Ask the Doctors October 2011 Issue

Ask The Doctors: October 2011

Depression and Arthritis . . . Alternative Treatments . . . Pain Med Side Effects

Q.) Is there any connection between depression—or stress—and arthritis?

A.) It is known that depression affects a person’s sleep patterns, appetite, and the perception of pain. Sleep-deprived people, in particular, frequently perceive pain more intensely than others. It is important that you bring to your doctor’s attention symptoms of depression so that treatment may be undertaken. Such treatment can enable you to better cope with arthritis pain and should be part of a comprehensive medical program to reduce the impact of arthritis on your mobility and quality of life.

Stress is another factor that affects arthritis, especially rheumatoid arthritis (RA). It can weaken the immune system, which in turn may affect the severity of onset of RA.

Q.) What’s considered an “alternative” arthritis treatment? How is it different from an “experimental” treatment?

A.) An alternative treatment is a surgical or non-surgical procedure that departs from a standard treatment but represents a proven approach to solving a specific problem. In arthritis of the hip, for example, a hip replacement is considered a standard treatment, whereas an injection followed by an exercise program and medication would be considered an alternative treatment. Both standard and alternative treatments have a long track record of proven results, with well-documented data to support them.

An experimental treatment is generally a new treatment that is thought to provide satisfactory results for a given problem but has no long-term data to support it. However, given other available scientific data, it is believed to be a viable treatment. An experimental treatment often involves a procedure or program that is still under study. If you elect this type of treatment, you then become part of the study.

Q.) How can I avoid the side effects of arthritis medication?

A.) Generally, you should take the minimum dose required to obtain relief from your arthritis symptoms. You should avoid unnecessary use of medications for minimal symptoms. You should also avoid taking multiple medications for the same reasons. Do not take two nonsteroidal anti-inflammatory drugs (NSAIDs) at the same time. Also, you should take NSAIDs with food, which will minimize gastric irritation.

Importantly, you should report any gastrointestinal problems caused by NSAIDs to your doctor. He or she may wish to change your dosage, the type of medication, or add a protective medication to your treatment regimen.

Q.) My doctor has suggested that I’ve developed rheumatoid arthritis because it is in my genes. But no one in my past or immediate family has ever had arthritis. Is there any connection?

A.) The gene HLA-DRW4 has been linked to rheumatoid arthritis. It is present only in a small number of individuals and can be detected by a genetic test. In clinical situations, this test is not widely used.

It is believed that genetics plays only a minor role in rheumatoid arthritis. If no one in your family has a history of rheumatoid arthritis, genetic disposition has probably not played a significant role in your case.