When Life Is A Pain

One in six Americans has some form of arthritis. For many, conquering the pain is a daily battle.

The American Pain Society has new guidelines to help ease their suffering, reports health and medicine correspondent Dr. Emily Senay.

New guidelines by the American Pain Society, the leading U.S. professional organization devoted to pain management, strongly emphasize that arthritis pain is best treated through a combination of ongoing pain assessment, medication, proper nutrition, exercise and patient and family education.

They are intended for use by physicians, nurses and other health care professionals who treat adults and children with more than 100 different forms of arthritis.

"Arthritis is one of the most expensive and debilitating diseases in the U.S., and the Guideline recognizes that this condition can adversely impact earning potential, function and lifestyle," said Arthur Lipman, co-chairman of the APS Guideline Committee. "Therefore, accurate assessment and management of pain requires differentiation of the types and causes of pain and an understanding of the patients' willingness to adhere to therapy and remain active."

For people with mild to moderate arthritis, the American Pain Society suggests they take acetaminophens. One of the most popular is Tylenol. Acetaminophens are not only inexpensive, but they don't require a prescription and have mild side effects.

The drugs of choice for moderate to severe arthritis are COX-2's, which are sold under the brand names of Celebrex and Vioxx. They are not only potent pain relievers but have few side effects on the gastrointestinal system. COX-2's tend to be expensive so people may want to consider non selective NSAIDs, non-steroidal anti-inflammatory drugs. Aspirin falls into this category as well as ibuprofen, which is sold generically and under the names of Advil, Motrin, Nuprin and Aleve.

For people with severe arthritis who don't respond to the COX-2 drugs, the American Pain Society suggests the use of opioid medications such as oxycodone and morphine. These drugs can be very addictive. In fact, oxycodone, which is sold under the brand name of OxyContin, has been blamed for a recent rash of overdose deaths among people who used the drug recreationally. But the doses needed to reduce arthritis pain are small and unlikely to be addictive.

It is very important that people with arthritis keep their weight under control and eat a balanced diet. The American Pain Society suggests that people should lose weight if their body mass index is greater than 30. If you find that you are not losing weight through diet alone your doctor may prescribe physical therapy.

Regular exercise or physical therapy can help manage the pain. Many people with arthritis take up walking or swimming and other low-impact activities.

For people who don't respond well to drug therapy and have a hard time with even the slightest physical movement, especially the elderly and the obese, the American Pain Society suggests surgery.

There are of course drawbacks to surgery: recovery is often a long and difficult process and until recently artificial joints would wear out after 20 years. Now, laboratories are starting to use new, highly durable material that often prolongs the life an artificial joint to about 35 years.