Arthritis Pain Relief Update (cont.)

MODERATOR:
What about swimming? Yoga? Are they particularly helpful?

KLIPPEL:
Swimming or even exercising in a pool are great forms of exercise for a person with arthritis. Most chapters of the Arthritis Foundation have aquatic programs and information can be found at arthritis.org. Yoga would be an example of a form of exercise that involves joint flexibility, muscle strengthening and mental discipline that many people with arthritis find beneficial. That would be an example of a joint-safe form of exercise that people with arthritis might want to consider.

"It's very important that people understand the importance of exercise in the management of their arthritis and get involved in a daily exercise regimen."

MODERATOR:
Who should you see to be evaluated and treated for arthritis?

KLIPPEL:
For most people, seeing their primary care or family doctor would be who they would see first. It's important to recognize there are two specialists who deal mostly with arthritis, and those would be a rheumatologist, or in the instance of a child, a pediatric rheumatologist. For many people, a specialist like a rheumatologist is very important to make a diagnosis -- there are more than 100 forms of arthritis -- and outline and begin a plan of treatment. The other specialist that plays an important role in arthritis and musculoskeletal disorders is an orthopaedic surgeon. In particular for people who have advanced disease or are limited by their arthritis, orthopedic surgeons play an important role in performing surgery on knees or hips, which can make a dramatic difference in improving the lives of people affected by arthritis.

MEMBER QUESTION:
I am very active, and arthritis limits my mobility at times. Can one overdo exercise? I play tennis, swim, walk and jog.

KLIPPEL:
A person with arthritis has to use common sense and listen to his or her body. If one overexercises, typically one pays a price -- often that night. The biggest challenge that we face though is to get people with arthritis to start an exercise program, simply because their joints hurt. It's very important that people understand the importance of exercise in the management of their arthritis and get involved in a daily exercise regimen.

MEMBER QUESTION:
Can you tell me the side effects of using Plaquenil with methotrexate for a period of two years for rheumatoid arthritis (RA)?

KLIPPEL:
Plaquenil is an example of an antimalarial drug, which is used in rheumatoid arthritis and other (inflammatory) forms of arthritis. When used in low dosages, typically 200 mg a day, Plaquenil is extremely safe, including when combined with methotrexate. Often physicians will have a person, after taking Plaquenil for a year, see an ophthalmologist for an eye exam to check for a very, very rare complication of Plaquenil that affects the eye.

MODERATOR:
Have there been any serious concerns about the medications used to treat RA or psoriatic arthritis?

KLIPPEL:
The important thing for anyone who has rheumatoid arthritis, psoriatic arthritis or related diseases has been the tremendous advances in drug therapy for these conditions, particularly over the past decade. Like all drugs, these drugs have side effects and a person considering or using these drugs should be familiar with the side effects. But, every person I have ever met who has benefited from these drugs would admit the benefits far outweigh any potential side effect which might be associated with these drugs.

MEMBER QUESTION:
Are there any supplements that help with arthritis? Aside from losing weight, are there any diet changes that help?

KLIPPEL:
There has been a lot of interest in two particular dietary supplements for the management of osteoarthritis, particularly arthritis affecting the knees. The supplements are glucosamine and condoitin sulfate. There have now been a number of studies which indicate that these supplements relieve pain, improve the person's ability to use the joint without pain, and intriguingly, several studies have suggested that these supplements may prevent joint damage.

I think that we would encourage people, based on studies we know of, the most important thing besides attention to calories is making sure the diet is balanced. There is a lot of interest in the role of vitamins in protecting people in the development of arthritis. We certainly think that taking a multivitamin each day would be good health maintenance for arthritis, and people have focused on the role of vitamin C and the various antioxidants in protecting people from developing osteoarthritis. In addition, it's important that people continue to take daily doses of vitamin D, along with calcium, to protect from the development of osteoporosis, a common complication seen in people with arthritis.



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