Items filtered by date: December 2016
Applying Relief
Pain is one of the most common reasons that a person visits the doctor. Often kidney disease, a fear of addiction, side effects, etc. may prevent a person from taking oral medications. What is left for the person to control the pain and go about their daily lives and special occasions?
The following topical medications can be used for pain relief:
- Diclofenac (Voltaren gel) – a proven anti-inflammatory that may be applied directly to the site of pain, especially effective in tendonitis, synovitis, soft tissue injuries and chronic joint conditions such as osteoarthritis
- Topical ibuprofen – similar to diclofenac
- Topical lidocaine – extremely useful for post-herpetic neuralgia and diabetic neuropathy. Evidence based medicine supports its use.
- Topical capsaicin – used anecdotally in diabetic neuropathy and neuritis but not supported by scientific literature
- Topical amitryptiline and ketamine – both have shown to be successful for treating peripheral neuropathy in small cohort studies
- Topical opioids – also provides relief from pain associated with injury or inflammation for most patients in small studies
- Topical menthol – shown to better for pain control than application of ice in small studies
The advantages of topical analgesics include no systemic effects, low side effect profile, and avoidance of addiction/withdrawal. If you are able to take oral medications, topical medications may be used as adjuncts as long as contraindications are avoided. Talk to your doctor today if your pain is poorly controlled.
Please visit our website for more information or call 614-885-3338 (FEET) to schedule an appointment with us at our Columbus or Gahanna office
When Growing Pains Are Not Growing Pains
Although rare, juvenile arthritis (JA) affects over 200,000 children in the US each year. It can cause a constellation of symptoms or be localized to one joint.
Examples of JA include:
- Oligoarticular – pain in four or less joints for at least six weeks
- Polyarticular – pain in five or more joints for at least six weeks and is rheumatoid factor negative or is rheumatoid factor positive
- Systemic – joint pain plus:
- Enlargement of the lymph nodes.
- Enlargement of the liver or spleen.
- Inflammation of the lining of the heart or the lungs.
- The characteristic rheumatoid rash, which is flat, pale, pink, and generally not itchy.
- Enthesitis JA – pain at muscle, ligament and capsule attachments and 2 of the following:
- Inflammation of the back
- A positive blood test for the human leukocyte antigen (HLA) B27 gene
- Onset of arthritis in males after age 6
- A first-degree relative diagnosed with ankylosing spondylitis, enthesitis-related arthritis, or inflammation of the sacroiliac joint in association with inflammatory bowel disease or acute inflammation of the eye.
Your podiatrist and/or dermatologist may recommend:
- Blood test for markers that identify types of arthritis (rheumatoid factor, human leukocyte antigen, etc.)
- Radiographs of the affected joints
- A team of specialists to coordinate treatment
- Non-steroidal anti-inflammatory drugs, disease modifying drugs or steroids
- Physical therapy, orthotics and/or splints
- In extreme cases or later in life, fusion of the joints may be recommended
Half of children who experience JA find it resolved within months to years. However, the remainder still have symptoms of arthritis into adulthood. Early recognition and early treatment can alleviate many of the symptoms and help the child to have a full life.
Please visit our website for more information or call 614-885-3338 (FEET) to schedule an appointment with us at our Columbus or Gahanna office
When Growing Pains Are Not Growing Pains
Although rare, juvenile arthritis (JA) affects over 200,000 children in the US each year. It can cause a constellation of symptoms or be localized to one joint.
Examples of JA include:
- Oligoarticular – pain in four or less joints for at least six weeks
- Polyarticular – pain in five or more joints for at least six weeks and is rheumatoid factor negative or is rheumatoid factor positive
- Systemic – joint pain plus:
- Enlargement of the lymph nodes.
- Enlargement of the liver or spleen.
- Inflammation of the lining of the heart or the lungs.
- The characteristic rheumatoid rash, which is flat, pale, pink, and generally not itchy.
- Enthesitis JA – pain at muscle, ligament and capsule attachments and 2 of the following:
- Inflammation of the back
- A positive blood test for the human leukocyte antigen (HLA) B27 gene
- Onset of arthritis in males after age 6
- A first-degree relative diagnosed with ankylosing spondylitis, enthesitis-related arthritis, or inflammation of the sacroiliac joint in association with inflammatory bowel disease or acute inflammation of the eye.
Your podiatrist and/or dermatologist may recommend:
- Blood test for markers that identify types of arthritis (rheumatoid factor, human leukocyte antigen, etc.)
- Radiographs of the affected joints
- A team of specialists to coordinate treatment
- Non-steroidal anti-inflammatory drugs, disease modifying drugs or steroids
- Physical therapy, orthotics and/or splints
- In extreme cases or later in life, fusion of the joints may be recommended
Half of children who experience JA find it resolved within months to years. However, the remainder still have symptoms of arthritis into adulthood. Early recognition and early treatment can alleviate many of the symptoms and help the child to have a full life.
Please visit our website for more information or call 614-885-3338 (FEET) to schedule an appointment with us at our Columbus or Gahanna office
