Michigan Medicine Comprehensive Hand Center
Our team of specialists at the Comprehensive Hand Center is dedicated to providing comprehensive care for a variety of hand problems. From arthritis injuries, to congenital hand conditions, to the most complex reconstruction, our hand specialists approach each case individually, with a specific plan designed to maximize the restoration of both form and function. Depending on the types of hand conditions our patients face, our physicians will help determine the best therapies or procedures to maximize hand functionality and normal hand appearances. Visit the Comprehensive Hand Center page to learn more about the program and to contact our hand specialists.
Manage Arthritis Flares Due To Stress
Stress is recognized as a factor that leads to arthritis flares. Naturally, managing your stress will not only curb the pain of a flare but it may also reduce the number of times flares occur in the first place.
Unfortunately, stress manifests in our lives in a multitude of ways. An obvious form of stress arises when we take on too many responsibilities with not enough time or resources. Other, more subtle forms are the result of caffeine, alcohol, nicotine, or a lack of sleep. Whatever the source of your stress is, the first step is simply being more aware of it. From there, you can better manage it in the moment and develop strategies for managing it over the long term.
What Is Arthritis Of The Hand
Arthritis is a disease that attacks the tissues of your joints. A joint is where two bones meet. Arthritis can attack the lining of your joint or the cartilage, the smooth covering at the ends of bones. Eventually the cartilage breaks down, the ends of your bones become exposed, rub against each other and wear away. You have many joints in your hand, therefore its a common site for arthritis to happen.
Arthritis of the hand causes pain and swelling, stiffness and deformity. As arthritis progresses, you cant use your hands to manage everyday tasks as you once could.
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How The Body Feels Pain
Pain works in mysterious ways. Actually, pain works in a couple different ways when it comes to the signals received by the brain, but Im sure you dont want a biochemistry 101 course, so this is the simplified version.
There are two types of pain receptors. One receptor reports injuries to the brain, and the other reports everything else. Because of these two types of receptors, pain also comes in two types :
- First Pain: This pain sensation is quickly transmitted. It is a sharp pain, similar to a pinprick. It is usually a localized pain as well meaning it comes from a specific area of the body, like your finger, or lip .
- Second Pain: As its name suggests, second pain typically follows first pain. It has a slower onset but is longer lasting. Typically diffusely localized, it is usually a dull, throbbing, or burning sensation and continues after the stimulus that caused the pain is removed.
Our central nervous system has the ability to modify its perception of pain. This is why when you are working out, you dont feel the back injury you just inflicted on yourself. You feel it the next day instead. This is also the brains gateway mechanism for pain. For example, if you have chronic pain in your leg, and you smash your hand with a bust of George Washington, your brain will register the pain in your hand, but your leg wont hurt anymore.
Now that we know a little bit about the different pain receptors, lets look at the different types of pain medications.
Treating Arthritis With Medications
Meds are usually very effective in helping to ease joint pain and other arthritis symptoms. Thats because most of them help reduce inflammation the source of all that aching. Some types of medications may be used simply to ease joint pain, without doing much to combat inflammation.
Over-the-counter pain-relievers. These include Tylenol , and nonsteroidal anti-inflammatory drugs like Aspirin, Aleve , and Advil or Motrin . Acetaminophen may be best used in conjunction with some prescription medications and is generally safe for long-term use, according to 2012 research in The Open Rheumatology Journal. But the researchers also noted that, while NSAIDs can ease an arthritis flare-up, high doses and long-term use may also be harmful the Food and Drug Administration cautions that NSAIDs can cause stomach bleeding and kidney damage in some people.
Acetaminophen is the first line of defense against osteoarthritis, says Robert T. Keenan, MD, a rheumatologist at Duke University Hospital in Raleigh, North Carolina. He considers the medicine to be very safe if you dont have significant liver damage or other contraindications and don’t take more than the maximum dosage . It seems to work best before the pain starts and preventing the pain associated with increased activity, Dr. Keenan says.
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Integrative Medicine Treatments For Hand Arthritis
Many doctors today recommend a treatment plan that uses integrative medicinea combination of conventional Western medicine and alternative medicine. Both Western and alternative treatments are supported by research.
Occupational therapy For many patients, hand exercises can be the most cost-effective treatment option.1 A licensed occupational therapist can teach a person exercises that help strengthen the joints in the wrists and fingers, improve hand dexterity, and protect joints from further degeneration.
SplintingStabilize and support the hand joints with splints. There are several different types of braces, including smaller braces that stabilize individual knuckles and larger ones that stabilize the wrist and hand. Bracing at night can prevent pain from interrupting sleep .
People who find braces too cumbersome or rigid to wear all the time may wear compression gloves or sleeves instead. The goal of these products is to support joints while allowing for some flexibility.
MedicationsBoth topical and oral pain medications can temporarily ease pain caused by hand arthritis.
- Topical pain relievers come in the form of creams, balms, gels, or patches, and are sold over-the-counter. Certain topical products require a physicians prescription.
Gout And Calcium Crystal Diseases
Gout is a type of inflammatory arthritis that can cause painful swelling in joints. It typically affects the big toe, but it can also affect other joints in the body.
Joints affected by gout can become red and hot. The skin may also look shiny and can peel.
Its caused by having too much urate, otherwise known as uric acid, in the body. We all have a certain amount of urate in our body.
However, being overweight or eating and drinking too much of certain types of food and alcoholic drinks can cause some people to have more urate in their bodies. The genes you inherit can make you more likely to develop gout.
If it reaches a high level, urate can form into crystals that remain in and around the joint. They can be there for a while without causing any problems and even without the person realising they are there.
A knock to a part of the body or having a fever can lead to the crystals falling into the soft part of the joint. This will cause pain and swelling.
There are drugs that can reduce the amount of urate in the body and prevent gout attacks. Examples are allopurinol and . If youre having a gout attack, youll also need short-term pain relief. Non-steroidal anti-inflammatory drugs as well as paracetamol can be good drugs to try first.
Men can get gout from their mid-20s, and in women its more common after the menopause. Taking water tablets can increase the risk of gout.
There are also conditions that cause calcium crystals to form in and around joints.
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Other Otc Pain Relievers
Along with medications, there are supplements and creams that you can buy at the drugstore to relieve arthritis pain. People may also use topical treatments along with other medications.
Many people with OA use the supplements glucosamine and chondroitin. For those with moderate to severe OA knee pain, the combination of the two may ease aches, although medical studies have not shown clear proof that they help a lot. If you choose to try it, take it for at least 3 months before you decide if it helps.
There donât seem to be any major side effects from glucosamine and chondroitin supplements, but because they are supplements, the FDA doesnât regulate them in the same way as drugs. That means itâs tough to be sure of the content and quality of supplements you see in stores.
Though the benefit is still unclear, one study showed long-term use of fish oil supplements improved pain and function.
Skin creams made from capsaicin, an extract from chili peppers, may help relieve mild arthritis pain. You may notice a mild stinging or burning feeling when you rub it on your skin, but it usually fades over time. Test the medication on a small part of your skin to make sure youâre not sensitive to any of the ingredients.
Cold or warm compresses on a painful joint a few times per week may also improve pain, swelling, and range of motion. Cold therapy may also help you feel better right after you exercise.
Methotrexate And Other Traditional Dmards
Disease-modifying antirheumatic drugs are used used to slow or stop rheumatoid arthritis by suppressing the immune system. The generic names for commonly used DMARDs include:
Biologic drugs target and prevent a specific reaction from happening, stopping the inflammatory process.
This class of medications, called biologic response modifiers, is technically a subset of DMARDs. They may be used with traditional DMARDs or as an alternative to them. Biologics:
- Disrupt certain parts of the cascade of events that lead to RA inflammation and have the potential to stop the disease process.
- Increase a persons risk of infection and tend to be expensive. Because of these potential downsides, biologics are used when methotrexate or other DMARDs prove insufficient or cause unacceptable side-effects.
- May become less effective and/or cause worsening side effects over time. The doctor and patient can work together to monitor changes and decide if and when switching medication is advisable.
Testing for TuberculosisBefore taking any type of biologic medication, a person must be tested for tuberculosis. People who have latent tuberculosis carry the Mycobacterium tuberculosis bacterium without having tuberculosis symptoms. If a person with latent tuberculosis takes immune-suppressing biologic medications the bacterium can multiply and cause symptomatic tuberculosis.
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Home Remedies And Lifestyle
Regular exercise can reduce pain and improve physical function, muscle strength, and quality of life for people with arthritis, and it is strongly recommended for people who have arthritis. While it can be difficult to be motivated to exercise when you are having symptoms such as pain or fatigue, choosing the right exercise that you also enjoy can make a big difference in your quality of life.
Eating a nutritious diet is important for maintaining ideal weight and for bone health. There is no known diet that can cure arthritis, so you can start by following the basics of healthy eating you may also benefit from incorporating anti-inflammatory foods.
Reducing stressmay also help calm the pain and stiffness associated with arthritis. Being under stress can heighten your pain perception. A study also found that psychological stress was associated with flares and relapse in people with rheumatoid arthritis.
Home remedies to manage pain and stiffness can help you keep it from interfering with daily living. You can try tactics such as cryotherapy , heat therapy or warm water therapy , or self-massage. Beware of folk remedies.
Assistive devices can help protect your joints and make it easier for you to go about your day. Look into canes, walkers, raised toilet seats, grabbers, and other helpful devices.
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Arthritis is a debilitating and persistent condition. In 2012, an estimated 52.5 million people in the U.S. had arthritis or one of the rheumatic diseases. That number is expected to increase to nearly 80 million people by 2040. But there are plenty of over-the-counter treatment options including creams, lotions, gels, and oils with anti-inflammatory, anesthetic, and additional properties to relieve pain.
Topical medications for pain relief come in multiple formscreams, gels, patches, etc., says Dena Barsoum, MD, a physiatrist at HSS. Consider what body part you are applying it to and what form might work best for you. Its always important to look closely at the active ingredients in any medication you use. Over-the-counter medications sometimes have very flashy packaging and make grand claims about what they can do.”
However, there isnt a one-size-fits-all solution. Product formulas include distinct active ingredients so each individual should test what works best for their arthritis symptoms and lifestyle.
Here are a few of the best arthritis creams on the market.
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Complementary And Alternative Medicine
If you prefer a natural approach to treating arthritis, or would like to explore complementary options, it’s imperative that you tell your healthcare provider what you want to try . There are many alternative treatment options that, while popular, are not verified for effectiveness and safety.
The National Center for Complementary and Integrative Medicine, a division of the National Institutes of Health , reports on the effectiveness of some CAM treatments for arthritis:
Be wary of dietary supplements or herbal treatments sold for arthritis relief. You could experience dangerous side effects or drug interactions and the U.S. Food and Drug Administration warns that many are tainted with prescription drugs.
Why Do I Have Ra
What is causing your joint pain? RA is an autoimmune disorder. Autoimmune disorders result from your immune system mistaking your normal cells for foreign cells and attacking/destroying them. When your immune system attacks the lining of the membrane surrounding your joints , inflammation occurs. The constant inflammation of the synovium thickens the membrane lining and wears away the cartilage and bone in your joints, causing the physical pain you experience.
The tricky thing about RA is that doctors are still unsure of what the underlying cause is. While genetics seem to be a contributing factor, the baffling mystery is that the majority of people suffering from RA have no family history of it.
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Types Of Dmards Used In Inflammatory Arthritis
- Traditional DMARDs. This category includes , hydroxychloroquine, sulfasalazine, and leflunomide. These drugs still have a place in the treatment of inflammatory arthritis but may not be enough on their own to adequately control symptoms and limit the damage that the disease may cause. They are taken orally , although methotrexate is also available as an injection.
- JAK inhibitors. Janus kinases are proteins involved in inflammation. JAK inhibitors include baricitinib, tofacitinib, and upadacitinib. These medications are taken orally.
- Biologic DMARDs. These drugs differ from traditional DMARDs because they are proteins targeting specific proteins fueling the symptoms and damage of inflammatory arthritis. There are many types of biologic DMARDs, which inhibit many different targets in the immune system. These drugs cannot be taken orally, and are given as a subcutaneous injection or intravenously . Biosimilar DMARDs are drugs that have very similar effects as biologic DMARDs, but may be available at a lower cost.
The Most Effective Medications For Arthritis Pain Relief
With over two decades of experience in medicine, Melissa Flagg writes patient education articles, keeping you informed about your health.
For many people, the symptoms of arthritis can be debilitating. Whether its rheumatoid arthritis or osteoarthritis, pain is pain, and any form of arthritis can be excruciating. I, myself, suffer from osteoarthritis and have a lifelong battle with chronic pain.
My battle started 13 years ago. I was left with a neck injury due to a car accident, and this injury gave me not only chronic neck pain but migraines as well. For 13 years, I have searched for the one medication or herb that would cure my pain. I did find one thing that alleviated all of my pain, but unfortunately, the government wont let me or anyone else have it.
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What Are The Symptoms Of Arthritis
The symptoms of arthritis vary from person to person. But if you have arthritis, you will almost certainly have symptoms relating to your joints, such as:
- redness and warmth in a joint
- stiffness or reduced movement of a joint
Some people also get other problems outside their joints. Other common symptoms include:
- weight loss
- feeling unwell
Types Of Medication That Treat Rheumatoid Arthritis
When prescribing a medication, a physician will take into account the patients age, disease activity, and other medical conditions, but each patient is unique. Figuring out which medication or combination of medications work best for an individual can be challenging and often requires a process of trial and error.
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