For many years, osteoarthritis has been called the “arthritis of wear and tear”. This view has come to be challenged and now osteoarthritis is better known as a disorder of cartilage repair. Furthermore, the predisposition to osteoarthritis seems to run in families. As a result, medical scientists have begun to search for a genetic predisposition to this common disabling condition.
Osteoarthritis begins to cause pain and disability when the cartilage lining a joint cavity wears through and fails to repair. Cartilage acts as the joints Teflon lining. In association with joint fluid, cartilage produces 200 times less friction than ice sliding on ice. When the cartilage is gone – bone rubs on bone. This action is like the broken end of two dry twigs being rubbed determinedly together. It is no wonder people with osteoarthritis suffer from incapacitating pain.
Arthritis tablets Ike Aspirin (NSAIDS) have a controversial role to play in the treatment and progression of osteoarthritis. These drugs suppress the action of prostaglandins which mediate the production of stiffness, swelling and pain. They do nothing to correct the underlying disorder of cartilage which lies at the heart of the osteoarthritis conundrum
The manufactures of Feldene, a long acting NSAID, are quick to point out that the products of many other drug companies actually accelerate the process of cartilage decay.
In the final analysis, it doesn’t matter which drug is used to relieve the pain of osteoarthritis. The condition gets worse whenever weight bearing activity continues. The more medication denies a joint the protection of painful stimuli; the sooner the damage gets worse.
Given the further propensity of NSAIDS to cause peptic ulceration and bleeding, people are advised to avoid this group of drugs whenever it becomes humanly possible. Some arthritics are so handicapped by swelling and pain that they have little choice. They take their chances with bleeding and the NSAIDS; rather than suffer the pain.
Home Remedies
In spite of the fact that continued usage accelerates the destruction of an osteoarthritic joint; immobilization is not the answer. Without mobilization, an arthritic joint rapidly loses its function. Arthritis Foundations in all states provide a wealth of advice and treatment aids that cannot be surpassed by your local medical practitioner. Get in touch with your local branch at the earliest opportunity. There is something very relaxing and relieving about emersing painful joints in warm water. The reduction of weight bearing and exercises in warm water has allowed hydrotherapy to stand the test of time. Don’t forget the services of your friendly physiotherapist. They too have more to offer than the pernicious pills, potions and poisons of your prescribing medical practitioner.
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An exciting recent development with evening primrose oil has been with rheumatoid arthritis. Evening primrose oil may help many patients reduce their dose of non-steroidal anti-inflammatory drugs, or give them up altogether.
A study was done at Glasgow Royal Infirmary with 49 patients with rheumatoid arthritis.’ Sixteen of these patients were given evening primrose oil (Efamol), 15 were given a combination of evening primrose oil and fish oil (Efamol Marine), and 18 patients a placebo (liquid paraffin.)
The aim of the study was to find out whether evening primrose oil or evening primrose oil combined with fish oil could replace the conventional non-steroidal anti-inflammatory drug (NSAID) treatment in rheumatoid arthritis.
The study lasted 15 months altogether. The initial 12 month treatment period was followed by three months of placebo for all groups. The dose was 12 capsules, usually taken as 3 capsules four times a day. No one knew what they were taking as all the capsules looked identical.
At the end of 12 months, results showed a significant subjective improvement for the Efamol and the Efamol Marine group, compared with the placebo group. Moreover, by 12 months the patients on Efamol and Efamol Marine had significantly reduced their NSAIDs. And despite this decrease in drugs, the disease did not get worse.
Sixty per cent of the patients on the Efamol alone were able to stop taking drugs, and a further 25% were able to halve the dose without ill effects.
The most consistent results, though, were for the Efamol Marine group. In this group, 60% were able to stop taking their anti-inflammatory drugs altogether, while 35% halved their dose. However, the amount of subjective improvement in the Efamol alone group was often greater than in the Efamol Marine group.
It was clear from this study that the evening primrose oil, or combination of oils, was the therapeutic anti-inflammatory agent. When the treatment group was switched to placebo for the last three months of the trial, all but one of the patients suffered a relapse.
The conclusion of this important study is that evening primrose oil and evening primrose oil with fish oils produce a subjective improvement in rheumatoid arthritis, and allow some patients to reduce or stop treatment with conventional anti-inflammatory drugs.
However, as yet there is no evidence that they act as agents which actually modify the disease.
The patients who had been taking evening primrose oil or evening primrose oil combined with fish oils experienced subjective improvements in their conditions, and felt a greater sense of well-being. However, the doctors working on this study were not able to measure any objective improvements.
All the patients in the Glasgow trial had a fairly mild form of rheumatoid arthritis. The results of this particular trial were much better than some previous ones in which a lower dose of evening primrose oil was given for a shorter period of time on more severely disabled patients.
The doctors conducting this study felt that, as those patients on the Efamol and the Efamol Marine treatment were able to decrease or stop their usual drugs, these oils can best be used in those cases where a patient cannot take NSAIDs because of conditions such as a peptic ulcer or renal impairment.
The great advantage of evening primrose oil for rheumatoid arthritis is that it is a natural product, without side-effects. In contrast to the NSAIDs, evening primrose oil has actually been shown to have a protective effect on the stomach.
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