7/9/2012, Relief for Joints Besieged by Arthritis

If your wrist or knee hurts, you can wrap these joints in an ace bandage or use a brace for support.  Likewise for your foot or elbow.  You can make a sling for your arm to support it while healing, and there are hip and back braces, too.  But there’s nothing you can do for your jaw joints.  There’s no brace or other supportive device you can use to support these joints.

I had the idea once that if I used a neck brace, I could give my painful head some rest.  My doctor at the time said no, this would only create weakness in my neck.  You’d think there would be some support from a mouth splint, an ability to allow the jaw to rest, but even with 7 different splints, that never happened for me.

The jaw joint is the most complex joint in the human body.  There’s not much media attention or general education about jaw joints or TMJ, which is weird considering how important these joints are.  So, here’s some general advice:  stop chewing gum.


Between 1979 and 2002, knee replacement surgery rose 800 percent among people 65 and older. [Sounds like an epidemic.]  Although Dr. Felson described hip replacement as “dynamite” — highly effective in relieving pain and restoring function — knee replacement may be far less helpful…

Some 27 million Americans have life-limiting osteoarthritis, and the numbers are rising as the population gets older and fatter…

It was recently estimated that out of the 100 million Americans estimated to suffer from pain, the figure for those who suffer from moderate-to-severe pain is a measly 25 million.  So, where do the 27 million Americans with “life-limiting” osteoarthritis fit in to those 25 million people with moderate-to-severe pain?

Any kind of joint injury or surgery, even if performed arthroscopically, raises the risk that a joint will become arthritic. That is why so many professional and recreational athletes develop arthritis at younger ages…

You know, my oral surgeon never mentioned that…

“The severity of pain is directly correlated with the degree of muscle weakness,” Dr. Felson wrote in The New England Journal of Medicine. (If the knee hurts during exercise, he added, then it should be avoided.)

If the knees hurt constantly, then what?  Get a wheelchair?

Wearing the right shoes with certain adjustments to the sole and heel, if needed, can help too. Get fitted in a store with expertise in evaluating feet and gait.

Dude, do you know how expensive that is?  Well, it’s an article in the NY Times, where there are no poor people.

Bracing an arthritic knee can help, too, especially with an unloader brace that shifts the stress away from the damaged part of the joint. Most patients are unlikely to wear such a brace all the time, Dr. Felson said. Still, knee braces can help arthritis sufferers continue to participate in physical activities, reduce the use of pain medication and postpone the need for surgery.

Pain relievers usually bring only temporary relief, if any. Daily dosing with acetaminophen (the ingredient in Tylenol) should be tried first, experts say, because it is significantly safer than ibuprofen and other nonsteroidal anti-inflammatory drugs, especially for older people.

No, opioids are not mentioned as a treatment option.

Well-designed clinical studies have shown no significant relief of arthritic knee pain from supplements of glucosamine and chondroitin sulfate, taken alone or in combination, though Dr. Felson said that if people feel better taking them, he does not discourage the practice…

I don’t know what those pills look like now, but back when I took glucosamine and chondroitin, the size of the pills was a huge problem.  The other problem is that they were expensive, and oh yeah, they didn’t work.

Nor is there good evidence of benefit from methylsulfonylmethane, SAM-e or acupuncture. Some evidence suggests that osteoporosis drugs may be helpful, though they have not yet been tested for arthritis relief in a randomized clinical trial, Dr. Felson said.

There are also hints of benefit from vitamin K, an essential nutrient found in cruciferous vegetables (broccoli, kale, cabbage and the like), which are good for health in general (unless you take blood thinners).

Doctor-administered treatments include steroid injections every three or four months to control pain and buy time, and injections of a synovial fluid replacement like Synvisc twice a year. In general, though, these are not very effective when arthritis has reached the bone-on-bone stage, Dr. Johnson said.


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