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All posts by Kristine Brons

Not all arthritis is created equally.

     The term arthritis refers to inflammation in joints leading to increased pain. There are multiple types of arthritis with the most common being Osteoarthritis and Rheumatoid arthritis. While some symptoms such as joint pain and stiffness are present in both diseases, their cause, progression and treatment differ.

Osteoarthritis (OA) is commonly referred to a degenerative arthritis.

    The cause is usually secondary to wear and tear of the protective cartilage over the joint. Diagnosis can be made after review of x-rays, but is largely based on physical exam. There is currently not a cure. However, treatment is aimed at decreasing inflammation through anti-inflammatories and procedure-based interventions with steroids.

Rheumatoid Arthritis (RA) is an autoimmune disorder.

    This means the body’s own immune system attacks the joints. Diagnosis is commonly made after review of blood work that tests for a specific antibody. Multiple joints can be affected and may have associated systemic symptoms such as a muscle aches and fatigue. In addition, some patients experience signs and symptoms outside of their joints (skin, heart lungs, etc.) Treatment is similar to OA. However, other medications termed Biologics, are used to suppress the immune response and alleviate pain. Just as with OA, there is no current cure for RA. There are groups of physicians called Rheumatologists that specialize in auto-immune disorders such as Rheumatoid Arthritis and typically manage treatment.

Talk with your provider today about management of your arthritis and treatment options.

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NSAID use in Chronic Pain Management

Non-steroidal anti-inflammatory drugs (NSAIDS) are a common class of medications used to treat pain and fever. The most widely prescribed and over the counter formulations are Ibuprofen, Naproxen, Mobic, Diclofenac and Celebrex. These have been utilized for pain control for many years. Their role in decreasing inflammation has been proven to be beneficial in the management of acute pain, but also intermittently with chronic pain.

Risks of taking NSAIDs

     Although these medications serve as good alternative to opioid medications, they do pose a risk to your overall health. In 2005, the Food and Drug Administration released a black box warning on the risk of experiencing a stroke or heart attack with NSAID use. In 2015, they strengthened their stance on this risk due to evidence revealing a stronger correlation between the two. In addition, NSAIDs have also been known to increase an individual’s risk of bleeding.

Talk with your provider before starting a new medication

    Before starting you on an NSAID your provider will likely inquire about your previous medical history. Any individual with a history of a bleeding disorder, GI ulcer, previous heart attack/heart problems, or previous stroke will likely need to refrain from using these medications. If you are currently taking an NSAID and you answered yes to any of the above medications, it is important you discuss this with your provider.

Are NSAIDS the appropriate medication to help treat your pain?

     In summary, while NSAIDS are very useful for pain control they are not always appropriate for every patient. They are preferably utilized short term for acute pain flares and discontinued after this time. However, they are always outlier situations in which they may be used for a longer periods of time. If you are concerned about your current NSAID use and how you can decrease your risk of side effects talk with your provider today.

Natalie Chism, CRNP

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