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Arthritis

The TVClubHouse: General Discussions ARCHIVES: 2006 Jun. ~ 2006 Dec.: Health Center (ARCHIVES): Arthritis users admin

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Herckleperckle
Member

11-20-2003

Thursday, July 06, 2006 - 7:01 pm   Edit Post Move Post Delete Post View Post Send Herckleperckle a private message Print Post    
Source: American Academy of Orthopaedic Surgeons
Date: June 2001


Inflammatory Arthritis of the Hip


Arthritis literally means "inflammation of a joint." In some forms of arthritis, such as osteoarthritis, the inflammation arises because the smooth covering (articular cartilage) on the ends of bones wears away. In other forms of arthritis, such as rheumatoid arthritis, the joint lining becomes inflamed as part of a systemic disease. These diseases are considered the inflammatory arthritides.

The three most common types of inflammatory arthritis that affect the hip are:

* Rheumatoid arthritis (RA): RA is a systemic disease of the immune system that usually affects multiple joints on both sides of the body at the same time.

* Ankylosing spondylitis (AS): AS is a chronic inflammation of the spine and the sacroiliac joint (the point where the spine meets the pelvic bone) that can also cause inflammation in other joints.

* Systemic lupus erythematosus (SLE or lupus): SLE is an autoimmune disease in which the body harms its own healthy cells and tissues.



Signs and symptoms

The classic sign of arthritis is joint pain. Inflammatory arthritis of the hip is characterized by a dull, aching pain in the groin, outer thigh, or buttocks. Pain is usually worse in the morning and lessens with activity; however, vigorous activity can result in increased pain and stiffness. The pain may limit your movements or make walking difficult.



Diagnostic tests

During the physical examination, your physician may ask you to move your hip in various ways to see which motions are restricted or painful. Your physician will want to know if you walk with a limp, if one or both hips are painful, and if you experience pain in any other joints. X-rays and laboratory studies will be needed. The X-rays will show if there is any thinning or erosion in the bones, any loss of joint space or any excess fluid in the joint. Laboratory studies will show whether a rheumatoid factor or other antibodies are present.



Treatment

Treatment depends on the diagnosis. If you have an infection in the hip joint, it must be eliminated, either through the use of medications or through surgical draining. Nonoperative treatments may provide some relief with relatively few side effects or complications:

* Anti-inflammatory medications, such as aspirin or ibuprofen, may help reduce the inflammation.

* Corticosteroids are potent anti-inflammatories, part of a drug category known as symptom-modifying antirheumatic drugs, or SMARDs. They can be taken by mouth, by injection, or in creams applied to the skin.

* Methotrexate and sulfasalazine may be prescribed to help retard the progression of the disease. These medications are part of a drug category called DMARDs, or disease-modifying antirheumatic drugs. For example, tumor necrosis factor is one of the substances that seem to cause inflammation in people with arthritis. Newer drugs that work against this factor seem to have a positive effect on arthritis in some patients as well.

* Physical therapy may help you increase the range of motion and strengthening exercises may help maintain muscle tone. Swimming is a preferred exercise for people with AS.

* Assistive devices, such as a cane, walker, long shoehorn or reacher, may make it easier for you to do daily living activities.



If these treatments do not relieve the pain, surgery may be recommended. The type of surgery depends on several factors, including your age, the condition of the hip joint, the type of inflammatory arthritis you have, and the progression of the disease. Your orthopaedic surgeon will discuss the various options with you. Do not hesitate to ask why a specific procedure is being recommended and what outcome you can expect. Although complications are possible in any surgery, your orthopaedic surgeon will take steps to minimize the risks.

The most common surgical procedures performed for inflammatory arthritis of the hip include:

* Total hip replacement is often recommended for patients with RA or AS because it provides pain relief and improves motion.

* Bone grafts may help patients with SLE to build new bone cells to replace those affected by osteonecrosis. People with SLE have a higher incidence of this disease, which causes bone cells to die and weakens bone structure.

* Another option for patients with SLE and osteonecrosis is core decompression, which reduces bone marrow pressure and encourages blood flow.

* Synovectomy (removing part or all of the joint lining) may be effective if the disease is limited to the joint lining and has not affected the cartilage.

Herckleperckle
Member

11-20-2003

Thursday, July 06, 2006 - 7:16 pm   Edit Post Move Post Delete Post View Post Send Herckleperckle a private message Print Post    
Source: American Academy of Orthopaedic Surgeons
Date: September 2000


Osteoarthritis of the Hip



Like other joints that carry your weight, your hips may be at risk for "wear and tear" arthritis (osteoarthritis), the most common form of the disease. The smooth and glistening covering (articular cartilage) on the ends of your bones that helps your hip joint glide may wear thin. Your first sign may be a bit of discomfort and stiffness in your groin, buttock or thigh when you wake up in the morning. The pain flares when you're active and gets better when you rest.

If you don't get treatment for osteoarthritis of the hip, the condition keeps getting worse until resting no longer relieves your pain. The hip joint gets stiff and inflamed. Bone spurs might build up at the edges of the joint. When the cartilage wears away completely, bones rub directly against each other. This makes it very painful for you to move. You may lose the ability to rotate, flex or extend your hip. If you become less active to avoid the pain the muscles controlling your joint get weak, and you may start to limp.

About 10 million Americans reported having been diagnosed with osteoarthritis. You're more likely to get it if you have a family history of the disease. You're also at risk if you are elderly, obese or have an injury that puts stress on your hip cartilage. You can get osteoarthritis if you don't have any risk factors. See your doctor as soon as possible if you think you may have it.



Evaluation

While you cannot reverse the effects of osteoarthritis, early nonsurgical treatment may help you avoid a lot of pain and disability and slow progression of the disease. Surgery can help you if your condition is already severe. You doctor will determine how much the disease has progressed. Describe your symptoms and when they began. Your doctor may rotate, flex and extend your hips to check for pain. He or she may want you to walk or stand on one leg to see how your hips line up. Both hips will probably be X-rayed to check if hip joint space has changed, and if you have developed bone spurs or other abnormalities.



Nonsurgical treatment

If you have early stages of osteoarthritis of the hip, the first treatment may be:

* Rest your hip from overuse.

* Follow a physical therapy program of gentle, regular exercise like swimming, water aerobics or cycling to keep your joint functioning and improve its strength and range of motion.

* Use nonsteroidal anti-inflammatory medications like ibuprofen for pain.

* Get enough sleep each night.

You may need to lose weight if you are overweight. As the disease progresses, you may need to use a cane.



Total hip replacement surgery

If you have later stages of osteoarthritis, your hip joint hurts when you rest at night and/or your hip is severely deformed, your doctor may recommend total hip replacement surgery (arthroplasty). You will get a two-piece ball and socket replacement for your hip joint. This will cure your pain and improve your ability to walk. You may need crutches or a walker for awhile after surgery. Rehabilitation is important to restore your hip's flexibility and work your muscles back into shape.

Herckleperckle
Member

11-20-2003

Thursday, July 06, 2006 - 7:29 pm   Edit Post Move Post Delete Post View Post Send Herckleperckle a private message Print Post    
Source: Adam Healthcare Center

Hip Pain


Hip pain involves any pain in or around the hip joint.

Hip-related pain is not always felt directly over the hip. Instead, you may feel it in the middle of your thigh. Similarly, pain you feel in the hip may actually reflect a problem in your back, rather than your hip itself. (See low back pain.)


Common Causes

Two common and concerning causes of hip pain are fractures and insufficient blood flow to the hip (aseptic necrosis).

A hip fracture can change the quality of your life significantly. Fewer than 50% of those with a hip fracture return to their former level of activity. In addition, while recovering from a hip fracture, several possible complications can be life-threatening. These include pneumonia and a blood clot in the leg, which can dislodge and cause a clot in the lungs. Both are due to immobility following a hip fracture and hip surgery.

Hip fractures become more common as people age because falls are more likely and bones become less dense. People with osteoporosis can get a fracture from simple, everyday activities, not just a dramatic fall or injury.

Aseptic necrosis can happen if you have been on steroids for a long time or you have sickle cell anemia. Regular use of alcohol and injury also increase your risk.

Legg-Calve-Perthes disease is a type of aseptic necrosis that happens in children.


Other possible causes of hip pain include:

* Arthritis -- often felt in the front part of your thigh

* Trochanteric bursitis -- inflammation of the bursa that sits on the outside of your hip joint. This hurts when you get up from a chair, walk, climb stairs, and drive

* Tendinitis from repetitive or strenuous activity

* Strain or sprain

* Low back pain such as sciatica

* Infection

Herckleperckle
Member

11-20-2003

Thursday, July 06, 2006 - 8:07 pm   Edit Post Move Post Delete Post View Post Send Herckleperckle a private message Print Post    
Source: Adam Healthcare Center


Arthritis


Arthritis involves inflammation of one or more joints and the breakdown of cartilage. Cartilage normally protects the joint, allowing for smooth movement. Cartilage also absorbs shock when pressure is placed on the joint, like when you walk or otherwise bear weight. Without the usual amount of cartilage, the bones rub together, causing pain, swelling, and stiffness.


Alternative Names
Joint inflammation


Causes, incidence, and risk factors

You may have joint inflammation for a variety of reasons, including:

* Broken bone

* Infection (usually caused by bacteria or viruses)

* An autoimmune disease (the body attacks itself because the immune system believes a body part is foreign)

* General "wear and tear" on joints



Often, the inflammation goes away after the injury has healed, the disease is treated, or the infection has been cleared.



With some injuries and diseases, the inflammation does not go away or destruction results in long-term pain and deformity. When this happens, you have chronic arthritis. Osteoarthritis is the most common type and is more likely to occur as you age. You may feel it in any of your joints, but most commonly in your hips, knees or fingers.



Risk factors for osteoarthritis include:

* Being overweight

* Previously injuring the affected joint

* Using the affected joint in a repetitive action that puts stress on the joint (baseball players, ballet dancers, and construction workers are all at risk)



Arthritis can occur in men and women of all ages. About 37 million people in America have arthritis of some kind, which is almost 1 out of every 7 people.



Other types or cause of arthritis include:

* Rheumatoid arthritis (in adults)

* Juvenile rheumatoid arthritis (in children)

* Systemic lupus erythematosus (SLE)

* Gout

* Scleroderma

* Psoriatic arthritis

* Ankylosing spondylitis

* Reiter's syndrome (reactive arthritis)

* Adult Still's disease

* Viral arthritis

* Gonococcal arthritis

* Other bacterial infections (non-gonococcal bacterial arthritis)

* Tertiary Lyme disease (the late stage)

* Tuberculous arthritis

* Fungal infections such as blastomycosis

Herckleperckle
Member

11-20-2003

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Source: Adam Healthcare Center


Arthitis Symptoms



Symptoms

If you have arthritis, you may experience:

* Joint pain

* Joint swelling

* Stiffness, especially in the morning

* Warmth around a joint

* Redness of the skin around a joint

* Reduced ability to move the joint



Signs and tests:

First, your doctor will take a detailed medical history to see if arthritis or another musculoskeletal problem is the likely cause of your symptoms.

Next, a thorough physical examination may show that fluid is collecting around the joint. (This is called an "effusion.") The joint may be tender when it is gently pressed, and may be warm and red (especially in infectious arthritis and autoimmune arthritis). It may be painful or difficult to rotate the joints in some directions. This is known as "limited range-of-motion."

In some autoimmune forms of arthritis, the joints may become deformed if the disease is not treated. Such joint deformities are the hallmarks of severe, untreated rheumatoid arthritis.

Tests vary depending on the suspected cause. They often include blood tests and joint x-rays. To check for infection and other causes of arthritis (like gout caused by crystals), joint fluid is removed from the joint with a needle and examined under a microscope. See the specific types of arthritis for further information.

Herckleperckle
Member

11-20-2003

Thursday, July 06, 2006 - 8:51 pm   Edit Post Move Post Delete Post View Post Send Herckleperckle a private message Print Post    
Source: Adam Healthcare Center


Treatment of Arthritis



Treatment of arthritis depends on the particular cause, which joints are affected, severity, and how the condition affects your daily activities. Your age and occupation will also be taken into consideration when your doctor works with you to create a treatment plan.

If possible, treatment will focus on eliminating the underlying cause of the arthritis. However, the cause is NOT necessarily curable, as with osteoarthritis and rheumatoid arthritis. Treatment, therefore, aims at reducing your pain and discomfort and preventing further disability.

It is possible to greatly improve your symptoms from osteoarthritis and other long-term types of arthritis without medications. In fact, making lifestyle changes without medications is preferable for osteoarthritis and other forms of joint inflammation. If needed, medications should be used in addition to lifestyle changes.

Exercise for arthritis is necessary to maintain healthy joints, relieve stiffness, reduce pain and fatigue, and improve muscle and bone strength. Your exercise program should be tailored to you as an individual. Work with a physical therapist to design an individualized program, which should include:

* Range of motion exercises for flexibility

* Strength training for muscle tone

* Low-impact aerobic activity (also called endurance exercise)

A physical therapist can apply heat and cold treatments as needed and fit you for splints or orthotic (straightening) devices to support and align joints. This may be particularly necessary for rheumatoid arthritis. Your physical therapist may also consider water therapy, ice massage, or transcutaneous nerve stimulation (TENS).

Rest is just as important as exercise. Sleeping 8 to 10 hours per night and taking naps during the day can help you recover from a flare-up more quickly and may even help prevent exacerbations.

You should also:

* Avoid positions or movements that place extra stress on your affected joints

* Avoid holding one position for too long

* Reduce stress, which can aggravate your symptoms. Try meditation or guided imagery. And talk to your physical therapist about yoga or tai chi.

* Modify your home to make activities easier. For example, have grab bars in the shower, the tub, and near the toilet.


Other measures to try include:

* Taking glucosamine and chondroitin -- these form the building blocks of cartilage, the substance that lines joints. These supplements are available at health food stores or supermarkets. Early studies indicate that these compounds are safe and may improve your arthritis symptoms. More research is underway.

* Eat a diet rich in vitamins and minerals, especially antioxidants like vitamin E. These are found in fruits and vegetables. Get selenium from Brewer's yeast, wheat germ, garlic, whole grains, sunflower seeds, and Brazil nuts. Get omega-3 fatty acids from cold water fish (like salmon, mackerel, and herring), flaxseed, rapeseed (canola) oil, soybeans, soybean oil, pumpkin seeds, and walnuts.

* Apply capsaicin cream (derived from hot chili peppers) to the skin over your painful joints. You may feel improvement after applying the cream for 3-7 days.


MEDICATIONS

Your doctor will choose from a variety of medications as needed. Generally, the first drugs to try are available without a prescription. These include:

* Acetaminophen (Tylenol) -- recommended by the American College of Rheumatology and the American Geriatrics Society as first-line treatment for osteoarthritis. Take up to 4 grams a day (2 extra-strength Tylenols every 6 hours). This can provide significant relief of arthritis pain without many of the side effects of prescription drugs. DO NOT exceed the recommended doses of acetaminophen or take the drug in combination with large amounts of alcohol. These actions may damage your liver.

* Aspirin, ibuprofen, or naproxen -- these anti-inflammatory drugs are often effective in combating arthritis pain. However, they have many potential risks, especially if used for a long time. They should not be taken in any amount without consulting your doctor. The most dangerous side effects are stomach ulcers, bleeding from the digestive tract, and kidney damage. If you have kidney or liver disease, or a history of gastrointestinal bleeding, you should not take these medicines unless your doctor specifically recommends them.


Prescription medicines include:

* Cyclo-oxygenase-2 (COX-2) inhibitors -- these drugs, such as Celecoxib and Rofecoxib, treat arthritis pain in a fashion similar to traditional NSAIDs. However, they seem to cause less stomach irritation and confer a lower risk of ulcers and gastrointestinal bleeding. Because these drugs can still affect the digestive tract and can be toxic to the kidneys, they should be taken under careful medical supervision.

* Corticosteroids ("steroids") -- these are medications that suppress the immune system and symptoms of inflammation. They are commonly used in severe cases of osteoarthritis, and they can be given orally or by injection. Steroids are used to treat autoimmune forms of arthritis but should be avoided in infectious arthritis. Steroids have multiple side effects, including upset stomach and gastrointestinal bleeding, high blood pressure, thinning of bones, cataracts, and increased infections. The risks are most pronounced when steroids are taken for long periods of time or at high doses. Close supervision by a physician is essential.

* Disease-modifying anti-rheumatic drugs -- these have been used traditionally to treat rheumatoid arthritis and other autoimmune causes of arthritis. These drugs include gold salts, penicillamine, sulfasalazine, and hydrochloroquine. More recently, methotrexate has been shown to slow the progression of rheumatoid arthritis and improve your quality of life. Methotrexate itself can be highly toxic and requires frequent blood tests for patients on the medication.

* Anti-biologics -- these are the most recent breakthrough for the treatment of rheumatoid arthritis. Such medications, including etanercept (Enbrel) and infliximab (Remicade), are administered by injection and can dramatically improve your quality of life.

* Immunosuppressants -- these drugs, like azathioprine or cyclophosphamide, are used for serious cases of rheumatoid arthritis when other medications have failed.

It is very important to take your medications as directed by your doctor. If you are having difficulty doing so (for example, due to intolerable side effects), you should talk to your doctor.



SURGERY AND OTHER APPROACHES

In some cases, surgery to rebuild the joint (arthroplasty) or to replace the joint (such as a total knee joint replacement) may help maintain a more normal lifestyle. The decision to perform joint replacement surgery is normally made when other alternatives, such as lifestyle changes and medications, are no longer effective.

Normal joints contain a lubricant called "synovial fluid." In joints with arthritis, this fluid is not produced in adequate amounts. A relatively recent treatment approach is to inject arthritic joints with a manmade version of joint fluid known as hylan G-F 20 (Synvisc). This synthetic fluid may postpone the need for surgery at least temporarily and improve the quality of life for arthritis patients. Many studies are evaluating the effectiveness of this type of therapy.


Expectations (prognosis)

A few arthritis-related disorders can be completely cured with treatment. Most are chronic (long-term) conditions, however, and the goal of treatment is to control the pain and minimize joint damage. Chronic arthritis frequently goes in and out of remission.



Complications

* Chronic pain

* Lifestyle restrictions or disability


Call your doctor if:

* Your joint pain persists beyond 3 days

* You have severe unexplained joint pain

* The affected joint is significantly swollen

* You have a hard time moving the joint

* Your skin around the joint is red or hot to the touch

* You have a fever or have lost weight unintentionally

Herckleperckle
Member

11-20-2003

Thursday, July 06, 2006 - 8:55 pm   Edit Post Move Post Delete Post View Post Send Herckleperckle a private message Print Post    
Source: Adam Healthcare Center


Arthritis Prevention


If arthritis is diagnosed and treated early, you can prevent joint damage. Find out if you have a family history of arthritis and share this information with your doctor, even if you have no joint symptoms.

Osteoarthritis may be more likely to develop if you abuse your joints (injure them many times or over-use them while injured). Take care not to overwork a damaged or sore joint. Similarly, avoid excessive repetitive motions.

Excess weight also increases the risk for developing osteoarthritis in the knees, and possibly in the hips and hands. See the article on body mass index to learn whether your weight is healthy.

Herckleperckle
Member

11-20-2003

Thursday, July 06, 2006 - 9:36 pm   Edit Post Move Post Delete Post View Post Send Herckleperckle a private message Print Post    
Source: Adam Healthcare Center


Osteoarthritis


knees


Osteoarthritis is a chronic disease of the joint cartilage and bone, often thought to result from "wear and tear" on a joint, although there are other causes such as congenital defects, trauma and metabolic disorders. Joints appear larger, are stiff and painful and usually feel worse the more they are used throughout the day.



hands


Osteoarthritis is associated with the aging process and can affect any joint. The cartilage of the affected joint is gradually worn down, eventually causing bone to rub against bone. Bony spurs develop on the unprotected bones causing pain and inflammation.

Herckleperckle
Member

11-20-2003

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Source: Adam Healthcare Center


Rheumatoid Arthritis


rheum1


Rheumatoid arthritis is an autoimmune disease in which the body's immune system attacks itself. The pattern of joints affected is usually symmetrical, involves the hands and other joints and is worse in the morning. Rheumatoid arthritis is also a systemic disease, involving other body organs, whereas osteoarthritis is limited to the joints. Over time, both forms of arthritis can be crippling.




rheum knee


Rheumatoid arthritis is a systemic autoimmune disease which initially attacks the synovium, a connective tissue membrane that lines the cavity between joints and secretes a lubricating fluid.


rheum knee 2

Rheumatoid arthritis is another form of arthritis. The body's own immune system attacks a joints synovial membrane, which secretes fluid and lines the joint. The synovium becomes inflamed, produces excess fluid, and the cartilage becomes rough and pitted.




rheum hand


The affect of rheumatoid arthritis can progress to the degree that it is crippling. Deformities distinctive to late-stage rheumatoid arthritis such as ulnar deviation of the bones of the hands, or swan-neck deviation of the fingers occur because muscles and tendons on one side of the joint may overpower those on the other side, pulling the bones out of alignment.

Herckleperckle
Member

11-20-2003

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Source: Adam Healthcare Center


Osteoarthritis vs Rheumatoid Arthritis


osteo vs rheum


Osteoarthritis is a deterioration of cartilage and overgrowth of bone often due to "wear and tear". Rheumatoid arthritis is the inflammation of a joint's connective tissues, such as the synovial membranes, which leads to the destruction of the articular cartilage.

Herckleperckle
Member

11-20-2003

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Source: Adam Healthcare Center


Arthritis of the Hip



arthritis in hip


Cartilage normally protects the joint, allowing for smooth movement. Cartilage also absorbs shock when pressure is placed on the joint, like when walking. Arthritis involves the breakdown of cartilage. Without the usual amount of cartilage, the bones of the joint rub together, causing pain, swelling and stiffness.




Hip Joint Replacement


hip joint replacement


The hip joint is a ball-in-socket joint where the ball or head of the femur (thigh bone) joins the pelvis at the socket called the acetabulum.

Herckleperckle
Member

11-20-2003

Thursday, July 06, 2006 - 10:22 pm   Edit Post Move Post Delete Post View Post Send Herckleperckle a private message Print Post    
Source: Medicinenet.com

Bursitis of the Hip


What is bursitis?

A bursa is a closed fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body. "Bursae" is plural for "bursa." The major bursae are located adjacent to the tendons near the large joints, such as the shoulders, elbows, hips, and knees. When the bursa becomes inflamed, the condition is known to as "bursitis." Most commonly, this is a noninfectious condition (aseptic bursitis) caused by inflammation resulting from local soft tissue trauma or strain injury. On rare occasions, the hip bursa can become infected with bacteria. This condition is called septic bursitis. Also uncommonly the hip bursa can become inflamed by crystals that deposit there from gout or pseudogout.



What is hip bursitis and what symptoms does it cause?

There are two major bursae of the hip, which can both be associated with stiffness and pain around the hip joint. The trochanteric bursa is located on the side of the hip. It is separated significantly from the actual hip joint by tissue and bone. Trochanteric bursitis frequently causes tenderness of the outer hip, making it difficult for patients to lie on the involved side, frequently making sleep difficult. It also causes a dull, burning pain on the outer hip that is often made worse with excessive walking or stair climbing. The ischial bursa is located in the upper buttock area. It can cause dull pain in this area that is most noticeable climbing up hill. The pain sometimes occurs after prolonged sitting on hard surfaces, hence the names "weaver's bottom" and "tailor's bottom."

Bursitis of the hip is the most common cause of hip pain.



How is bursitis of the hip diagnosed?

Bursitis of the hip is diagnosed based on the history of outer hip pain, specific areas of tenderness of the outside of the hip, and confirmed by relief with local injection of anesthetic in the doctor's office. Patients frequently notice pain in the outer hip with stair climbing or descending and tenderness of the hip when lying on the affected side at night. The doctor can localize the tender areas to the location of the bursae of the hip. Occasionally, x-ray tests of the hip are used to rule out other conditions of the bone and joints, such as arthritis. Sometimes, but not always, x-rays can highlight areas of calcium deposits in an inflamed bursa.



How is bursitis of the hip treated?

The treatment of any bursitis depends on whether or not it involves infection. Noninfectious or aseptic hip bursitis can be treated with ice compresses, rest, and anti-inflammatory and pain medications. Occasionally, it requires aspiration of the bursa fluid. This procedure involves removal of the fluid with a needle and syringe under sterile conditions. It can be performed in the doctor's office. Sometimes the fluid is sent to the laboratory for further analysis. Frequently there is inadequate fluid accumulation for aspiration. Noninfectious hip bursitis can be treated with an injection of cortisone medication, often with an anesthetic, into the swollen bursa. This is sometimes done at the same time as the aspiration procedure.

Patients with hip bursitis can often benefit by weight reduction, stretching exercises, and proper footwear for exercise activities. Sometimes physical therapy programs can be helpful. Generally, patients should avoid hills and stairs and direct pressure on the affected hip (sleep on the other side), when possible, while symptoms are present.

Septic bursitis (again, uncommon in the hip) requires even further evaluation by a doctor. This is unusual in the hip bursa, but does occur. The bursal fluid can be examined in the laboratory for the microbes causing the infection. Septic bursitis requires antibiotic therapy, often intravenously. Repeated aspiration of the inflamed fluid may be required. Surgical drainage and removal of the infected bursa sac (bursectomy) may also be necessary.



Bursitis Of The Hip At A Glance

* A bursa is a fluid-filled sac that functions as a gliding surface to reduce friction between moving tissues of the body.

* There are two major bursae of the hip.

* Bursitis is usually not infectious, but the bursa can become infected.

* Treatment of non-infectious bursitis includes rest, ice, and medications for inflammation and pain. Infectious bursitis (uncommon) is treated with antibiotics, aspiration, and surgery.

* Bursitis of the hip is the most common cause of hip pain.

Herckleperckle
Member

11-20-2003

Thursday, July 06, 2006 - 10:26 pm   Edit Post Move Post Delete Post View Post Send Herckleperckle a private message Print Post    
Source: MedicineNet.com

Medications for Hip Bursitits


Sorted Alphabetically A-Z

* acetaminophen, Tylenol
* acetylsalicylic acid, Aspirin, Ecotrin
* celecoxib, Celebrex
* flurbiprofen, Ansaid
* ibuprofen, Advil, Motrin, Medipren, Nuprin
* indomethacin, Indocin, Indocin-SR
* ketoprofen, Orudis, Oruvail


Sorted by Popularity (as read on MedicineNet)

* ibuprofen, Advil, Motrin, Medipren, Nuprin
* acetaminophen, Tylenol
* ketoprofen, Orudis, Oruvail
* celecoxib, Celebrex
* acetylsalicylic acid, Aspirin, Ecotrin
* indomethacin, Indocin, Indocin-SR
* flurbiprofen, Ansaid

Herckleperckle
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11-20-2003

Thursday, July 06, 2006 - 10:36 pm   Edit Post Move Post Delete Post View Post Send Herckleperckle a private message Print Post    
Source: MedicineNet.com
Author: Medical Author: William C. Shiel Jr., MD, FACP, FACR

Calcific Bursitis



What is calcific bursitis?

A bursa is a thin fluid-filled sac that reduces friction forces between tissues of the body. Chronic (repeated or long-standing) inflammation of the bursa (bursitis) can lead to calcification of the bursa. This is referred to as "calcific bursitis." The calcium deposits (calcification) can occur as long as the inflammation is present and remain after it has resolved. Calcific bursitis occurs most commonly in the shoulder.



How is calcific bursitis diagnosed?

Calcific bursitis is diagnosed when viewed with an x-ray test or MRI scan of the inflamed, painful bursa.



What is the treatment of calcific bursitis?

Treatment of the inflammation of calcific bursitis can help to prevent further calcification as well as relieve pain and stiffness. Treatments include medications for inflammation, ice, immobilization, injections of cortisone into the bursa, and occasionally surgical removal of the inflamed bursa.



What is the outlook for a patient with calcific bursitis?

When the inflammation is quieted the long-term outlook (prognosis) is excellent. Optimal improvement can require physical therapy treatment. The calcium deposit can remain indefinitely and may not cause any problems. Significant calcium deposits can sometimes, however, cause a mechanically abrasive area of tenderness. These deposits that continue to cause symptoms are considered for surgical removal.

Herckleperckle
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11-20-2003

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Source: Arthritis Foundation (article published in USA Today--Life, page 6D) (Site: USA Today article
Date: June 10, 2006


Exercise, medicines keep disease in check; years of pain are a distant memory for 54-year-old Kathleen Fackelmann



Twenty years ago, Monica Blake was a single mother with a case of rheumatoid arthritis so bad that she feared she was headed for a life of disability.

"I literally had a leg that I dragged behind me," Blake says now about a disease that had destroyed the cushioning in her left knee joint. She worried that she wouldn't be able to continue to work or care for her son, who was then just 10.

Today, Blake, 54, of Pasadena, Calif., works full time as a human resources executive for a food company and has enough energy at the end of the day to teach Pilates, a form of exercise that strengthens core muscles. "I'm not in pain, and I'm strong," she says.

You'd never guess that Blake has had three knee-replacement operations and takes Enbrel, one of several new drugs that help push back the incurable joint disease. But she says she wouldn't be where she is today without Pilates.

Rheumatoid arthritis is an incurable autoimmune disease of the joints that afflicts more than 2 million Americans. About 50% are so disabled by the disease 10 years after their diagnosis that they can no longer work.

Just a few decades ago, a diagnosis meant a life of increasing disability, says Stephen Lindsey, chief of rheumatology at the Ochsner Health System in Baton Rouge. However, drugs introduced in the '90s, along with regular physical activity, have greatly changed the treatment of the disease, he says.

Blake couldn't agree more. "I have a new lease on life."

Blake was just 25 and at home with her 2-month-old baby when the disease first attacked in 1975. She said her knees were so swollen she could barely stand.



Back to work and in pain

After eight months, Blake realized she needed to get on with her life. "I went back to work limping and in pain," she says. Blake was a supervisor in a General Motors factory in Ohio and had to walk the floor -- something that wasn't easy for her at the time.

For the next 10 years she followed doctor's orders: She took aspirin and other non-steroidal anti-inflammatory drugs that can help quell the joint pain.

Then, in 1980, Blake's marriage fell apart. The years that followed were difficult as she worked full time and was a single parent. "I was a supermom," she says, and was coping with the daily pain of rheumatoid arthritis. "Think of someone putting a nail through your knee or through your wrist."

Year after year, the disease destroyed more of the cartilage cushioning her left knee. By 1986, the bones in Blake's left knee joint had started to rub together, causing excruciating pain. So she got her first artificial knee, and that stopped the pain for a while.

But the surgery cannot stop the underlying disease. So once again, Blake was taking medications such as methotrexate, an anti-cancer drug that helps suppress the immune attack but doesn't stop the disease.

By 1993 the pain was back full force, and the disease had begun to attack her right knee.

She says she was desperate when her chiropractor mentioned Pilates, which, like other forms of exercise, might help by strengthening the muscles that support the damaged joints.

A few years later Blake started to take Enbrel, a drug that was part of a class called biologic response modifiers. Rheumatoid arthritis is thought to develop when the body's immune system mistakenly attacks the joints. Drugs like Enbrel limit or stop that damage by interfering with that attack.

Patients taking these new drugs could get a temporary reprieve from the disease. "We began to think about not just stopping the pain but ending the disability and allowing patients to live a normal life," Lindsey says.



Exercise is key

The drug didn't halt Blake's disease outright, but it helped. So did the Pilates class that she was now taking three or four times a week.

Pilates and other low-impact exercises such as swimming help keep the muscles around the joints stronger, which reduces disability from arthritis, says John Klippel, president and CEO of the Atlanta-based Arthritis Foundation.

No drug on the market today can stop the disease completely, and by 2001 the disease had decimated the cartilage in Blake's right knee and had attacked the bones in her left knee.

This time, Blake could hardly wait to get the surgery. She got the right knee done and then the left.

She says she had a fast recovery because her body was so strong from years of Pilates. Most people who get a knee replacement must use crutches for two weeks after the surgery, but she stopped using them after two days.

After her recovery, Blake increased her Pilates training and got certified in 2005 to teach the routine. She now teaches four or five classes a week, is pain-free and walks without a limp. She gets up at 5 most mornings for a home workout before going to work.

But years of battling the disease have left her with permanent joint damage.

For example, Blake can't completely straighten her arms or her fingers. She has two artificial knees and worries about what will happen a decade from now when the implants start to wear out.

Still, Blake feels better than she ever imagined she would after more than three decades of battling this disease. "I'm in a great place."

Texannie
Member

07-16-2001

Friday, July 07, 2006 - 12:01 am   Edit Post Move Post Delete Post View Post Send Texannie a private message Print Post    
Thanks HP! It's so discouraging to see that the one of the top things is weight loss and exercise. He ran every day of his life from the time he was 16 until about 65 and then started swimming a 1/4 mile every day. That man is in good shape! He had back surgery about 4 years ago for drop foot and has just seemed to be in constant pain since. He has really aged in the last year. (goes back to my personal theory!)

Skootz
Member

07-23-2003

Friday, July 07, 2006 - 1:52 am   Edit Post Move Post Delete Post View Post Send Skootz a private message Print Post    
I just found out recently that the reason I ( and other family members) have Osteoarthritis is due to lack of blood flow in the right hip area. I have also developed OA in both of my knees. Due to recently losing 30lbs, I found it discouraging that my knees have not improved - but figure this due to working at my cleaning business) I have however noticed that my hip is much better.

Twinkie
Member

09-24-2002

Tuesday, September 12, 2006 - 6:59 pm   Edit Post Move Post Delete Post View Post Send Twinkie a private message Print Post    
Yesterday, I went to the ER because I was in so much pain. I had the pain for 2 days before finally going, it was that bad. The pain is around my left shoulder blade on my back. They took xrays and said it was arthritis and drugged me to the gills and sent me home with Vicodin. I've heard of arthritis in joints but never of the shoulder blade. In fact, I've had arthritis in my left hip for a while now but never pain like this. It feels like a knife is sticking about 3 inches into me and the knife is twisting. Has anyone ever heard of this? I'm going to my pain mngmt doctor on Friday to see about getting a more permanent solution like maybe a shot of cortisone or something because when the pills are gone I'm going to be a hurting puppy again. If you've heard of this before please let me know. Until the xrays I was actually worried it was a lung problem, its that deep.

Sunshyne4u
Member

06-17-2003

Wednesday, September 13, 2006 - 12:25 am   Edit Post Move Post Delete Post View Post Send Sunshyne4u a private message Print Post    
sounds like the arthritic area has inflamed some nerves and irritated muscles.

I dont have arthritis but i get pinched nerves from my back. It is definitely the same as you are describing.

I found it hard to even take a medium deep breath it is like a knife stabbing. Massage sometmes helps, A hot shower/ cold compress, Laying FLAT on your back with a low pillow and arm moved over your chest stretching your shoulder blade OUT.

if its badly spazmed, irritated nothing really helps though. I usually just try to ride it out.

*******
On another point though, Chest pain, heart probs CAN show up as back pain. If you have any flipflops or funny heart beats DO go into ER and be checked out.

take care

Sunshyne4u
Member

06-17-2003

Wednesday, September 13, 2006 - 12:25 am   Edit Post Move Post Delete Post View Post Send Sunshyne4u a private message Print Post    
sounds like the arthritic area has inflamed some nerves and irritated muscles.

I dont have arthritis but i get pinched nerves from my back. It is definitely the same as you are describing.

I found it hard to even take a medium deep breath it is like a knife stabbing. Massage sometmes helps, A hot shower/ cold compress, Laying FLAT on your back with a low pillow and arm moved over your chest stretching your shoulder blade OUT.

if its badly spazmed, irritated nothing really helps though. I usually just try to ride it out.

*******
On another point though, Chest pain, heart probs CAN show up as back pain. If you have any flipflops or funny heart beats DO go into ER and be checked out.

take care

Twinkie
Member

09-24-2002

Wednesday, September 13, 2006 - 6:31 pm   Edit Post Move Post Delete Post View Post Send Twinkie a private message Print Post    
Thanks, Sun! Hubby tried massaging the area but that hurt even more. a deep breath or cough or sneeze also causes intense pain. My pain doctor is getting the xrays from the ER before my appt. Friday so they will know the whole story. I'm hoping they can do something more permanent than pills because the pills make me loopy and sleepy and when they wear off the pain is bad. I can't wait til Friday. I need some relief.

Sunshyne4u
Member

06-17-2003

Saturday, September 16, 2006 - 12:54 am   Edit Post Move Post Delete Post View Post Send Sunshyne4u a private message Print Post    


Laying FLAT on your back with a low pillow under your head and arm moved over your chest stretching your shoulder blade OUT.

Be very gentle. This is a move that I will only do laying down and will try to relax the arm down in that position for awhile until things loosen up a bit. Sometimes there is more pain then a little clunk as it moves back into place. DONT sit up right away. Let the arm move back to normal position at your side and relax on back to allow the muscle to stay in its new position.

It may spasm again (mine usually do) but if you lay down on a regular basis you can maybe keep things under control.

Just trying to help...not giving "medical" information but only what I do at home myself.

By the way, the hubby will do more damage unless he knows where the pressure point release areas are. Massage is torture for me unless a specialist.

Sunshyne4u
Member

06-17-2003

Saturday, September 16, 2006 - 12:56 am   Edit Post Move Post Delete Post View Post Send Sunshyne4u a private message Print Post    
it occurs to me that the pic that I swiped ISNT exactly how i do it LOL

I cannot hold the arm straight with the other arm that way. I gently hold my elbox with my hand.

Gilda
Member

08-21-2006

Saturday, September 16, 2006 - 8:16 am   Edit Post Move Post Delete Post View Post Send Gilda a private message Print Post    
Good site on arthritis

http://arthritis.about.com/

Twinkie
Member

09-24-2002

Saturday, September 16, 2006 - 5:52 pm   Edit Post Move Post Delete Post View Post Send Twinkie a private message Print Post    
Well, turns out it wasn't arthritis. It was deep spasming. The doctor felt it as soon as she touched the area. She gave me shots in the whole area and that seemed to help. She also gave me more pain pills so I'm sleeping a lot. zzzzzzzzzzzzzzzz

Twinkie
Member

09-24-2002

Wednesday, September 20, 2006 - 4:00 pm   Edit Post Move Post Delete Post View Post Send Twinkie a private message Print Post    
Well, here we go again. The pain in the spasming area is back. The shots she gave me seemed to help some for the first night and the next day but then it was back to the same pain I had before. I'm calling the pain doc's office tomorrow to see what can be done now. I would have called them today but I already had 2 different doc appts. today. I know my DH is sick of taking me to doctors all the time but bless his heart he doesn't complain at all.

Sunshyne4u
Member

06-17-2003

Tuesday, October 03, 2006 - 6:51 pm   Edit Post Move Post Delete Post View Post Send Sunshyne4u a private message Print Post    
Said it was spasms.

Herckleperckle
Member

11-20-2003

Saturday, October 21, 2006 - 7:19 am   Edit Post Move Post Delete Post View Post Send Herckleperckle a private message Print Post    
Source: Ivanhoe.com
Reported September 18, 2006


Gleevec for Rheumatoid Arthritis


(Ivanhoe Newswire) -- For many years, only the pain caused by rheumatoid arthritis (RA) could be treated and not the deterioration of the joints caused by inflammation. Now, researchers report a new way to stop the progression of the disease.

Researchers from Stanford University report imatinib mesylate (Gleevec, Novartis) is effective at stopping the progression of a RA-like disease in mice.

They say there needs to be more research before this treatment can be recommended for humans. However, there are two documented cases of humans taking Gleevec to treat their cancer and showing an improvement in their RA.

Doctors often prescribe Gleevec to treat people with chronic myelogenous leukemia or gastrointestinal stromal tumors, but doctors have not measured its effect on RA before now.

RA causes inflammation in joint linings, which wipes out surrounding cartilage and bone. Many people with the disease require constant pain management. Some sufferers require multiple joint replacements.

Researchers report when they gave Gleevec to mice with the RA-like disease, it prevented the start of the disease and halted its progression if it was already underway.


SOURCE: Journal of Clinical Investigation, 2006;doi:10.1172

Herckleperckle
Member

11-20-2003

Saturday, October 21, 2006 - 7:23 am   Edit Post Move Post Delete Post View Post Send Herckleperckle a private message Print Post    
Source: Ivanhoe.com
Reported September 5, 2006


Same Treatment, new Approach
for Rheumatoid Arthritis


(Ivanhoe Newswire) -- A new study reveals there may be a more effective way to deliver drugs to treat rheumatoid arthritis, according to researchers from the University of California, San Diego.

The study reveals the very same drugs currently used to relieve the joint pain and inflammation of RA may now work even better if administered using a different method.

The body monitors the pain and inflammation associated with RA using the central nervous system, which includes the brain and spinal cord. Previous data shows the central nervous system can regulate inflammation, but doctors needed more research to find out exactly how this happens.

Researchers focused on a protein called p38. Several substances that block the action of p38 are effective when tested on rats and in clinical trials with patients suffering from RA.

The researchers induced inflammation in the joints of rats and then looked for responses in their spinal cords. They found that inflammation activated p38 in the spinal cord. Then they blocked p38 with drugs directly delivered to the spinal cord of the arthritic rats. This dramatically reduced inflammation, compared to rats that received no active drug.

Next they injected the same amount of active drugs underneath the skin of rats, but that location didn't produce the same beneficial effects seen when the drugs were administered directly into the spine.

According to the researchers, the method of administering directly to the spinal cord may improve the benefits, reduce the side effects -- and possibly even the costs -- of p38 blockers without compromising the benefits for patients.


SOURCE: Public Library of Science Medicine, 2006, 3:e338

Herckleperckle
Member

11-20-2003

Friday, November 03, 2006 - 6:59 pm   Edit Post Move Post Delete Post View Post Send Herckleperckle a private message Print Post    
Source: Ivanhoe.com
Reported October 30, 2006


Curry for Arthritis


(Ivanhoe Newswire) -- A spice commonly used in curries and other South Asian dishes may help treat arthritis.

A new report from the National Institutes of Health reveals turmeric -- a flowering plant in the ginger family -- has anti-arthritic benefits.

Researchers used an experimental compound containing turmeric that was similar to over the counter turmeric dietary supplements.

Study results reveal the dose they gave to rats blocked a protein that leads to inflammation and also blocked other key genes that cause inflammation. Researchers also found turmeric could prevent acute and chronic arthritis, block the destruction of joints due to arthritis, and prevent an increase in the cells that break down bone in joints.

The authors say the turmeric dietary supplements seem to work in the same way as drugs that are currently being developed to target the same protein to treat arthritis. And because of the chemical complexity of turmeric, it may also block other causes of inflammation.

“In summary, just as the willow bark provided relief for arthritis patients before the advent of aspirin, it would appear that the underground stem (rhizome) of a tropical plant [turmeric] may also hold promise for the treatment of joint inflammation and destruction,” write the authors.

They say more studies are needed before turmeric supplements can be recommended as a treatment for arthritis.

More than 40 percent of arthritis patients in the United States use complementary and alternative medicine, including dietary supplements. The use has gone up since the FDA warned consumers about the dangers of anti-inflammatory drugs such as Celebrex.

SOURCE: Arthritis & Rheumatism, 2006;54:3452-3464