Arthritis Treatment Update (cont.)

MEMBER QUESTION:
I have arthritis in my hip. Vioxx worked wonders until it was pulled off the market. I tried Bextra until it was pulled and Celebrex does not help as much as 400 milligrams of Advil three times a day. I am 54 years old and trying to put off replacement surgery as long as possible. How long can I continue to take the Advil before I risk having stomach problems? If you have any other suggestions, please advise. I have to tell you -- Vioxx worked wonders. I wish it was still available somewhere in the world.

SMITH:
That dose of Advil three times a day is a medium dose. However it can lead to problem over the long term. There is no way to really tell if you'll have stomach problems or when.

There are other medications like Advil that you can take fewer times a day that really should offer you the same degree of relief. There have actually been no studies to show that one arthritis drug works better than another, some people just seem to respond better for whatever reason.

Be sure to let your doctor know how much you're taking. If you start having stomach problems there are ways to protect your stomach with other medications.

MEMBER QUESTION:
Would an orthopaedic surgeon ever consider doing replacements on both a hip and knee at the same time? They are both on the right side. I have been diagnosed since 1987 with OA of the hip. As far as the knee, I can't use it for getting up out of a chair or out of a car. I'm 61 and had the meniscus cartilage completely removed from my right knee when I was 20.

SMITH:
I'm not an orthopaedic surgeon so it's hard for me to answer this one. WebMD actually has a board on joint replacement that's monitored by an orthopedic surgeon and this would be a perfect question for him.

I would think it's unlikely to do both joints at the same time. This would be a lengthy risky surgery and the rehabilitation would be extremely hard. I would recommend asking this question to Dr. Kirschenbaum on the message board because he would be able to help you out much better than I can.

MEMBER QUESTION:
Would pain in the collar bone likely be from arthritis? It starts in the center, but shoots to the right side when holding a book or typing, and it comes and goes.

SMITH:
It does sound like you could possibly have arthritis in the joint that connects the collar bone to the ribs, but it's tough to tell without knowing exactly where the pain is. Your symptoms are consistent with this possibility, so a doctor would need to examine you to be able to tell for sure.

MEMBER QUESTION:
I have RH at 55 and CRP at 20. I also have fibromyalgia (FM). What medicines would help to reduce inflammation? I have a constant feeling like my body is stretching itself inside with nowhere to go and I am tired all the time. What would you recommend for this?

SMITH:
My first concern is that FM doesn't typically cause inflammation. So my question is whether or not you have something more going on like some inflammatory condition. If you haven't seen a rheumatologist I would recommend doing so to be sure that you don't have some other condition that may be causing inflammation.

MEMBER QUESTION:
I have aches and pains in all my joints including my jaw. I exercise regularly and am of normal weight. I do not take medication. Do you have any suggestions? (RA has been ruled out)

SMITH:
It's tough to say that this would be arthritis if it affects your entire body. You can have osteoarthritis in many joints in the body at the same time. However it's unusual for it to be so widespread in the way that you describe.

Fibromyalgia can cause widespread pain but this is more muscle pain than joint pain, although it's often hard for people to tell the difference.

I would recommend that you see a rheumatologist if your primary doctor is not able to pinpoint a cause.

"We recently discovered that being overweight may be the most important cause of gout attacks; there is something about being overweight that seems to trigger gout attacks."

MEMBER QUESTION:
I have been diagnosed with arthritis in my lower back and in my hip. The doctor also found a cyst in my hip between my ball joint and where it connects, which causes me a lot of pain and immobility. What can they do for this?

SMITH:
A cyst like you describe is not uncommon in someone who has hip arthritis. The cyst can be drained if it's thought to cause such pain, but if the arthritis is so severe that draining the cyst isn't likely to help, you may need to discuss other options with your doctor. This could include joint replacement but it depends on the severity of your arthritis, your age, and your overall medical condition. Draining these cysts isn't particularly common but can be done if necessary.

MEMBER QUESTION:
I had my foot partially amputated about three years ago and I was told my only option was fusion. I have no cartilage in my ankle area. Why fusion and not joint replacement?



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