Some people with arthritis feel that doctor-patient communication can sometimes seems narrow and impersonal. Integrative medicine aims to be different.
“Patients are at the center of integrated medicine; our goal is to partner with them to address the physical, emotional, social, environmental and spiritual factors that affect health,” says internist Adam Perlman, MD, executive director of Duke Integrative Medicine in Durham, N.C. “This approach is very inclusive. We practice and believe in Western medicine, but we also have an openness to complementary modalities that help address the whole person.”
For 20 years, Frances Muller’s rheumatoid arthritis (RA) was misdiagnosed. A neurologist told her the pain in her hands was carpal tunnel syndrome. An internist told her the all-over aches were the flu. An orthopaedic surgeon said she had bursitis in both shoulders. “None of my symptoms made any sense,” and none of the treatments helped, says Muller, who lives in Scottsdale, Ariz. After she’d seen 13 other doctors, an orthopaedic surgeon who ordered an X-ray of her pelvis finally figured it out: there was no way she could have so much damage to her hips and not have RA.
Misdiagnosis is one of the most common medical errors, occurring in about 10 to 20 percent of cases, according to the National Center for Policy Analysis. It can lead to unnecessary or delayed treatments and physical and emotional suffering.
In rheumatology, where symptoms and diseases frequently overlap, even experienced and well-intentioned physicians can miss important clues. “For many rheumatic diseases, there’s no gold standard [for diagnosis],” says Don L. Goldenberg, MD, chief of rheumatology at Newton-Wellesley Hospital in Massachusetts. “You don’t biopsy it. There aren’t a lot of laboratory tests.” If patients are concerned, they should get a second opinion, he adds.
Whether it’s magnetic resonance imaging (MRI), an ultrasound or a good old-fashioned X-ray, your doctor is likely to order some type of medical imaging to see what’s going on below the surface with your arthritis.
“The most important thing rheumatologists can do to assess patients is still a good history and clinical exam. The role of imaging is to assist in assessing the degree of severity,” says Orrin Troum, MD, professor of medicine at University of Southern California and spokesperson for the International Society for Musculoskeletal Imaging in Rheumatology. Understanding its severity helps a doctor decide how aggressively to treat the disease.
Biologics have revolutionized the treatment of rheumatoid, psoriatic and other inflammatory types of arthritis for almost two decades, but plenty of misconceptions about them remain. Rheumatologist Eric Matteson, MD, helps separate fact from fiction.
Rather than rely completely on conventional Western medications, some people with arthritis also look to herbal products – and the expertise of an herbalist — to provide natural relief for their symptoms.
Exercise can be a powerful balm for many of the things that ail us, including depression, bone loss, fatigue, heart disease, diabetes and arthritis. But if a goal of exercise is to lose weight, you’ll increase your chances of success by changing your diet.
Pain and aging—it’s an unfortunate fact of life. As we increase in age, so does our risk for painful health conditions. Research also suggests the experience of pain changes as we age; the treatments for it must often change as well.
More Painful Problems
“As we get older we are more likely to experience pain because of the kinds of health problems that go with getting older,” says Patricia A. Parmelee, PhD, director of the Alabama Research Institute on Aging at the University of Alabama in Tuscaloosa. “There are a number of disorders linked with the aging body that are painful,” she says. Of these, one of the most common is osteoarthritis (OA).
The likelihood of developing arthritis increases with age. The CDC reports that 7% of people between the ages of 18 and 44 say they have doctor-diagnosed arthritis. Among people 65 and older, that number is 50%.
Continue reading Aging and Arthritis Pain: Should Treatment Plans Change as We Age?
Treating fibromyalgia with both pregabalin (Lyrica) and duloxetine (Cymbalta) is more effective that using either drug alone, according to a new study out of Canada.
Fibromyalgia is a chronic health condition characterized by widespread muscle pain, fatigue, memory problems, sleep disturbance and mood changes. If non-drug treatments such as exercise and avoiding triggers (which can include physical and psychological stress) don’t provide enough relief, medication may be prescribed. Common choices in the United States include pregabalin, duloxetine and milnacipran (Savella).
Continue reading Combining Meds for Fibromyalgia May Offer Added Benefits
Researchers agree – meditation can help with a host of health problems. “Relaxing and quieting your mind by focusing on your breathing can reduce stress – even the stress that comes with arthritis flares,” says David E. Yocum, MD, director of the Arizona Arthritis Center in Tucson. His studies, as well as others, found that patients who meditated responded to stress with lower heart rates and improved immune function; and that meditation, in combination with traditional medicines, appears to help patients with chronic pain. Studies have shown that meditation inhibits or relieves pain perception. And in a study published in the American Academy of Pain Medicine’s scientific journal in April 2015, 43 patients who used a mindfulness meditation program as part of their pain management experienced lower general anxiety and depression, better mental quality of life (psychological well-being), a greater feeling of control of the pain, and higher pain acceptance.
Continue reading Easy Meditation Options for Pain