Arm pain
In addition, prophylactic treatment to reduce risk of gastrointestinal ulceration, perforation and bleeding is recommended in patients > 60 years of age with: prior history of peptic ulcer disease; anticipated duration of therapy of > 3 months; moderate to high dose of NSAIDs; and, concurrent corticosteroids. arm pain Rectal-pain-diagnosis. Misoprostol, at a dose of 200 mg four times daily, constitutes effective anti-ulcer prophylaxis but is often poorly tolerated due to diarrhea. Omeprazole, and other proton pump inhibitors, are also very effective anti-ulcer prophylactic agents, although cost can be limiting. The development of selective cyclooxygenase-2 (COX-2) inhibitors (see full discussion on COX-2 inhibitors) offers a strategy for the management of pain and inflammation that is likely to be less toxic to the GI tract. arm pain Arthritis aids. (top of section)Analgesic Agents Local analgesic therapies include topical capsaicin and methyl salicylate creams. Occasionally in late stage disease, patients will require narcotic analgesics to control pain. Oral glucosamine and chondroitin sulfate have been shown (each individually) to have a mild to moderate analgesic effect in several double-blind, placebo-controlled studies. arm pain New drug for arthritis. (top of section)(top of page) Intraarticular Therapies Judicious use of intra-articular glucocorticoid injections is appropriate for OA patients who cannot tolerate, or whose pain is not well controlled by, oral analgesic and anti-inflammatory agents. Periarticular injections may effectively treat bursitis or tendonitis that can accompany OA. The need for four or more intra-articular injections suggests the need for orthopedic intervention. Intraarticular injection of hyaluronate preparations has been demonstrated in several small clinical trials to reduce pain in OA of the knee. These injections are given in a series of 3 or 5 weekly injections (depending on the specific preparation) and may reduce pain for up to 6 months in some patients. (top of page) Non-pharmacological Management Weight reduction in obese patients has been shown to significantly relieve pain, presumably by reducing biomechanical stress on weight bearing joints. (more info on OA and Body Weight) Exercise has also been shown to be safe and beneficial in the management of OA. It has been suggested that joint loading and mobilization are essential for articular integrity. In addition, quadricep weakness, which develops early in OA, may contribute independently to progressive articular damage. Several studies in older adults with symptomatic knee OA have shown consistent improvements in physical performance, pain and self-reported disability after 3 months of aerobic or resistance exercise.
Arm pain
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