Millions of patients have moderate and severe rheumatoid arthritis which causes significant stiffness, pain and swelling of joints. They may have difficulty doing simple tasks first thing in the morning such as squeezing toothpaste, grasping and taking lids off jars. They feel like ‘the tin man in the Wizard of Oz and could sure use a lube job.
Ankylosing spondylitis ,A.S., is a common inflammatory disorder that causes back pain and stiffness. The symptoms are very different than those of osteoarthritis, O.A., of the spine.
We are living in an epidemic of gout arthritis. Almost 10 million people in the United States have high uric acid and gout. Often, we think of gout affecting men who drink too much alcohol and eat too much. This has changed . Many postmenopausal women have gout. Why ?
Osteoarthritis, as it is often referred to as degenerative arthritis, is the most common of all arthritic conditions. This affects about 1 in 4 adults. The cause of osteoarthritis is not known. What occurs is that the cartilage or ‘shock absorber’ in the joint, which protects the bones, breaks down and leads to pain and stiffness and often significant immobility. The symptoms are related to where the arthritis occurs. For example, the cervical spine in the neck, patients may have a burning and radiating pain to their shoulder and arm. This is often referred to as a pinched nerve.
Osteoporosis is a common disease of bone loss which often occurs in postmenopausal women. One in two women over the age of 50 will have either a hip ,spine or wrist fracture. Men over the age of 60 are also at increased risk.
Some medications thin bone. These include corticosteroids (prednisone), Dilantin, Heparin, PPI (medicines that treat heartburn and indigestion), SSRI (medications treat anxiety and depression), and testosterone lowering medications used to treat prostate cancer (Lupron). Some intestinal conditions block the absorption of vitamin D and calcium in the small intestine. This includes lactose intolerance, celiac and Crohn’s disease.
Low bone mass and osteoporosis can lead to fractures often of the spine and hip. The impact of having a severe fracture can be life changing for not only the patient but their family. Many times, patients will no longer be able to adequately care for themselves in their home and find themselves moving to an extended care facility.
The treatment for patients with low bone mass and osteoporosis includes taking adequate amounts of calcium and vitamin D.
The following oral medications are alendronate, risedronate and ibandronate. Side effects of these meds may be indigestion and digestion problems. An important alternative are injectable and intravenous medicines.
See the medication site.
Psoriasis and Psoriatic Arthritis
Psoriasis is a very common skin condition. The cause is unknown. However, like rheumatoid arthritis and other autoimmune diseases, there is an imbalance of cytokines which are molecules produced in the skin, as well as in the joints. Patients will often develop whitish, itchy patches and plaques.
Raynauds is a constriction of the small blood vessels of the hands or feet. This occurs in cold temperatures. Raynauds is more common in women and people who have autoimmune diseases like rheumatoid arthritis, lupus ,sjogrens and scleroderma. The symptoms can be mild with discoloration or very painful.
Systemic Lupus Erythematosis (S.L.E.)
Systemic lupus is a chronic inflammatory disease that can cause many different symptoms including pain and swelling of the joints, skin rashes and at times more serious internal organ disease. SLE is at times an elusive disease to diagnose. There are a number of laboratory tests which are very helpful in confirming the diagnosis, as well as monitoring treatment.