are cells called chondrocytes which are responsible for producing and maintaining the integrity of the matrix.

Trigger factors for the development of osteoarthritis can be such factors as trauma.

Weight also plays a significant role. A study by Messier and colleagues presented at the 2011 meeting of the American College of Rheumatology clearly demonstrated that patients losing 11% of their body weight could experience a 50% reduction in pain related to their OA.

Another key factor in the development of OA is malalignment of the joint. This places excessive stress on the joint. The response is for the chondrocytes to begin to produce chemical messengers called cytokines, metalloproteinases, and other factors that accelerate joint damage. The end result is stoppage of matrix production by the chondrocyte and wearing away of cartilage. There is also evidence that overloading due to malalignment may stimulate bone cells underneath the cartilage to become abnormal.

But that's not all. Obesity is associated with OA in non-weight-bearing areas like the hands .. So being obese may contribute to the development of OA above and beyond mechanical factors.

Scientists are now viewing adipose tissue (“fat”) as being an endocrine organ. Adipose tissue produces chemical messengers such as cytokines and adipokines that promote inflammation. These cytokines have been found to be present in the joint tissue of obese patients. The obvious therapeutic action here would be to encourage a patient to lose weight because reduction in the production of these cytokines could assist in symptomatic improvement along with the mechanical relief of just getting weight off the affected joints. So really what happens is an additive beneficial effect of weight loss.

One adipokine that is often mentioned is leptin. Leptin is produced by fat cells. Leptin levels are associated with the amount of body fat a person has but leptin is also regulated by inflammatory messengers. Leptin has a direct effect on cartilage. Normal cartilage does not make leptin but osteoarthritic cartilage does. What is perplexing is that leptin is a double-edged sword. While it sees to stimulate the manufacture of growth factors that promote cartilage growth, it also stimulates the production of factors that increase inflammation.

The net effect though seems to favor cartilage degradation.

In summary, the biology of cartilage and OA is experiencing some major new developments that could provide insight into newer therapies.

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Arthritis Treatment: The Role of Weight Loss In Osteoarthritis Treatment

Osteoarthritis (OA) is the most common form of arthritis and affects more than 20 million Americans. It is a condition that affects hyaline articular cartilage, the tough gristle that caps the ends of long bones.

Hyaline cartilage consists of a matrix made up of a combination of proteoglycans (complexes of proteins and sugars) and chondrocytes. Chondrocytes are cartilage cells that manufacture matrix under normal circumstances. They are responsible for nourishing the matrix as well.

However, when OA develops, a distinct change in the milieu of the joint environment occurs. Chondrocytes begin to eradicate destructive enzymes causing cracks in the cartilage, the synovium (lining of the joint) becomes inflamed, and the under bone bone becomes hard and forms spurs.

What causes OA to develop is usually injury or trauma. In any event an injury to the joint appears to be the inciting factor. Genetics play a role as well.

As OA progresses, biomechanical factors come into play. And this is where obesity plays a huge role in the worsening of disease. While overloading of the joint is the obvious major consideration, there is now ample evidence that fat itself acts as an “organ” that perpetuates inflammation.

“Adipokines” are chemical messengers produced mainly by adipocytes (fat cells). The major adipokine is a substance called leptin. Leptin is interesting because it has contradictory actions. While it appears to help with the synthesis of growth factors that optimize cartilage growth, it also appears to lead to the production of inflammatory proteins that cause further cartilage deterioration.

But that's not all. There are other adipokines that make a significant contribution in this cascade of events. Adipopkinin also appears to promote inflammation in arthritis. It causes the cartilage matrix to degrade and also promotes the manufacture of destructive enzymes.

Visfatin levels are also associated with cartilage degradation. Resistin promotes inflammation.

These fat produced proteins may explain why symptoms in people with OA who are overweight seem to get better with loss of body fat rather than just with weight reduction.

The bottom line is that OA is more than just a mechanical disease. Abnormal fat metabolism appears to lead to the production of factors that cause further cartilage loss and deterioration.

These new developments confirm the long held belief that people with symptomatic OA who carry excess fat may benefit from fat reduction.

These finds have been substantiated in real life clinical trials. Richette and colleagues (Richette P, et al. Ann Rheum Dis. 2011; 70: 139-140) demonstrated that obese individuals with knee OA who underwent gastric band surgery not only had improvements in their symptoms but also blood levels of adipokines plummeted along with other inflammatory marks.

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Natural Treatment for the Common Condition of Arthritis

For many people the word arthritis is associated with old age, but this is not the case. Arthritis is a fancy word for joint inflammation and can affect an individual at any age. The most common word to describe arthritis symptoms is rheumatism.

Chiropractic treatment for arthritis depends on the type of chiropractor, whether he or she is a straight chiropractor or a mixed chiropractor. Straight chiropractors manipulate the spelling to correct the subluxation along with any other imbalances. Mixed chiropractors normally treat the condition with a spinal adjustment as well as using other remedies such as acupressure.

Dr. Lynn Kelly, DC has identified the improperly moving joints caused by misalignments of the bones as the top reason for arthritis. Spinal manipulations will always involve the sound of the bones “popping”. The sound is actually the joints relieving tiny gas pockets (mostly of nitrogen) due to the adjustment of the vertebrae.

Chiropractors are trained to know when a condition is outside of their scope of practice. In a situation such as this, the patient is referred to someone who can properly treat the condition, such as a pain management doctor. Movement is vital and highly beneficial to the maintenance of arthritic joints. This helps stimulate cartilage health, formation, and prevention of degradation. Preventative measures can be assessed for arthritis starting at an early age.

· To avoid future disability, always make sure that any injuries to the joints are treated as soon as possible to allow proper healing.

· Anyone who works at a place that requires standing or walking for long periods of time should wear appropriate and comfortable shoes.

· A proper diet and healthy weight loss will reduce the amount of pressure that is placed on the joints.

· Joints maintain good health through natural minerals, antioxidants and vitamins.

Although the direct cause of rheumatoid arthritis is unknown, the immune system appears to play a large role in the condition. Most commonly, the affected joints of arthritis are the hands and fingers, feet, shoulders, and knees. Numerous patients with arthritis know when the weather is going to change because their joints start hurting. This is also a common symptom associated with arthritis; stiff joints in the morning that are worsened by movement.

Depending on the severity of the condition, chiropractic treatment is primarily the way to help patients with arthritis because they are trained to tackle the underlying cause of the problem. Rather than offering medications that temporarily mask the pain, chiropractic treatment gets to the core of the condition causing arthritis, or pain in the joints.

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Arthritis Treatment: What’s Involved With Osteoarthritis Of The Ankle Treatment?

Osteoarthritis (OA) is, by far, the most common form of arthritis and affects more than 20 million Americans. It is a condition that adversely affects hyaline articular cartilage, the tough gristle that caps the ends of long bones.

Hyaline cartilage is made up of a matrix consisting of a combination of proteoglycans (complexes of proteins and sugars) and chondrocytes. Chondrocytes are cartilage cells that manufacture matrix under normal healthy circumstances. They are responsible for nourishing the matrix as well.

However, when OA develops, a distinct change in the joint environment occurs. Chondrocytes begin to eradicate destructive enzymes causing cracks in the cartilage. These are called “fibrillations.”

The synovium (lining of the joint) becomes inflamed, and the underlying bone becomes sclerotic (hard) and forms spurs.

The soft tissue structures surrounding the joint such as ligaments, tendons, and muscles also become affected as a secondary result of OA.

One joint that is often ignored because it is not as commonly affected as others is the ankle.
Approximately 1 per cent of people have ankle osteoarthritis. However, the incidence of this condition is expected to increase.

OA of the ankle typically comes about as a result of injury. The most common injuries leading to ankle OA are fractures, ligament injuries, and osteochondral injuries. The latter are a specific type of condition that causes a small section of cartilage and underlining bone to die.

Other types of arthritis such as rheumatoid arthritis can also lead to OA of the ankle. Because trauma is the leading cause of ankle OA, people with ankle OA tend to be younger than patients with OA incorporating other weight-bearing joints.

Despite the relatively small number of people affected, the health burden of an ankle OA is still infinite. People with ankle OA have difficulty with performing voluntary and recreational activities as well as activities of daily living, according to a number of studies.

Treatment of ankle OA involves the same modalities as that used for other weight-bearing joints. Weight loss, physical therapy, exercise, patient education, and assistive devices such as braces can be helpful adjuncts. Non-steroidal anti-inflammatory drugs, analgesics, and neutriceuticals such as glucosamine and chondroitin are also possible additions. Joint injections glucocorticoids and viscosupplements can be used. More recently, the utilization of autologous stem cell procedures to slow down and possibly regrow damaged cartilage has appeared promising.

Surgery should be a last resort. Unlike the knee and hip, joint replacements for the ankle are less than adequate. Fusion of the joint carries risks both during the procedure as well as after.

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Arthritis Flare-Ups: Don’t Ignore Them!

Once you have diagnosed with arthritis and you have chosen, with your doctor or naturopath, a course of action, you will probably enter a 'remission' phase (I did, thanks to my homeopath), after which, you may face a ' flare-up '. In fact, most forms of inflammatory arthritis, including ankylosing spondylitis, are made of these periods when the disease is either manageable or completely absent from your body.

What is a flare-up?

Simply put, it is a phase when your arthritis symptoms get significantly worse; if you have symptoms all the time then these may become unbearable during this phase; if you do not have symptoms most of the time, those phases are when you actually have symptoms. In severe cases, your joint stiffness and pain can be so bad that daily activities become unbearable; the affected joints may also become swollen and red and, to make matters worse, you may be 'hit' by some degree fatigue. These flare-ups can appear suddenly and they can be very distressful. I remember I was on holiday in Las Vegas when once night I had such sudden, severe pain in my right knee that, the following days, it was practically impossible for me to walk: I was young and I was extremely distracted by the whole situation . When my knee became swollen like a balloon (it almost felt as if it was full of liquid), I took matters in my own hands and 'resolved' my rheumatoid arthritis.

What are the causes of a flare up?

Many 'specialists' maintain that the causes are still unclear or not fully understood. What we do know, is that it can be caused by 'triggers': the main trigger is stress, of course, and this can be almost undetected by you if it's some form of mild anxiety due to factors you may be overlooking: in my case my worst flare up was caused by my mother's visiting me for a long period (it was challenging at times). I had completely overlooked it but, when my homeopath persuaded me to write a chart of my 'worst phases', including the onset of the disease, it was clear that they were all linked to my mother and my relationship with her (and various events within this relationship). This helped my homeopath find the right course of action and now, I am pleased to say, my flare ups consist only of extremely mild sensations (I can not call it 'pain', since it's far from painful) in my knee and, delightfully , they last only hours and disappear for weeks. I can still link those extremely mild events to stressful events or challenging times. For other people who may not suffer from stress at all, physical traumas (falling, illnesses or even pregnancies) can be the triggers.

Emergency home measures during these phases. What works for some may not work for others, of course, but many resort to a temporary use of painkillers and anti-inflammatory medicine (the latter is probably even more important); they are not going to cure the disease nor even tackle the 'root' of the problem, but these two measures may make many sufferers feel better in the short-term. Eating food which has anti-inflammatory properties is also essential. Do not ignore these phases, because, because untreated inflammatory conditions of your joints will damage them further, some times irreversibly. Although it may be tempting to avoid movement, lack of physical activity is always worse in the long run: low-impact exercises and activities are best for those severely hit by arthritis, such as swimming. At the same time, do not exert yourself doing things which bring no benefit to your body if you find them hard to do: if house keeping has become a struggle, delegate or get a cleaner a few times a week instead.

During these phases it is always important to see your rheumatologist and check if further deterioration of the affected area has taken place. Even if you are being treated by a naturopath or homeopath for your arthritis, checking your joints during a flare up is beneficial and a great way to monitor the progress and efficiency of the treatment received.

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Is Meat Bad for Rheumatoid Arthritis?

Meat and Rheumatoid Arthritis

I am a previous sufferer of Rheumatoid Arthritis so I know how horrible the disease can be and how difficult life becomes during those terrible years. I explain in my natural cure for rheumatoid arthritis book how to go about eliminating the underlying cause of the disease by taking out of your diet the foods that are most offensive to the digestive system and overall inflammation in the body. One of the worst offenders is meat.

Most people love meat and consider it the main part of every meal. They also believe it is essential to the diet to be healthy and strong, providing beneficial protein, iron, energy and nutrients. The truth is, meat is not essential to human wellbeing whatsoever and any positive benefits it offers can be easily obtained from plant sources, without all the negative side effects that meat holds.

There are many downsides to meat from the point of view of an RA sufferer:

• Meat, including fish, is very high in fat as a percentage of calories.

• Animal meat contains no dietary fiber. Our healthy bacteria need to eat plant fiber, whilst unwanted pathogens thrive on animal waste. In addition, fiber is key for steady, regular stools that are easy to pass. I've found that it makes no sense to have a substantial part of my meal that contains no dietary fiber when I've found fiber such a key component to getting well.

• Carbohydrates are easier to digest than meat, so relieving work off a stomach that is currently under stress.

• Proteins are acid-forming since they are composed entirely of amino acids. (More on amino acids below). The most acidifying for the body are the sulfur-containing amino acids which break down to sulfuric acid. These sulfur-containing amino acids are most abundant in animal products like meat, chicken, fish and eggs. In fact, meat contains 4 times the amount of the highly acidifying sulfur-containing amino acids than any vegetable-based protein. You may remember from chemistry in school that to neutralize an acid you need a base. The body neutralizes the acids from these animal products using the most effective base that it has – calcium. The calcium gets withdrawn from the bones and is used to offset these acids. Through this process the bones are weakened, resulting in osteoarthritis and osteoporosis.

There are also some valid arguments put forward by others, which are non-specific to RA, but worth knowing also for your overall health and wellbeing:

• Animal proteins (including all animal products like milk, cheese and all dairy products) are linked to other chronic diseases, including the top 3 killers of Heart Disease, Cancer and Diabetes. (By the way, the fourth largest killer in the US behind these is prescription medicine, and that is taking the medicine as prescribed!) By eliminating all animal-based foods from his diet for 4 days my Dad was able to reduce his blood pressure from 160/110 to 127/78. This kind of express improvement is unheard of in Western medicine, yet entirely predictable and repeatable when you understand the effects of foods on the body. Why eat something that contributes to other diseases when you're already dealing with a damn tough condition already? • Animal proteins develop fat cells on the body, by creating store houses for the over acidity that the body is trying to cope with. The fat you eat is fat you keep.

• Animal foods are high in cholesterol. Nobody wants that in their bloodstream. There is zero cholesterol in plant-based foods.

• Animal products contain uric acid, the excess of which is behind arthritic conditions like gout. There is an incredible testimonial in my book Natural Cure for Rheumatoid Arthritis book about a man with gout who followed the program and eliminated all pain in 1 week.

• Not eating animal foods is the single largest thing that can be done to help the environment (a whole book called 'Diet for the New America' is all about this. food vs. the tiny fraction required to produce the equivalent calories via plant-based foods). If everyone only ate plant-based foods our world would be an extraordinarily different place.

• A plant-based diet is non-violent, upholding the Commandment of 'thou shall not kill'.

• Meat tastes bad. Seriously! Try eating it without ketchup, without mustard, without salt or any seasoning whatever. Just a plain bit of animal muscle without seasoning. Good luck.

It's worth noting that I have no pre-existing prejudice toward eating meat. I grew up on a farm where steak was on my plate at least once a day. In fact, I was very dependent to stop eating meat and I only did so once I reviewed the truth about meat and observed the benefits that a meat-free diet had on my body.

Everyone is concerned about getting another source of protein. Westerners seem to have a love affair with protein that borders on obsession. The truth is, protein is just a combination of building blocks called 'Amino Acids' which combine together in various permutations to create various forms of proteins. Think of this in exactly the same way that all words in the English language are put together from various combinations of letters of the alphabet. There are 20 different amino acids that are the building blocks for protein. Plants (and some bacteria) can manufacture all of these amino acids and therefore make 'complete' proteins. However, humans can only manufacture 12 of the amino acids without food, so we require the other 8 in our diet. These 8 amino acids are called 'essential' amino acids, referring to 'essential to our diet'. Plants contain these 8 essential amino acids in abundance.

Obviously, feel free to keep meat meat if you want, I'm not your Mother. I can not tell you what to do, but the evidence is strong towards omitting it and I'm being omitting it soon. Does now sound like a good time? I do not expect you will cure yourself of Rheumatoid Arthritis if you keep meat in your diet. Nor, for that matter, dairy products … but that's another story (or Ezine Article!).

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Arthritis Treatment: Medicine Strategies For Treating Osteoarthritis

Osteoarthritis (OA) is the most common form of arthritis and affects more than 20 million Americans. It is a condition that affects hyaline articular cartilage, the tough gristle that caps the ends of long bones.

Hyaline cartilage consists of a matrix made up of a combination of proteoglycans (complexes of proteins and sugars) and chondrocytes. Chondrocytes are cartilage cells that manufacture matrix under normal circumstances. They are responsible for nourishing the matrix as well.

However, when OA develops, a distinct change in the milieu of the joint environment occurs. Chondrocytes begin to eradicate destructive enzymes causing cracks in the cartilage, the synovium (lining of the joint) becomes inflamed, and the under bone bone becomes hard and forms spurs.

What causes OA to develop is usually injury or trauma. In any event an injury to the joint appears to be the inciting factor. Genetics play a role as well.

The treatment of osteoarthritis usually begins with non-drug therapies such as weight loss, patient education, exercise and physical therapy.

Meditations do play a major role in the management of symptoms related to OA.

Acetaminophen is usually recommended as the first line treatment for OA. While it's more effective than placebo, it is less effective than non-steroidal anti-inflammatory drugs (NSAIDS). Acetaminophen is used much more commonly than NSAIDS. Recent data has shown that its effect on pain from OA is not that great and the long term consequences of acetaminophen use are not inconsequential. Potential side effects from long term use include kidney damage, hypertension, and possibly stroke. In addition, it is the most common cause of drug-induced liver failure in the United States.

NSAIDS are more effective than acetaminophen for pain control in OA. They are divided into two groups: NSAIDS that are non-selective in regards to cyclooxygenase (the major enzyme pathway that is blocked by these drugs) and selective COX-2 inhibitors (drugs which block the inflammatory cyclooxygenase pathway only).

The COX-2 drugs have a better profile as far as gastrointestinal side effects but both types of NSAIDS carry an increased risk of cardiovascular events.

Topical formulations of NSAIDS containing diclofenac are effective for patients with a limited area of ​​OA. They have a much better gastrointestinal risk profile than oral NSAIDS but do have more dermatological problems associated with their use.

Injections are also helpful. Glucocorticoids are effective for treating pain short term and there is evidence that they also help restore quadriceps muscle (thigh muscle) strength in patients with OA. They should not be administrated more often than three times per year per affected joint because of the danger of inducing further cartilage damage.

Injections of hyaluronates, lubricants that reduce OA pain, are also helpful. These are particularly useful in those patients for whom joint replacement surgery is not a viable option.

Another drug is duloxetine (Cymbalta). This was initially approved as a treatment for depression. However, it also has analgesic properties and was approved by the FDA for treatment of chronic musculoskeletal pain related to OA. This drug can be used either alone or in combination with acetaminophen or NSIADS. The side effects are those found typically with antidepressant therapy.

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Arthritis Treatment: Another Cause of Knee Pain – Medial Plica Syndrome

Knee pain is one of the most common problems patients come in with to a rheumatologists office. There are multiple causes of knee pain ranging from arthritis to bursitis to tendonitis and so on.

One type of knee pain that is rarely mentioned is the pain from an inflated medial plica. This is considered an arthritis condition.

In order to understand this type of knee pain, it's important to have an understanding of basic knee anatomy.

The knee is a joint consisting of four bones, the femur (upper leg bone), tibia (the larger of two lower leg bones), the fibula (the smaller of the two lower leg bones), and the patella (the knee cap) .

All the articulating (interacting) surfaces of the knee bones are covered with a thin layer of hyaline cartilage, a tough type of gristle, that helps with cushioning and shock absorption.

This entire system is enclosed inside a joint capsule. The capsule is lined with synovium, a type of tissue that provides nourishment and lubrication for the joint.

On occasion, the synovium can form a fold of tissue. This fold can occur above the knee cap, below the knee cap, and between the knee cap and femur, along the inside part of the knee.

When the fold occurs along the inside part of the knee between the patella and the femur, it can cause problems. This is called medial plica syndrome.

Pain in the region of the patella is the most common symptom. A person may also note snapping, clicking, locking, and even a sense of instability. This latter symptom is relatively rare.

Inflammation of the knee capsule, as may occur with arthritis, or trauma can aggravate the pain. In addition, bending and straightening the knee (eg. Stair climbing) can also aggravate the pain of a medial plica.

The diagnosis can be suspected clinically by the history. On examination, the patient may complain of pain located over the medial (inside) part of the joint. A sensation of snapping may be felt when the knee is flexed and straightened.

The diagnosis can be confirmed by magnetic resonance imaging (MRI) scanning.

Typically, a patient will undergo arthroscopy (insertion of a telescope inside the knee joint). At the time of arthroscopy, the medial plica will appear to be thickened and inflamed. The treatment is also rendered arthroscopically.

By introducing a motorized trimmer, the arthroscopist can carefully trim the inflated plica so it no longer becomes trapped. This procedure is usually curative. We have seen a number of symptomatic medial plica cases that were essentially cured by this arthroscopic approach.

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