THE BETTER TREAT JOINT PAIN
The pain associated with rheumatism can today be relieved by many treatments. The best known being nonsteroidal anti-inflammatory drugs. But there are other solutions such as simple paracetamol for mild pain and even short-term morphine in acute cases…
93% of French people say they have already suffered from joint pain. They are either transient (acute) or regular over long periods (chronic). The pain felt can be of mechanical, traumatic, inflammatory origin. The causes are multiple: it can be osteoarthritis, arthritis, rheumatoid arthritis, inflammation due to shock or excessive stress. A gout attack or a virus (such as the flu) can also cause symptoms.
To combat this pain, there is a fairly wide therapeutic arsenal. If doctors generally use the latest innovations from research, we often forget that certain long-known drugs can also effectively relieve the patient. In all cases, the treatment must be adapted to the intensity of the pain, its origin, its duration …
Paracetamol effective for mild joint pain
Paracetamol was discovered in 1883. Everyone has taken it at least once! It is also one of the 5 most prescribed drugs in the world. Its effectiveness against rheumatoid pain is very good, comparable to that of Ibuprofen, and above all it is well tolerated by the digestive system. When there is no inflammation, it can be used to treat joint pain. It is also recommended by the European League against Osteoarthritis (EULAR). The analgesic effect of paracetamol takes place after 30 minutes and works for approximately 4 hours. This is why it is essential to take it at a fixed time. The treatment can thus be divided into four doses: 8 a.m., 12 p.m., 5 p.m., 10 p.m.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
In case of significant inflammation such as severe knee arthritis (with pain and swelling), NSAIDs (non-steroidal anti-inflammatory drugs) are the best solution. These are drugs that are intended to decrease or suppress the symptoms caused by inflammation. They have anti-inflammatory and analgesic properties which make them interesting in the treatment of joint pain. As part of rheumatoid arthritis for example, they will treat morning pain and stiffness.Today there are a dozen drugs covering different chemical families including ibuprofen, piroxicam, diclofenac etc. The disadvantage of NSAIDs is that they can cause side effects such as digestive disorders (pain, nausea, burns, diarrhea …) most often, but also risks of high blood pressure, dizziness, asthma attacks … They are also contraindicated in certain cases like breastfeeding, for pregnant women from the 6th month of pregnancy, people under 15 or over 65 … Before taking this treatment ask your doctor or pharmacist for advice for those sold without a prescription.
Non-drug solutions exist
Some non-drug strategies can be used:
• Cold, in particular through the GREC protocol, better known in the context of sports medicine. It consists of 4 stages: Ice, Rest, Elevation of the affected joint and Compression using bandage;
• Heat, especially to relieve the pain of osteoarthritis;
• Spa treatments, the French Rheumatology Society recommends them to relieve symptoms over a period of several months. They are however not suitable for treating intense pain.
Relieve joint pain with natural solutions
To treat joint pain, it is possible to turn to milder solutions. Certain essential oils, such as that of lemon eucalyptus, known for its anti-inflammatory properties, can be applied by massage to the painful area. Turmeric is also reputed to be an anti-inflammatory. Easy to integrate into meal preparation, it acts against stiffness and functional discomfort.
A poultice of green or red clay, thanks to its analgesic and relaxing properties, can also be effective. For the followers of homeopathy, Arnica 5CH is an interesting solution: anti-bruise, analgesic, anti-inflammatory, Arnica is a plant with multiple virtues. Acupuncture.
Acute joint pain: morphine versus chronicity?
When it comes to acute joint pain, another compound may be considered: morphine. Be careful, this is not a long treatment for a chronic problem, but on the contrary a short cure (7 days on average, but often less) in order to eliminate an unbearable illness. Morphine can be used in case of severe acute pain and refractory to weaker analgesics. The doses are for example around 30 mg morning and evening. The advantage is that not only does the pain go away, but there is no risk of withdrawal for a short treatment like this. However, one of the major side effects remains the slowing of transit, which requires taking laxatives. This type of short course of morphine could be the future of the treatment of acute rheumatoid pain. Because according to several specialists, « hitting fast and hard » would prevent the problem from turning into chronic pain. But more studies are needed to confirm this long-term effect.
Treatments on a case-by-case basis
It is also possible to adapt the treatment depending on the location of the pain and the disease that causes it.
Intra-articular infiltrations are very useful in relieving joint pain. Corticosetroids are the most used substances for this type of treatment. These infiltrations are widely used by rheumatologists in daily practice. They make it possible to treat a mono-articular attack as in osteoarthritis or pauci-articular attacks of systemic rheumatism. The principle: deliver an active product near the targeted tissue. The advantage: a lower dose is sufficient and the systemic effects are limited.
HYALURONIC ACID INJECTIONS
Hyaluronic acid injections will lubricate the painful joint to improve mobility and reduce pain. Hyaluronic acid in particular has an anti-inflammatory and analgesic effect. This treatment is particularly used to treat joint pain due to osteoarthritis of the knee but it is a method which remains controversial.
Biotherapies are based on substances produced from living cells or organisms such as bacteria, yeast, components of animal origin. The majority are antibodies that resemble those found naturally in the body. As part of joint pain, they will block the mechanisms responsible for inflammation by specifically targeting a cell or a chemical messenger.
When joint pain affects the feet, it may be useful or even essential to be prescribed orthopedic insoles to correct posture, better distribute the body load and limit deformation. They are recommended in cases of osteoarthritis of the knee, for example. Therapeutic shoes may also be necessary, especially in the event of significant deformation of the foot.
Occupational therapy is a specialty in the assessment and rehabilitation of people with disabilities. In the context of joint pain, it allows you to relearn everyday gestures so as not to stress the joints too much. In severe cases, the occupational therapist can go home to assess the essential arrangements to be made at home (sliding doors, elevator, etc.), at work (post fitting), or behind the wheel (power steering, height adjustable seat etc.). The goal is to preserve his autonomy as much as possible in daily life.
Having a healthy lifestyle is important to avoid or reduce joint pain. It is recommended:
- Practice regular physical activity, giving priority to aquatic activities, which are particularly suitable;
- Perform daily exercises promoting mobility prescribed by the doctor, in particular upon awakening to facilitate « morning rust removal »;
- Eat a balanced diet;
- Do not smoke, tobacco being a risk factor or aggravating;
- Monitor your weight, being overweight will stress the joints too much.