Living well with arthritis

In spite of the many great advances in the medical and surgical management of arthritis, some residual loss of comfort and function may remain. Thus the opportunity is to learn strategies for living well with arthritis.

We have assembled some information that may be useful to patients for managing their arthritis

Lifestyle

  College and arthritis

  Diet

  Family

  Fatigue

  Frequently asked questions about arthritis

  Frequently asked questions about living with arthritis

  Joints

  Laboratory tests

  Pain

  Pregnancy

  Sex

  Stress

  Travel

  Using joints wisely

  Vocational rehabilitation

  Work

Exercises

  Exercise

  Exercise videos

  Water exercises

Medications - the good and the bad
  Arthritis Foundation Drug Guide
  Medications and joint replacement

Unproven remedies

Related conditions
  Back Pain
  Carpal Tunnel Syndrome
  Diabetes
  Fibromyalgia

The Arthritis Foundation
The Arthritis Foundation - Washington/Alaska Chapter

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Relative safety of non-steroidal anti-inflammatory medications

A recent study has made some important observations on the cardiovascular risk of different NSAIDs. The summary of this study is presented below.

For those patients with normal kidney function, who are not on anticoagulants, who do not have other contraindications, we commonly suggest naproxen (Aleve) used according to the manufacturer's specifications.


"Data from a study published online in the journal PLoS Medicine suggest that, among widely used non-steroidal anti-inflammatory drugs (NSAIDs), naproxen and low-dose ibuprofen are the least likely to increase cardiovascular risk. The authors conducted a systematic review of 30 case-control studies covering 184,946 cardiovascular events, and 21 cohort studies that described outcomes in more than 2.7 million exposed individuals. Of the most extensively studied drugs, the highest overall risks were seen with rofecoxib and diclofenac, and the lowest with ibuprofen and naproxen. In a sub-set of studies, risk was elevated with low doses of rofecoxib, celecoxib, and diclofenac, with risk increasing with higher doses. Ibuprofen risk was seen only with higher doses, while naproxen was risk-neutral at all doses."

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Use the "Search the Blog" box to the right to find other topics of interest to you.

You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty,  and rotator cuff surgery.

See the countries from which our readers come on this post.

Shoulder arthritis: medications and joint replacement

Patients with arthritis are often on medications to control the condition and its symptoms. Certain of these medications can substantially affect the safety of and recovery from joint replacement for shoulder arthritis.


My colleague Greg Gardner has put together a very nice summary of these concerns in this article published in the AAOS journal. Quoting from this article "Managing the perioperative drug regimen of the patient with RA can be challenging, but it is essential in order to optimize surgical outcome.

Perioperative consultation and collaboration with the patient’s rheumatologist or internist is recommended. In patients with RA, correct timing of discontinuation of NSAIDs in preparation for surgery may avoid patient discomfort without risking complications resulting from cyclooxygenase inhibition. Corticosteroid management depends on the type of orthopaedic procedure and must be part of perioperative planning. The goal of perioperative management of DMARDs is to reduce the risk of infection and optimize wound healing while minimizing the chance of a disease flare that could compromise recovery. Currently,methotrexate is the only medication with evidencebased data supporting continuing treatment through surgery.Without data to the contrary, we recommend that the more powerful biologic agents should be used as described in Table 1. These recommendations may change as experience and data accumulate"

The tables from this article are shown below

See also Medicines to Avoid Before Surgery

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Use the "Search the Blog" box to the right to find other topics of interest to you.

You may be interested in some of our most visited web pages including: shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery.

See the countries from which our readers come on this post.

Drugs for arthritis: the good and the bad

Oral medications are often used to manage the symptoms of shoulder arthritis. While drugs such as Enbrel or Humira can modify the course of rheumatoid arthritis, there is little evidence that medications can change the course of osteoarthritis, chondrolysis, or capsulorrhaphy arthropathy, the commonest forms of shoulder arthritis.

The most common medications used for the symptoms of shoulder arthritis are basic pain relievers and NSAIDs (non-steroidal anti inflammatory medications). Taking these medications is not without risks -some of which are substantial - such as the increased risk of heart attack and stroke, bleeding, ulcers, interactions with alcohol, interactions with other medications (including blood thinners, heart medications, blood pressure medications, seizure medications, antibiotics and over the counter medications), kidney failure, liver failure, pregnancy or breast feeding problems, dizziness, vision changes, allergic reactions and increased risk of surgery.

I've listed some of the more commonly used drugs below. If you click on the name of the drug, it will take you to the National Library of Medicine Public Health site that tells you of the potential side effects and risks of the medication. If you are taking or considering taking any of these medications, you may wish to review the material the government has provided.

Tylenol (also a part of many compound drugs)
Asprin/Bufferin
Advil/Motrin
Aleve/Naproxen
Orudis
Torodol
Clinoril
Indocin
Feldene
Dolobid
Relafen

The Arthritis Foundation has a useful drug guide.

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Use the "Search the Blog" box to the right to find other topics of interest to you.

You may be interested in some of our most visited web pages including: shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery.

See the countries from which our readers come on this post.