Easing The Pain
For people with arthritis, pain management is
more complex than just taking aspirin. Arthritis is a chronic
disease that can cause significant pain and discomfort. It requires
a careful approach to pain management, including a combined effort
involving you and your doctor.
The following provides a general overview of
medications and other approaches to pain management. It will help
you gain additional insight into pain management, but remember, it
is very important that you discuss this subject with your doctor to
determine what specific pain management course is right for
you.
Here are a few basic considerations about the
use of pain medications:
- Not every drug is right for every patient.
- Most drugs have some type of side effect.
- A combination of drugs may be appropriate either by themselves
or in conjuction with other drugs for some conditions if
recommended by your doctor.
- There's a great deal of information - and misinformation -
available about medications. One helpful source is your pharmacist.
The package insert and other labeling provided by the drug
manufacturer is another. No matter where you start, it's important
to talk with your doctor about using, changing, or discontinuing
medications.
What are the analgesics prescribed
for?
The primary purpose of an analgesic is to relieve pain. Some
patients use aspirin, an analgesic that also reduces joint
inflammation. The most commonly used analgesic, acetaminophen, is
relatively effective and has few side effects. Acetaminophen does
not contain aspirin, however, so it doesn't relieve joint
inflammation. For this reason, acetaminophen is less likely to be
used with rheumatoid arthritis and other types of arthritis that
cause inflammation, and more likely to be used to treat
osteoarthritis and fibromyalgia.
The main side effect of analgesics is a slight
risk of dependency that can occur if the drugs are used for long
periods of time.
What can you tell me about NSAIDs?
Nonsteroidal anti-inflammatory drugs (NSAIDS) are the most
frequently used medications for arthritis. They are often used to
treat osteoarthritis, rheumatoid arthritis, gout, juvenile
arthritis, and bursitis. Some are available by prescription only,
while others (such as aspirin, ibuprofen, and naproxen) can be
purchased over the counter.
NSAIDs help reduce redness and swelling and
relieve pain. The type of NSAID that your doctor recommends for you
will depend on several factors:
- The type of arthritis you have
- The degree of pain and inflammation
- How your body reacts to the NSAID
- Other medications you are taking
As with all medications, there are side effects
that can occur with NSAIDs. The most common side effects include
constipation and stomach irritation (ranging from indigestion and
heartburn to development of stomach ulcers if symptoms are left
untreated). For this reason, your doctor will monitor you
carefully, and you should report any symptoms immediately.
When would a doctor prescribe
corticosteroids?
Corticosteroids are similar to the hormone, cortisol, which occurs
naturally in the body. Corticosteroids reduce painful inflammation
in joints, but because of potentially serious side effects, they
are rarely used as a first choice for long-term treatment.
Corticosteroids are almost never used to treat
osteoarthritis, and when they are prescribed for rheumatoid
arthritis, it is generally to relieve severe symptoms while waiting
for another drug, such as an NSAID, to reach an effective level. If
they are used for a longer period of time, they are generally used
in lower doses.
Are there any medications that can help
people with fibromyalgia?
Fibromyalgia is often mistaken for chronic fatigue syndrome because
the patients never feel fully rested. Fibromyalgia, affecting deep
muscle tissues and their attachments to bone, is extremely painful.
A number of drugs that are not generally used to treat other types
of arthritis may be prescribed for fibromyalgia, including
antidepressants and antianxiety drugs.
Taken in smaller doses than for depression,
these drugs can give patients the type of deep sleep they need,
which contributes to pain relief and increased energy. Muscle
relaxants can also promote sleep and ease painful muscles. Possible
side effects vary depending on which type of medication is taken.
You should discuss with your doctor the side effects of the drug
prescribed for you.
Do I have to take drugs to relieve arthritis
pain?
Arthritis patients have found that they may benefit from a number
of other pain management techniques that do not involve medication.
The most popular are:
- Sleep
- Exercise
- Stress Management
- Massage Therapy
- Relaxation Therapy
- Biofeedback
- Hot/Cold Treatment
Is it true that sleep can be a factor in
arthritis pain?
Not getting a good night's sleep is a problem for many people with
arthritis. If your pain continually awakens you, you may never
reach Stage 3 sleep - the deep sleep that's needed for true rest.
And your fatigue can worsen your pain. There are many sources of
information about getting a better night's sleep - magazine
articles, books, web sites, etc., and you should consult with your
doctor, nurse, or therapist.
