Thursday, December 1, 2011
FUN FACTS - AND A GREAT WAY TO MAKE EXTRA INCOME AND LOTS OF IT - AND - CHECK OUT " WWW.MELODY'SHAPPYWORLD.COM " FOR A FREE WAY TO BRING HAPPINESS, LOVE AND HOPE TO THE WORLD WE LIVE IN!!
* According to Gaming Law, casinos have to stock enough cash to cover all the chips on the 'floor'. *
* Women mature much faster than men. *
* If a native Hawaiian woman places the flower on her right ear, she is available. (The bigger the flower, the more desperate!) *
* Children laugh about 400 times a day, while adults laugh on average only 15 times a day. *
* Children's sense of smell is better than adults'. *
* As a rule, 66 percent of people keep their eyes closed while kissing. The rest take pleasure in watching the emotions run the gamut on the faces of their partners. *
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* FOR A GREAT WAY TO MAKE EXTRA INCOME AND LOTS OF IT PLEASE GO TO WWW.GOKIVIA.COM - IT IS THE BEST COMPANY TO BE INVOLVED WITH AND THERE ARE FANTASTIC PRODUCTS AND THE BEST PEOPLE IN THE WORLD TO WORK WITH!! IT HAS THE BEST MARKETING PLAN THAT I'VE EVER SEEN AND YOU WILL BE VERY HAPPY!! WHAT A GREAT WAY TO MAKE MONEY AND SHOP FOR CHRISTMAS GIFTS AT THE SAME TIME!! I CAN'T BEGIN TO EXPLAIN HOW WONDERFUL THE PRODUCTS ARE, I'VE NEVER USED BETTER!! IF YOUR INTERESTED AND I HOPE YOU'LL TRY IT, CALL ME TO GET INVOLVED AT 310-326-3633 - Home - 310-986-7777 - Cell -, email: HereForYou@sbcglobal.net, THANK YOU AND BEST REGARDS, Catrina DeMicelli *
________________________________________________________________________
WWW.MELODYSHAPPYWORLD.COM - "True happiness is not looking back with regret, but looking forward to the future and creating your own exciting, magnificent destiny and masterpiece, YOUR LIFE!"
MELODY JENSEN IS THE MOST WONDERFUL PERSON AND THE GREATEST HUMANITARIAN I KNOW. CHECK OUT MELODY'S HAPPY WORLD, IT'S FREE!!
ASSOCIATIONS:
WWW.MELODYSSECRET.COM
WWW.MJHLC.COM
* Women mature much faster than men. *
* If a native Hawaiian woman places the flower on her right ear, she is available. (The bigger the flower, the more desperate!) *
* Children laugh about 400 times a day, while adults laugh on average only 15 times a day. *
* Children's sense of smell is better than adults'. *
* As a rule, 66 percent of people keep their eyes closed while kissing. The rest take pleasure in watching the emotions run the gamut on the faces of their partners. *
_____________________________________________________________________
* FOR A GREAT WAY TO MAKE EXTRA INCOME AND LOTS OF IT PLEASE GO TO WWW.GOKIVIA.COM - IT IS THE BEST COMPANY TO BE INVOLVED WITH AND THERE ARE FANTASTIC PRODUCTS AND THE BEST PEOPLE IN THE WORLD TO WORK WITH!! IT HAS THE BEST MARKETING PLAN THAT I'VE EVER SEEN AND YOU WILL BE VERY HAPPY!! WHAT A GREAT WAY TO MAKE MONEY AND SHOP FOR CHRISTMAS GIFTS AT THE SAME TIME!! I CAN'T BEGIN TO EXPLAIN HOW WONDERFUL THE PRODUCTS ARE, I'VE NEVER USED BETTER!! IF YOUR INTERESTED AND I HOPE YOU'LL TRY IT, CALL ME TO GET INVOLVED AT 310-326-3633 - Home - 310-986-7777 - Cell -, email: HereForYou@sbcglobal.net, THANK YOU AND BEST REGARDS, Catrina DeMicelli *
________________________________________________________________________
WWW.MELODYSHAPPYWORLD.COM - "True happiness is not looking back with regret, but looking forward to the future and creating your own exciting, magnificent destiny and masterpiece, YOUR LIFE!"
MELODY JENSEN IS THE MOST WONDERFUL PERSON AND THE GREATEST HUMANITARIAN I KNOW. CHECK OUT MELODY'S HAPPY WORLD, IT'S FREE!!
ASSOCIATIONS:
WWW.MELODYSSECRET.COM
WWW.MJHLC.COM
Lipitor Price Plunges as Generics Hit Market
Lipitor is so valuable that Pfizer is practically paying people to keep taking its blockbuster cholesterol medicine after generic competition hits the U.S. market this week.
Pfizer has devised discounts and incentives for patients, insurers, and companies that process prescriptions that will, at least for the next six months, make the brand-name drug about as cheap as or cheaper than the generics. Pfizer also has spent tens of millions of dollars this year on marketing to keep patients on Lipitor, which loses patent protection Wednesday.
Normally when a drug's patent ends, generic rivals grab nearly all its market share in a year or less, and the original maker quietly shifts focus to its newer products.
Pfizer Inc., the world's biggest drugmaker, is not giving up that easily on the best-selling drug in history. Lipitor had peak sales of about $13 billion and still brings in nearly $11 billion a year, about a sixth of Pfizer's revenue. With no new blockbusters to fill that hole, the company is making an unprecedented push to hang onto Lipitor revenue as long as possible.
Patients seem to buy into the logic.
"If I can get the name brand at the same price or for pennies more than the generic, I have no motivation to switch," said Richard Shiekman, 59, who has been taking Lipitor for six years and credits the drug with sharply cutting his bad cholesterol. Shiekman, a wine and spirits importer from Redding, Conn., got a $4 copay card two weeks ago after his pharmacy sent an offer guaranteeing that price through December 2012.
Pfizer's strategy is cunning and could become the new norm, as most other drugmakers also face generic competition to top-selling medicines and haven't been coming up with replacements.
"People getting a month of life-saving medicine for the price of a cup of Starbucks is ... pretty impressive," said Michael Kleinrock, a research director at data firm IMS Health.
Pfizer's effort includes:
• Offering insured patients a discount card to get Lipitor for $4 a month, far below the $25 average copayment for a preferred brand-name drug and below the $10 average copay for a generic drug. Pfizer is promoting this heavily through ads, information distributed at doctors' offices, and its website. Pfizer, based in New York, said Tuesday that sign-ups have exceeded its goals.
• Paying pharmacies to mail Lipitor patients offers for the $4 copay card and to counsel patients that Lipitor lowers bad cholesterol more than rival drugs and helps prevent heart attacks and strokes.
• Keeping U.S. marketing spending nearly level until the last minute, versus the typical two-thirds drop in a drug's final year under patent. From July through September, Pfizer spent almost $90 million on doctor sales calls and free samples, about the same as a year earlier, according to Cegedim Strategic Data. Ads targeting patients fell about 60 percent to $19 million. All that will soon taper off.
• Negotiating unusual deals with some insurance plans and prescription benefit managers, the companies that process prescription claims for insurers or employers, to block pharmacists from dispensing generic Lipitor. Pfizer is giving them rebates that bring their cost for Lipitor down to the price of a generic or slightly less — if they agree to dispense only Lipitor for the six months before additional generic competition slashes prices. The move has generated some controversy and means many of the 3 million Americans taking Lipitor won't be able switch to the generic.
Under those contracts, patients will pay either their plan's standard generic copayment or just $4 — the lowest copayment pharmacies at supermarkets and discounters such as Wal-Mart offer for the most widely used generic drugs.
While generic medicines work the same as brand drugs for nearly everyone, some patients prefer the brand.
"We want to make sure that patients who are currently taking Lipitor and want to continue ... have the opportunity to do so," said David Simmons, who heads Pfizer's Established Products business. He said research shows more than a third of patients want to stay on Lipitor.
Pfizer also is continuing assistance programs that subsidize uninsured patients wanting Lipitor, which costs about $115 to $160 a month, depending on dosage. Generic Lipitor, called atorvastatin, should cost 30 percent to 50 percent less.
People without insurance also can order the generic, with a prescription, through websites such as HealthWarehouse.
Patients could save even more by taking other generic drugs in the same class that have been on sale for several years: pravastatin (Pravachol) and simvastatin (Zocor). But they're not as potent as Lipitor, the key reason its sales have held up.
Typically, brand-name drugs get one or two generic competitors initially, priced about 25 percent lower. Six months later, other generic companies are allowed to jump in and the price drops up to 80 percent.
About 90 percent of the branded drug's sales ultimately vanish, as insured patients seeking a lower copayment switch over and most pharmacies automatically substitute a generic for a brand name.
Sanford Bernstein analyst Dr. Tim Anderson estimates that for a 90-day supply of Lipitor, even after paying rebates to insurers and patients, Pfizer can make a profit of roughly $100, compared with about $225 before generic competition. That's partly because administrative and advertising costs will decline, and it barely costs a dime to make a pill.
Anderson expects Pfizer's strategy to boost its earnings per share about 2 percent next year.
Meanwhile, Watson Pharmaceuticals Inc. looks to be the biggest loser in this. It has a deal to distribute an "authorized generic" version manufactured by Pfizer but sold under Watson's brand, with Pfizer keeping an estimated 70 percent of the price.
Watson CEO Paul Bisaro said he had thought Pfizer would retain about 25 percent of Lipitor users for the next six months, but now "it looks like it will be 40 to 45 percent."
Bisaro said that could reduce his company's anticipated profit next year.
"This is sort of the new generation of brand protection," he added.
India's Ranbaxy Laboratories is the only company besides Watson with the right to sell generic Lipitor in the United States for the next six months. But Ranbaxy has had repeated manufacturing quality problems, and it's unclear whether it will have the Food and Drug Administration's approval to ship its version Wednesday.
Ranbaxy said it would not reveal what will happen until then. The FDA, as is its custom, declined to comment. But Pfizer executives say they expect Ranbaxy to have a generic on the market.
An independent pharmacists group called Pharmacists United for Truth and Transparency has raised alarms that the rebate deals will stick plan sponsors — employers, unions, and taxpayers — with higher costs than for generics.
But spokespeople for a few prescription benefit managers that have received Pfizer's offer say it would cost insurance plans and patients the same as, or slightly less than, for generic Lipitor.
"Next year we're going to save clients and members over $1 billion just on this drug," said Tim Wentworth, head of employer and key client accounts for Medco Health Solutions Inc., one of the biggest pharmacy benefits managers.
Pfizer has devised discounts and incentives for patients, insurers, and companies that process prescriptions that will, at least for the next six months, make the brand-name drug about as cheap as or cheaper than the generics. Pfizer also has spent tens of millions of dollars this year on marketing to keep patients on Lipitor, which loses patent protection Wednesday.
Normally when a drug's patent ends, generic rivals grab nearly all its market share in a year or less, and the original maker quietly shifts focus to its newer products.
Pfizer Inc., the world's biggest drugmaker, is not giving up that easily on the best-selling drug in history. Lipitor had peak sales of about $13 billion and still brings in nearly $11 billion a year, about a sixth of Pfizer's revenue. With no new blockbusters to fill that hole, the company is making an unprecedented push to hang onto Lipitor revenue as long as possible.
Patients seem to buy into the logic.
"If I can get the name brand at the same price or for pennies more than the generic, I have no motivation to switch," said Richard Shiekman, 59, who has been taking Lipitor for six years and credits the drug with sharply cutting his bad cholesterol. Shiekman, a wine and spirits importer from Redding, Conn., got a $4 copay card two weeks ago after his pharmacy sent an offer guaranteeing that price through December 2012.
Pfizer's strategy is cunning and could become the new norm, as most other drugmakers also face generic competition to top-selling medicines and haven't been coming up with replacements.
"People getting a month of life-saving medicine for the price of a cup of Starbucks is ... pretty impressive," said Michael Kleinrock, a research director at data firm IMS Health.
Pfizer's effort includes:
• Offering insured patients a discount card to get Lipitor for $4 a month, far below the $25 average copayment for a preferred brand-name drug and below the $10 average copay for a generic drug. Pfizer is promoting this heavily through ads, information distributed at doctors' offices, and its website. Pfizer, based in New York, said Tuesday that sign-ups have exceeded its goals.
• Paying pharmacies to mail Lipitor patients offers for the $4 copay card and to counsel patients that Lipitor lowers bad cholesterol more than rival drugs and helps prevent heart attacks and strokes.
• Keeping U.S. marketing spending nearly level until the last minute, versus the typical two-thirds drop in a drug's final year under patent. From July through September, Pfizer spent almost $90 million on doctor sales calls and free samples, about the same as a year earlier, according to Cegedim Strategic Data. Ads targeting patients fell about 60 percent to $19 million. All that will soon taper off.
• Negotiating unusual deals with some insurance plans and prescription benefit managers, the companies that process prescription claims for insurers or employers, to block pharmacists from dispensing generic Lipitor. Pfizer is giving them rebates that bring their cost for Lipitor down to the price of a generic or slightly less — if they agree to dispense only Lipitor for the six months before additional generic competition slashes prices. The move has generated some controversy and means many of the 3 million Americans taking Lipitor won't be able switch to the generic.
Under those contracts, patients will pay either their plan's standard generic copayment or just $4 — the lowest copayment pharmacies at supermarkets and discounters such as Wal-Mart offer for the most widely used generic drugs.
While generic medicines work the same as brand drugs for nearly everyone, some patients prefer the brand.
"We want to make sure that patients who are currently taking Lipitor and want to continue ... have the opportunity to do so," said David Simmons, who heads Pfizer's Established Products business. He said research shows more than a third of patients want to stay on Lipitor.
Pfizer also is continuing assistance programs that subsidize uninsured patients wanting Lipitor, which costs about $115 to $160 a month, depending on dosage. Generic Lipitor, called atorvastatin, should cost 30 percent to 50 percent less.
People without insurance also can order the generic, with a prescription, through websites such as HealthWarehouse.
Patients could save even more by taking other generic drugs in the same class that have been on sale for several years: pravastatin (Pravachol) and simvastatin (Zocor). But they're not as potent as Lipitor, the key reason its sales have held up.
Typically, brand-name drugs get one or two generic competitors initially, priced about 25 percent lower. Six months later, other generic companies are allowed to jump in and the price drops up to 80 percent.
About 90 percent of the branded drug's sales ultimately vanish, as insured patients seeking a lower copayment switch over and most pharmacies automatically substitute a generic for a brand name.
Sanford Bernstein analyst Dr. Tim Anderson estimates that for a 90-day supply of Lipitor, even after paying rebates to insurers and patients, Pfizer can make a profit of roughly $100, compared with about $225 before generic competition. That's partly because administrative and advertising costs will decline, and it barely costs a dime to make a pill.
Anderson expects Pfizer's strategy to boost its earnings per share about 2 percent next year.
Meanwhile, Watson Pharmaceuticals Inc. looks to be the biggest loser in this. It has a deal to distribute an "authorized generic" version manufactured by Pfizer but sold under Watson's brand, with Pfizer keeping an estimated 70 percent of the price.
Watson CEO Paul Bisaro said he had thought Pfizer would retain about 25 percent of Lipitor users for the next six months, but now "it looks like it will be 40 to 45 percent."
Bisaro said that could reduce his company's anticipated profit next year.
"This is sort of the new generation of brand protection," he added.
India's Ranbaxy Laboratories is the only company besides Watson with the right to sell generic Lipitor in the United States for the next six months. But Ranbaxy has had repeated manufacturing quality problems, and it's unclear whether it will have the Food and Drug Administration's approval to ship its version Wednesday.
Ranbaxy said it would not reveal what will happen until then. The FDA, as is its custom, declined to comment. But Pfizer executives say they expect Ranbaxy to have a generic on the market.
An independent pharmacists group called Pharmacists United for Truth and Transparency has raised alarms that the rebate deals will stick plan sponsors — employers, unions, and taxpayers — with higher costs than for generics.
But spokespeople for a few prescription benefit managers that have received Pfizer's offer say it would cost insurance plans and patients the same as, or slightly less than, for generic Lipitor.
"Next year we're going to save clients and members over $1 billion just on this drug," said Tim Wentworth, head of employer and key client accounts for Medco Health Solutions Inc., one of the biggest pharmacy benefits managers.
Dr. Chauncey Crandall: How to Avoid a Holiday Heart Attack
The holidays are the deadliest time of the year for heart attacks, and are so common there's a name for it — "Holiday Heart Syndrome." According to statistics, Christmas Day is the deadliest, followed by December 26 and New Year's Day.
"There are two main reasons," says Dr. Chauncey Crandall, chief of the cardiac transplant program at the world-renowned Palm Beach Cardiovascular Clinic in Florida, and author of Newsmax's Heart Health Report newsletter. "We're not eating correctly, and we have a lot of fat floating around in our systems," he said in an exclusive interview with Newsmax Health. "We also have a lot of stress. The holidays are very stressful for many people."
During the holidays, we inadvertently create a lot of stress for ourselves, says Dr. Crandall. "We're trying to make the holidays wonderful for our families, but we're probably trying to do many things that are unnecessary, and we're putting a lot of undue stress on ourselves.
"People in cold-weather climates are more at risk," he says. Unhealthy food and stress can make cold temperatures deadly, especially when exercising. "Cold weather can cause spasm of the coronary arteries, and spasm of the coronary arteries can lead to a heart attack. We've all heard the story of the man shoveling show."
How can you avoid a holiday heart attack? Follow Dr. Crandall's tips:
• Prepare before the holidays. "Buy presents ahead of time."
• Avoid stress. This includes maintaining good relations with family members.
• Keep meals small and healthy.
If you do begin to experience chest pain, don't "wait and see," advises Dr. Crandall. "Call 911. Many people don't die of heart attacks but of sudden death, an electrical event that can be prevented by a defibrillator." Emergency professionals carry defibrillators, and they are well-trained. "They can quickly evaluate your condition," says Dr. Crandall. "If it's not a heart attack, they'll leave, and you can enjoy your holiday."
"There are two main reasons," says Dr. Chauncey Crandall, chief of the cardiac transplant program at the world-renowned Palm Beach Cardiovascular Clinic in Florida, and author of Newsmax's Heart Health Report newsletter. "We're not eating correctly, and we have a lot of fat floating around in our systems," he said in an exclusive interview with Newsmax Health. "We also have a lot of stress. The holidays are very stressful for many people."
During the holidays, we inadvertently create a lot of stress for ourselves, says Dr. Crandall. "We're trying to make the holidays wonderful for our families, but we're probably trying to do many things that are unnecessary, and we're putting a lot of undue stress on ourselves.
"People in cold-weather climates are more at risk," he says. Unhealthy food and stress can make cold temperatures deadly, especially when exercising. "Cold weather can cause spasm of the coronary arteries, and spasm of the coronary arteries can lead to a heart attack. We've all heard the story of the man shoveling show."
How can you avoid a holiday heart attack? Follow Dr. Crandall's tips:
• Prepare before the holidays. "Buy presents ahead of time."
• Avoid stress. This includes maintaining good relations with family members.
• Keep meals small and healthy.
If you do begin to experience chest pain, don't "wait and see," advises Dr. Crandall. "Call 911. Many people don't die of heart attacks but of sudden death, an electrical event that can be prevented by a defibrillator." Emergency professionals carry defibrillators, and they are well-trained. "They can quickly evaluate your condition," says Dr. Crandall. "If it's not a heart attack, they'll leave, and you can enjoy your holiday."
Your Fibromyalgia Health Team - If your tring to help your Fibromyalgia, you may need to try these avenues...
For fibromyalgia, you may choose to see one or more of the following types of doctors:
Internist
Internal medicine specialists focus primarily on treating adult medical disorders. Despite the name, they are schooled in treating the whole body, not just the internal organs, and see patients for a variety of conditions and complaints. Also known as internists, these doctors often work as general practitioners. Patients see an internist for an annual checkup and diagnosis, as well as for treatment and management of acute and chronic illnesses (including prescriptions for medications). Preventive medicine and patient education are often emphasized.
Rheumatologist
Rheumatologists practice a branch of internal medicine or pediatrics that focuses on joint, muscle and bone disorders, including autoimmune diseases. Some of the most common conditions treated by rheumatologists include rheumatoid arthritis, juvenile rheumatoid arthritis, fibromyalgia, osteoarthritis, osteoporosis, lupus and back pain. Diagnostic procedures can include patient history and physical examinations, X-rays and blood tests. In addition to evaluating and treating these ailments, many rheumatologists engage in research.
Pain management specialist
A pain management specialist uses a range of approaches to prevent, evaluate and treat pain disorders. Pain management specialists may be trained in a number of other specialties, including physical medicine and rehabilitation (also called physiatry) and anesthesiology, and may work alongside obstetricians and surgeons during childbirth and surgical procedures. Conditions treated by pain management specialists include pain from disease, such as cancer; post-operative pain; pain caused by an injury; or pain that is the condition itself, such as headaches or fibromyalgia. Treatment options may include oral or injected medications, therapy and counseling. Pain management specialists may also be trained in nontraditional forms of pain management, such as acupuncture.
Physical medicine and rehabilitation (PM&R) specialist
Physical medicine and rehabilitation (PM&R), also known as physiatry, focuses on helping patients recover functionality after an illness or injury – for example, a stroke, sports injuries, spinal cord or brain injury, or flare-ups from arthritis or fibromyalgia. A physical medicine and rehabilitation specialist may use diagnostic tools such as nerve conduction studies (NCS), which measure the nerves’ responses to electrical stimulation, and needle electromyographies (EMGs), which assess the effects of needle electrodes on the muscles. Treatments include physical therapy, medication, orthotics and adaptive devices. Physiatrists may work with physical, occupational and speech therapists. Physical medicine and rehabilitation specialty training may be combined with pediatrics, neurology and internal medicine training.
Occupational medicine specialist
An occupational medicine specialist is trained in the study of work- or employment-related health and safety. In addition to knowledge of general medicine, occupational medicine specialists have in-depth knowledge of specific workplace conditions and often work with nurses and other health care professionals to adjust diagnoses and treatment according to the risks associated with the patient’s employment conditions. A subset of the occupational medicine specialty is occupational health psychology (OHP), which combines traditional health and safety factors with an exploration of work-related psychological factors that can have an impact on patients’ health. Occupational medicine specialists can be employed by specific companies or work in private practice, and may have training in labor law, environmental hazards and other subspecialties.
Psychologist
Psychologists are professionals who focus on patients’ mental and emotional health. Unlike psychiatrists, psychologists are not typically physicians, but they usually hold a Ph.D. or other advanced academic degree. Patients may see a psychologist for a variety of issues, such as eating disorders, anxiety, or depression, but also may see one to discuss the emotional effects of chronic illness. Treatment options can include counseling or psychotherapy, although psychologists cannot prescribe medication. There are two branches of psychology: applied psychology, which refers to clinical practitioners who deal with patients; and research or investigational psychology, which involves the scholarly study and/or teaching about the human mind (such as cognition and behavior).
Massage therapist
A massage therapist applies pressure or vibration to the soft tissues of the body, including muscles, connective tissue, tendons, ligaments and joints to heal injury, relieve psychological stress, minimize pain, improve circulation and relieve tension.
Internist
Internal medicine specialists focus primarily on treating adult medical disorders. Despite the name, they are schooled in treating the whole body, not just the internal organs, and see patients for a variety of conditions and complaints. Also known as internists, these doctors often work as general practitioners. Patients see an internist for an annual checkup and diagnosis, as well as for treatment and management of acute and chronic illnesses (including prescriptions for medications). Preventive medicine and patient education are often emphasized.
Rheumatologist
Rheumatologists practice a branch of internal medicine or pediatrics that focuses on joint, muscle and bone disorders, including autoimmune diseases. Some of the most common conditions treated by rheumatologists include rheumatoid arthritis, juvenile rheumatoid arthritis, fibromyalgia, osteoarthritis, osteoporosis, lupus and back pain. Diagnostic procedures can include patient history and physical examinations, X-rays and blood tests. In addition to evaluating and treating these ailments, many rheumatologists engage in research.
Pain management specialist
A pain management specialist uses a range of approaches to prevent, evaluate and treat pain disorders. Pain management specialists may be trained in a number of other specialties, including physical medicine and rehabilitation (also called physiatry) and anesthesiology, and may work alongside obstetricians and surgeons during childbirth and surgical procedures. Conditions treated by pain management specialists include pain from disease, such as cancer; post-operative pain; pain caused by an injury; or pain that is the condition itself, such as headaches or fibromyalgia. Treatment options may include oral or injected medications, therapy and counseling. Pain management specialists may also be trained in nontraditional forms of pain management, such as acupuncture.
Physical medicine and rehabilitation (PM&R) specialist
Physical medicine and rehabilitation (PM&R), also known as physiatry, focuses on helping patients recover functionality after an illness or injury – for example, a stroke, sports injuries, spinal cord or brain injury, or flare-ups from arthritis or fibromyalgia. A physical medicine and rehabilitation specialist may use diagnostic tools such as nerve conduction studies (NCS), which measure the nerves’ responses to electrical stimulation, and needle electromyographies (EMGs), which assess the effects of needle electrodes on the muscles. Treatments include physical therapy, medication, orthotics and adaptive devices. Physiatrists may work with physical, occupational and speech therapists. Physical medicine and rehabilitation specialty training may be combined with pediatrics, neurology and internal medicine training.
Occupational medicine specialist
An occupational medicine specialist is trained in the study of work- or employment-related health and safety. In addition to knowledge of general medicine, occupational medicine specialists have in-depth knowledge of specific workplace conditions and often work with nurses and other health care professionals to adjust diagnoses and treatment according to the risks associated with the patient’s employment conditions. A subset of the occupational medicine specialty is occupational health psychology (OHP), which combines traditional health and safety factors with an exploration of work-related psychological factors that can have an impact on patients’ health. Occupational medicine specialists can be employed by specific companies or work in private practice, and may have training in labor law, environmental hazards and other subspecialties.
Psychologist
Psychologists are professionals who focus on patients’ mental and emotional health. Unlike psychiatrists, psychologists are not typically physicians, but they usually hold a Ph.D. or other advanced academic degree. Patients may see a psychologist for a variety of issues, such as eating disorders, anxiety, or depression, but also may see one to discuss the emotional effects of chronic illness. Treatment options can include counseling or psychotherapy, although psychologists cannot prescribe medication. There are two branches of psychology: applied psychology, which refers to clinical practitioners who deal with patients; and research or investigational psychology, which involves the scholarly study and/or teaching about the human mind (such as cognition and behavior).
Massage therapist
A massage therapist applies pressure or vibration to the soft tissues of the body, including muscles, connective tissue, tendons, ligaments and joints to heal injury, relieve psychological stress, minimize pain, improve circulation and relieve tension.
IF YOU HAVE FIBROMYALGIA, YOU SHOULD READ THIS!!! - What is Fibromyalgia? - Get Facts on the Disorder and 4 Ways to Manage Fibromyalgia
You’re in pain all over, always tired and can’t sleep, yet your doctor can’t figure out what’s wrong. Those are all fibromyalgia symptoms. Learn more about fibromyalgia from a doctor who's been pioneering in the field, plus 4 ways to manage. …
If fibromyalgia were a pastime, it would be The New York Times’ infamous Sunday crossword: a confounding, bedeviling, even exhausting puzzle.
The disease – a complex illness marked by chronic muscle, tendon and ligament pain, fatigue and multiple tender points on the body – affects about 2% of Americans, most of them women.
Since the first clinical, controlled study of fibromyalgia was conducted nearly 30 years ago, doctors still haven’t been able to pinpoint a cause.
Physicians and patients alike are frustrated about how to treat fibromyalgia. Countless women are told the pain must be in their head.
What is Fibromyalgia? Identifying a Puzzling, Painful Disease
But experts are inching closer to the causes of fibromyalgia and treatment, thanks to maverick thinkers like Daniel Clauw, M.D., who saw clues where many did not.
In the late 1980s, many patients seeking lower back pain relief were referred to him.
“As it turned out, most of [them] had pain in areas other than the back, as well as fatigue, insomnia and memory problems. They had fibromyalgia – unrecognized and undiagnosed, as it often was,” recalls Clauw, a professor of anesthesiology and medicine at the University of Michigan in Ann Arbor and director of the Chronic Pain and Fatigue Research Center.
Fast-forward 20 years: Clauw is still at it, still excited. But he’s now one of a growing number of physicians and practitioners approaching the puzzle of how to treat fibromyalgia from a new angle – the pain. Aided by dramatic advances in brain imaging and mapping, they’re getting a clearer view of the disease, and the source of sore neck muscles or other sore muscles on the body.
“We may not know what causes fibromyalgia, but it absolutely exists,” says George Griffing, M.D., a professor of medicine at St. Louis University in Missouri.
Seeing Is Believing
In the 1950s, when fibromyalgia was first described, the illness was thought to be a rheumatologic disorder like lupus because it was characterized by musculoskeletal pain.
Despite this hypothesis – or maybe because it was inaccurate – it remained difficult to treat fibromyalgia for decades.
But a landmark 2002 study, published by Clauw in the medical journal Arthritis and Rheumatism, shed new light on the disease. Rather than being rooted in the muscles and joints, the current thinking revolves around pain and sensory "amplification," he says.
His research showed that fibromyalgia sufferers are doubly sensitive to pain.
Clauw produced scans to show that the brains of fibromyalgia sufferers display significant pain signals from finger squeezes so gentle that they barely register as unpleasant in people without the disease.
"It’s as if the volume control on pain and sensory processing is set too high in people with fibromyalgia," Clauw says. The level at which touch to the skin [or noise or odor] becomes painful or uncomfortable is much lower in someone with fibromyalgia than in someone without it.
The brain, he says, is the key to the puzzle and, by quieting it, you’ll treat and manage fibromyalgia more effectively than before.
4 Ways to Manage Fibromyalgia
Here are four ways to calm your mind and improve your quality of life with fibromyalgia:
1. Find a doctor who "gets it." If you’re sore all over, suffer overwhelming fatigue and have trouble sleeping but don’t know why, see a rheumatologist. Such specialists are best able to differentiate fibromyalgia from other illnesses with similar symptoms.
But if your diagnosis is clearly fibromyalgia, start “with a physician – any physician – who fully acknowledges that the disease exists,” Griffing says.
2. Carefully test available meds and treatments. Many studies have shown that anti-convulsants and antidepressants can lower the pain volume for people with fibromyalgia.
One study, reported in the January 2009 issue of The Journal of the American Medical Association (JAMA), revealed that antidepressants may reduce pain, depression, fatigue, sleep disturbances and improve quality of life.
The study showed that these drugs worked but with varying success.
Tricyclic and tetracyclic antidepressants such as Elavil or Pamelor provided the most pain relief, helping soothe sore neck muscles and other aches and pains. Selective serotonin reuptake inhibitors (SSRIs) can help with fatigue and depression.
Because there’s not enough evidence on the long-term effects of antidepressants, patients should be evaluated regularly to determine if the benefits outweigh adverse effects, according to the JAMA report.
Clauw adds that patients should systematically try a few medications – but slowly.
“One of the biggest problems I see is that doctors and patients want to try too many things at once,” he says. So they can’t tell if something is working or whether a new symptom is a side effect of a treatment.
“There's no silver bullet yet,” Griffing says. The cocktail approach – a dash of pharmacology here, a dose of non-drug therapies there – has been proven to work.
Coming soon: Neurostimulatory therapies in which the brain or spinal cord is stimulated by electricity or magnets to reduce fibromyalgia pain symptoms. Ask your doctor about it.
3. Be your own advocate. Learn as much as you can about the disease and the many ways you can treat fibromyalgia. How do you find out about options? Sites like the American Fibromyalgia Syndrome Association, the National Fibromyalgia Partnership and Know Fibro, which Clauw helped develop, can help educate patients about non-drug approaches such as cognitive behavioral therapy.
“They’re an excellent way for people with fibromyalgia to get the non-drug therapies that are rarely prescribed in routine clinical practice,” he says.
4. Retrain your brain. The key to coping with the illness is to manage your brain’s sensitivity to stimuli – which means, in part, “unlearning what you’ve always done," says Barbara Keddy, Ph.D., professor emerita in the School of Nursing at Dalhousie University in Halifax, Nova Scotia.
Keddy, founder of the blog womenandfibromyalgia.com, has struggled with and studied fibromyalgia for 40 years.
Living in the moment is one effective tool to deal with fibromyalgia symptoms, she says, to help avoid dweling on sore neck muscles and other aches and pains.
“It means being constantly aware of how your body is responding to different stimuli and working to breathe deeply, engaging your diaphragm and moving in different ways to subvert the stress response.”
For more information on this strategy, called the "relaxation response," check out relaxationresponse.org.
How Much Do You Know About Fibromyalgia?
Fibromyalgia is one of the world’s oldest medical mysteries. How much do you know about the illness and how to treat fibromyalgia?
If fibromyalgia were a pastime, it would be The New York Times’ infamous Sunday crossword: a confounding, bedeviling, even exhausting puzzle.
The disease – a complex illness marked by chronic muscle, tendon and ligament pain, fatigue and multiple tender points on the body – affects about 2% of Americans, most of them women.
Since the first clinical, controlled study of fibromyalgia was conducted nearly 30 years ago, doctors still haven’t been able to pinpoint a cause.
Physicians and patients alike are frustrated about how to treat fibromyalgia. Countless women are told the pain must be in their head.
What is Fibromyalgia? Identifying a Puzzling, Painful Disease
But experts are inching closer to the causes of fibromyalgia and treatment, thanks to maverick thinkers like Daniel Clauw, M.D., who saw clues where many did not.
In the late 1980s, many patients seeking lower back pain relief were referred to him.
“As it turned out, most of [them] had pain in areas other than the back, as well as fatigue, insomnia and memory problems. They had fibromyalgia – unrecognized and undiagnosed, as it often was,” recalls Clauw, a professor of anesthesiology and medicine at the University of Michigan in Ann Arbor and director of the Chronic Pain and Fatigue Research Center.
Fast-forward 20 years: Clauw is still at it, still excited. But he’s now one of a growing number of physicians and practitioners approaching the puzzle of how to treat fibromyalgia from a new angle – the pain. Aided by dramatic advances in brain imaging and mapping, they’re getting a clearer view of the disease, and the source of sore neck muscles or other sore muscles on the body.
“We may not know what causes fibromyalgia, but it absolutely exists,” says George Griffing, M.D., a professor of medicine at St. Louis University in Missouri.
Seeing Is Believing
In the 1950s, when fibromyalgia was first described, the illness was thought to be a rheumatologic disorder like lupus because it was characterized by musculoskeletal pain.
Despite this hypothesis – or maybe because it was inaccurate – it remained difficult to treat fibromyalgia for decades.
But a landmark 2002 study, published by Clauw in the medical journal Arthritis and Rheumatism, shed new light on the disease. Rather than being rooted in the muscles and joints, the current thinking revolves around pain and sensory "amplification," he says.
His research showed that fibromyalgia sufferers are doubly sensitive to pain.
Clauw produced scans to show that the brains of fibromyalgia sufferers display significant pain signals from finger squeezes so gentle that they barely register as unpleasant in people without the disease.
"It’s as if the volume control on pain and sensory processing is set too high in people with fibromyalgia," Clauw says. The level at which touch to the skin [or noise or odor] becomes painful or uncomfortable is much lower in someone with fibromyalgia than in someone without it.
The brain, he says, is the key to the puzzle and, by quieting it, you’ll treat and manage fibromyalgia more effectively than before.
4 Ways to Manage Fibromyalgia
Here are four ways to calm your mind and improve your quality of life with fibromyalgia:
1. Find a doctor who "gets it." If you’re sore all over, suffer overwhelming fatigue and have trouble sleeping but don’t know why, see a rheumatologist. Such specialists are best able to differentiate fibromyalgia from other illnesses with similar symptoms.
But if your diagnosis is clearly fibromyalgia, start “with a physician – any physician – who fully acknowledges that the disease exists,” Griffing says.
2. Carefully test available meds and treatments. Many studies have shown that anti-convulsants and antidepressants can lower the pain volume for people with fibromyalgia.
One study, reported in the January 2009 issue of The Journal of the American Medical Association (JAMA), revealed that antidepressants may reduce pain, depression, fatigue, sleep disturbances and improve quality of life.
The study showed that these drugs worked but with varying success.
Tricyclic and tetracyclic antidepressants such as Elavil or Pamelor provided the most pain relief, helping soothe sore neck muscles and other aches and pains. Selective serotonin reuptake inhibitors (SSRIs) can help with fatigue and depression.
Because there’s not enough evidence on the long-term effects of antidepressants, patients should be evaluated regularly to determine if the benefits outweigh adverse effects, according to the JAMA report.
Clauw adds that patients should systematically try a few medications – but slowly.
“One of the biggest problems I see is that doctors and patients want to try too many things at once,” he says. So they can’t tell if something is working or whether a new symptom is a side effect of a treatment.
“There's no silver bullet yet,” Griffing says. The cocktail approach – a dash of pharmacology here, a dose of non-drug therapies there – has been proven to work.
Coming soon: Neurostimulatory therapies in which the brain or spinal cord is stimulated by electricity or magnets to reduce fibromyalgia pain symptoms. Ask your doctor about it.
3. Be your own advocate. Learn as much as you can about the disease and the many ways you can treat fibromyalgia. How do you find out about options? Sites like the American Fibromyalgia Syndrome Association, the National Fibromyalgia Partnership and Know Fibro, which Clauw helped develop, can help educate patients about non-drug approaches such as cognitive behavioral therapy.
“They’re an excellent way for people with fibromyalgia to get the non-drug therapies that are rarely prescribed in routine clinical practice,” he says.
4. Retrain your brain. The key to coping with the illness is to manage your brain’s sensitivity to stimuli – which means, in part, “unlearning what you’ve always done," says Barbara Keddy, Ph.D., professor emerita in the School of Nursing at Dalhousie University in Halifax, Nova Scotia.
Keddy, founder of the blog womenandfibromyalgia.com, has struggled with and studied fibromyalgia for 40 years.
Living in the moment is one effective tool to deal with fibromyalgia symptoms, she says, to help avoid dweling on sore neck muscles and other aches and pains.
“It means being constantly aware of how your body is responding to different stimuli and working to breathe deeply, engaging your diaphragm and moving in different ways to subvert the stress response.”
For more information on this strategy, called the "relaxation response," check out relaxationresponse.org.
How Much Do You Know About Fibromyalgia?
Fibromyalgia is one of the world’s oldest medical mysteries. How much do you know about the illness and how to treat fibromyalgia?
How to Treat Arthritis Joint Pain - Learning the Symptoms and Finding Relief
Your knees ache and hips creak. Did you do too much over the weekend? Or is it age? If you’re a woman in your 40s, you may have osteoarthritis, the most common form of arthritis. Find out what causes this painful joint disease and how to ease the aches and stiffness. Plus, how much do you know about osteoarthritis? Take our quiz and find out…
You feel great after that six-mile hike, those rousing sets of tennis, that morning jog. But lately, there’s an ache in your step. Some days walking feels more like hobbling.
You may be paying for living a longer, more active life than Mom or Grandma. Hobbies like hiking, tennis and gardening keep us fit and youthful into our senior years, but they also conspire against us.
The result of the wear and tear?
Osteoarthritis, a degenerative joint disease that causes pain and stiffness.
Arthritis has many forms, but osteoarthritis is the most common: More than 27 million Americans suffer from it, and women over age 45 are 10 times more likely to have osteoarthritis than men. Researchers don't know why, but it could be blamed on women's bone structure, or even the high heels women sometimes wear.
Former competitive athletes – from runners to divers to gymnasts – are particularly vulnerable.
Aging, excess weight and having a joint injury also increase risk. The disease usually targets weight-bearing joints, such as the hips, knees and lower back, but also the neck, fingers and big toe.
Osteoarthritis’ most common symptoms include:
Joint soreness after overuse or inactivity
Morning stiffness that improves with activity
Changes in posture or walking because of stiffness
What Causes the Pain?
Osteoarthritis breaks down cartilage, the primary shock absorber covering the joint ends. The subsequent damage occurs in several stages:
First, the cartilage cushion loses elasticity and is more easily damaged from injury or use.
As the cartilage wears down, the underlying bone thickens and develops growths or spurs. At this stage, bits of bone and cartilage float in the joint.
The joint lining then becomes inflamed and releases irritants that damage cartilage even more. The normal lubricant also deteriorates, further exposing the joint surfaces to injury.
Eventually, the joint becomes so painful and stiff that replacement may be the only option. The procedures are hugely successful: A study published in the journal Arthritis and Rheumatism showed that 77% of 112 knee replacement patients were satisfied or very satisfied with the results; 80% said they would have the surgery again.
Where You Feel It Most
Hips: If you have osteoarthritis of the hips, you may feel pain in the groin, inner thigh or buttocks.
The discomfort may radiate to the thigh or knee and force you to limp when walking.
Knees: Osteoarthritis of the knees usually causes pain, grating or catching at the joint as you move, especially on stairs.
Women tend to wear out their knees differently than men. First, women are more likely to tear one of their key knee ligaments, the anterior cruciate ligament, or ACL. (Female college basketball players, for example, are up to eight times more likely to sustain an ACL injury than their male counterparts.)
The resulting knee instability increases the risk for developing arthritis.
Women also are more likely to wear down the outer knees. Our broader pelvis force the legs to angle inward at the knee instead of straight down.
Researchers have developed gender-specific joint replacements for a more comfortable fit.
High-heel shoes also increase osteoarthritis risk. Shoes with three-inch heels, whether stilettos or platform, put at least 22% more pressure on knee joints than low-heeled shoes because they strain muscles and tendons.
Hands: It’s common in the fingers too, causing joints to ache and swell. They may develop boney outgrowths and your hand may lose its grip strength or fine motor skills that help you pick up small items or hold a pencil.
Back: Repetitive stress on the spinal discs that cushion the vertebrae can cause them to break down. Again, boney spurs may develop, placing pressure on the nerves exiting the spinal canal.
Osteoarthritis of the back can lead to stiffness and pain in the neck, shoulder, arm, lower back and legs. It can also cause pinched nerves, which leads to weakness in arms and legs.
Treating Joint Pain
So how do you get rid of the pain?
Step 1: See a physician for tests, such as a blood count, joint X-rays and possibly a joint MRI.
Sometimes the doctor will remove some joint fluid to look for deterioration and to rule out other forms of arthritis, which are treated differently than osteoarthritis.
Early diagnosis and treatment are key to managing the disease. You can’t reverse the clock, but you can minimize joint damage and maintain range of motion.
You can also control pain and swelling, improve function and slow osteoarthritis' progression. Often treatment includes weight management (the less weight, the less stress on the joint), exercise, physical therapy and medication.
Traditional medications include:
Non-steroidal anti-inflammatories (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin) and naproxen (Aleve)
Pain relievers such as acetaminophen (Tylenol)
Topical pain relievers, such as creams and rubs containing wintergreen oil or camphor
Steroids and viscosupplements, such as Synvisc, that a doctor can inject into the knee to supplement its normal lubricating fluid.
Fitted braces can also relieve some stress and reduce damage over time. Arthroscopic surgery may be necessary to clean up the joint, trim worn or torn cartilage and remove debris.
For advanced osteoarthritis, you may need a total joint replacement. Partial replacements (often called joint resurfacing) repair only the damaged area, allowing you to retain more of the original joint.
Relief, Naturally
Alternative treatments like glucosamine with chondroitin sulfate and methylsulfonylmethane (MSM) can help, often in combination with conventional methods.
Among the most popular:
Glucosamine: This sugar seems to play a role in cartilage formation and repair. One study showed that 50% of osteoarthritis patients had less pain when taking glucosamine supplements, particularly among those with mild to moderate symptoms.
But watch out: Glucosamine may upset your stomach and raise blood sugar levels. Also, don’t take it if you are allergic to shellfish.
Chondroitin sulfate: This protein part gives cartilage its elasticity. It may improve its shock-absorbing properties and help it retain water. Like glucosamine, chondroitin can upset your stomach.
Glucosamine and chondroitin: They've been used in combination for years in Europe to manage joint pain.
A study published in the New England Journal of Medicine in 2006 showed that the supplements were more effective together. They had little effect on mild pain, but showed a significant benefit in people with moderate to severe pain.
Methylsulfonylmethane or MSM: This naturally occurring sulfur compound found in fruits, vegetables and grains may also reduce pain and inflammation.
A pilot study of 50 men and women with osteoarthritis showed that MSM reduced pain and improved physical function without major side effects, but no controlled trials substantiate the claim.
Before you add a nutritional supplement to your treatment regimen, check with your doctor.
Exercise for Osteoarthritis
Doctors are increasingly recommending physical activity as a means for improving joint health.
As tempting as it may be to rest aching joints, structured mobility programs, combined with muscle-strengthening exercise and weight loss, seem to be the best treatments..
Besides weight control, a range of exercises are prescribed by doctors to help manage osteoarthritis. Each pound of weight loss reduces pressure on the knee by four pounds. So even modest amounts of weight loss can reduce the risk of osteoarthritis or improve symptoms.
Exercises that improve flexibility can help decrease joint stiffness and improve range of motion. These include hamstring and calf stretches, knee-to-chest flexing and neck and back stretches.
Activities that strengthen muscles are also important, as long as they don’t put undue stress on affected joints. Ideal exercises include cycling, elliptical trainers, Pilates, yoga, swimming and Tai Chi.
For more information and expert advice, visit our Arthritis Health Center .
Are You Bad to the Bone?
For years, you’ve been the first one on the tennis courts, the weekend hiker, the intrepid gardener on your knees for hours. While all those activities are great for you, they can also be hard on your joints.
You feel great after that six-mile hike, those rousing sets of tennis, that morning jog. But lately, there’s an ache in your step. Some days walking feels more like hobbling.
You may be paying for living a longer, more active life than Mom or Grandma. Hobbies like hiking, tennis and gardening keep us fit and youthful into our senior years, but they also conspire against us.
The result of the wear and tear?
Osteoarthritis, a degenerative joint disease that causes pain and stiffness.
Arthritis has many forms, but osteoarthritis is the most common: More than 27 million Americans suffer from it, and women over age 45 are 10 times more likely to have osteoarthritis than men. Researchers don't know why, but it could be blamed on women's bone structure, or even the high heels women sometimes wear.
Former competitive athletes – from runners to divers to gymnasts – are particularly vulnerable.
Aging, excess weight and having a joint injury also increase risk. The disease usually targets weight-bearing joints, such as the hips, knees and lower back, but also the neck, fingers and big toe.
Osteoarthritis’ most common symptoms include:
Joint soreness after overuse or inactivity
Morning stiffness that improves with activity
Changes in posture or walking because of stiffness
What Causes the Pain?
Osteoarthritis breaks down cartilage, the primary shock absorber covering the joint ends. The subsequent damage occurs in several stages:
First, the cartilage cushion loses elasticity and is more easily damaged from injury or use.
As the cartilage wears down, the underlying bone thickens and develops growths or spurs. At this stage, bits of bone and cartilage float in the joint.
The joint lining then becomes inflamed and releases irritants that damage cartilage even more. The normal lubricant also deteriorates, further exposing the joint surfaces to injury.
Eventually, the joint becomes so painful and stiff that replacement may be the only option. The procedures are hugely successful: A study published in the journal Arthritis and Rheumatism showed that 77% of 112 knee replacement patients were satisfied or very satisfied with the results; 80% said they would have the surgery again.
Where You Feel It Most
Hips: If you have osteoarthritis of the hips, you may feel pain in the groin, inner thigh or buttocks.
The discomfort may radiate to the thigh or knee and force you to limp when walking.
Knees: Osteoarthritis of the knees usually causes pain, grating or catching at the joint as you move, especially on stairs.
Women tend to wear out their knees differently than men. First, women are more likely to tear one of their key knee ligaments, the anterior cruciate ligament, or ACL. (Female college basketball players, for example, are up to eight times more likely to sustain an ACL injury than their male counterparts.)
The resulting knee instability increases the risk for developing arthritis.
Women also are more likely to wear down the outer knees. Our broader pelvis force the legs to angle inward at the knee instead of straight down.
Researchers have developed gender-specific joint replacements for a more comfortable fit.
High-heel shoes also increase osteoarthritis risk. Shoes with three-inch heels, whether stilettos or platform, put at least 22% more pressure on knee joints than low-heeled shoes because they strain muscles and tendons.
Hands: It’s common in the fingers too, causing joints to ache and swell. They may develop boney outgrowths and your hand may lose its grip strength or fine motor skills that help you pick up small items or hold a pencil.
Back: Repetitive stress on the spinal discs that cushion the vertebrae can cause them to break down. Again, boney spurs may develop, placing pressure on the nerves exiting the spinal canal.
Osteoarthritis of the back can lead to stiffness and pain in the neck, shoulder, arm, lower back and legs. It can also cause pinched nerves, which leads to weakness in arms and legs.
Treating Joint Pain
So how do you get rid of the pain?
Step 1: See a physician for tests, such as a blood count, joint X-rays and possibly a joint MRI.
Sometimes the doctor will remove some joint fluid to look for deterioration and to rule out other forms of arthritis, which are treated differently than osteoarthritis.
Early diagnosis and treatment are key to managing the disease. You can’t reverse the clock, but you can minimize joint damage and maintain range of motion.
You can also control pain and swelling, improve function and slow osteoarthritis' progression. Often treatment includes weight management (the less weight, the less stress on the joint), exercise, physical therapy and medication.
Traditional medications include:
Non-steroidal anti-inflammatories (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin) and naproxen (Aleve)
Pain relievers such as acetaminophen (Tylenol)
Topical pain relievers, such as creams and rubs containing wintergreen oil or camphor
Steroids and viscosupplements, such as Synvisc, that a doctor can inject into the knee to supplement its normal lubricating fluid.
Fitted braces can also relieve some stress and reduce damage over time. Arthroscopic surgery may be necessary to clean up the joint, trim worn or torn cartilage and remove debris.
For advanced osteoarthritis, you may need a total joint replacement. Partial replacements (often called joint resurfacing) repair only the damaged area, allowing you to retain more of the original joint.
Relief, Naturally
Alternative treatments like glucosamine with chondroitin sulfate and methylsulfonylmethane (MSM) can help, often in combination with conventional methods.
Among the most popular:
Glucosamine: This sugar seems to play a role in cartilage formation and repair. One study showed that 50% of osteoarthritis patients had less pain when taking glucosamine supplements, particularly among those with mild to moderate symptoms.
But watch out: Glucosamine may upset your stomach and raise blood sugar levels. Also, don’t take it if you are allergic to shellfish.
Chondroitin sulfate: This protein part gives cartilage its elasticity. It may improve its shock-absorbing properties and help it retain water. Like glucosamine, chondroitin can upset your stomach.
Glucosamine and chondroitin: They've been used in combination for years in Europe to manage joint pain.
A study published in the New England Journal of Medicine in 2006 showed that the supplements were more effective together. They had little effect on mild pain, but showed a significant benefit in people with moderate to severe pain.
Methylsulfonylmethane or MSM: This naturally occurring sulfur compound found in fruits, vegetables and grains may also reduce pain and inflammation.
A pilot study of 50 men and women with osteoarthritis showed that MSM reduced pain and improved physical function without major side effects, but no controlled trials substantiate the claim.
Before you add a nutritional supplement to your treatment regimen, check with your doctor.
Exercise for Osteoarthritis
Doctors are increasingly recommending physical activity as a means for improving joint health.
As tempting as it may be to rest aching joints, structured mobility programs, combined with muscle-strengthening exercise and weight loss, seem to be the best treatments..
Besides weight control, a range of exercises are prescribed by doctors to help manage osteoarthritis. Each pound of weight loss reduces pressure on the knee by four pounds. So even modest amounts of weight loss can reduce the risk of osteoarthritis or improve symptoms.
Exercises that improve flexibility can help decrease joint stiffness and improve range of motion. These include hamstring and calf stretches, knee-to-chest flexing and neck and back stretches.
Activities that strengthen muscles are also important, as long as they don’t put undue stress on affected joints. Ideal exercises include cycling, elliptical trainers, Pilates, yoga, swimming and Tai Chi.
For more information and expert advice, visit our Arthritis Health Center .
Are You Bad to the Bone?
For years, you’ve been the first one on the tennis courts, the weekend hiker, the intrepid gardener on your knees for hours. While all those activities are great for you, they can also be hard on your joints.
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