Platelets

By eating which fruits will help to increase blood platelets rapidly? Best Answer bannana, grapes, tomato strawberry, kiwie, blackberries these fruits and vegetables are spinach, cron, carrots, mashroom, potatos, sweet potatos, broccoli, peas etc. these are increas heamoglobin level in blood cell. genaraly it happens in children and owmen and pregnant owmen. if heamoglobin level more decrease then you consult with doctor Shaljam and Palak are the best sources in fruits and vegetables; if you are a non-veg - Liver is the richest source RB-TONE - a tonic specially for the purpose. Wishing everybody best health....... Green leafy vegetables, liver, rice flakes, dates, are some of the foods which increase Wiki.answers.com Increase Platelet Count Naturally: Foods to Treat Low Platelet Thrombocytopenia Platelets are small, irregular shaped cell fragments present in the blood. Platelets are also known as Thrombocytes. A normal platelet count in a healthy individual is between 150,000 and 450,000 per μl (microlitre) of blood. Platelets are responsible for the clotting of blood. Maintaining proper platelet count is critical, as low count could lead to excessive bleeding that could prove fatal. On the other hand, excessive platelets could lead to thrombosis, of blood clots in vessels leading to stroke, heart ailments and could block blood vessels in other parts of the body. A low platelet count is associated with internal bleeding. This situation is far more dangerous than having a low platelet count. Causes of Decreased or Low Platelet Count There are several reasons why some people have low platelet count: • Medications: Aspirin is known to contribute to the reduction of platelet count. Ibuprofen is also known to lower platelet count, although the effect is not long lasting. • Anemia: The effect of anemia is of particular concern to women, especially during their menstrual period, wherein their platelet count are severely low. Anemia demands special attention when it begins to rob the body of iron. • Chemotherapy: Chemotherapy and other similar medical treatments can also cause a reduction in the platelet count. • Dengue: Common in tropical areas in Asia and Africa, dengue is a mosquito-borne disease and can severely dent the level of platelets in the body. • Idiopathic (no known cause). • Autoimmune: There are auto antibodies within the body which destroy the platelets, thus reducing platelet count. How to Increase Platelet Count Here are some ways that will help prevent platelet count from dropping: • Take a lot of vitamin C supplements. You can obtain vitamin C from fruits and vegetables. Because vitamin C is water soluble, it can be easily absorbed by the body and will immediately help in restoring the body’s platelet count. • Herbal medications are also helpful in restoring platelet count. Pound the herb with pestle and mortar to extract the juice. Although the juice is very bitter and requires a lot of effort downing them, it is worth it. Most people even add sugar to the juice to make it more palatable and easy to drink. • However, the most common home remedy is to drink the bitter extract from a papaya leaf. Two leaves without the stalk can yield approximately two tablespoons of the extract. Question: I have tiny red dots on both feet which are recurring. They have not spread above the feet. Is it because of low platelet count. What treatment or diet to treat low platelet count should I follow? Answer: You are suffering from thrombocytopenia or a low platelet count. Thrombocytopenia Origin • A decreased platelet production within the bone marrow • An increased peripheral destruction of the platelets Types of Thrombocytopenia • Thrombocytopenia could be acute or chronic. • Acute thrombocytopenia predominantly occurs in children. • Chronic thrombocytopenia occurs in young adults. Clinical features • Easy bruising • Purpura or red spots • Epistaxis or nose bleed • Menorrhagia or prolonged and profuse menstruation • A major hemorrhage occurs rarely. Investigations • A regular blood count must be done • Sometimes a bone marrow aspirate is helpful. Treatment for Low Platelet Count • The initial treatment comprises of prednisolone. But you have to be extremely cautious and the treatment ought to be conducted under the supervision of a specialist. With this treatment, patients show a moderate response, requiring no other treatment. • In a large number, surgically removing the spleen becomes necessary. • A transfusion of platelets to bring back the count to normal. Diet to Increase Platelet Count: • Avoid all refined and processed foods – sugar, saturated fats, and aerated drinks to avoid low platelet count. Include fresh and organic foods. This will help in stimulating the body’s internal mechanism and increase platelet count. • Red foods are your key. Tomatoes, plums, watermelons, cherries and berries are loaded with vitamins and minerals and and have strong anti-oxidant properties which helps to raise platelet count. • tandurust.com/ Foods that Increase Blood Platelets Low platelet count is one of the major battles of people suffering from dengue and in other serious medical state. A healthy person should have a platelet count anywhere between 150,000 and 450,000. Some hospitals peg the levels to up to 350,000. The average lifespan of each platelet is only around 10 days so the body needs tao keep up production of new platelets which are produced in the bone marrow. Children and teens who have dengue will experience low (and dropping) of blood platelets. The platelets are one of the most important components of human blood, along with the red blood cells and plasma. So any number that is lower than the normal level, medication, therapy, surgery or even blood transfusion may be required. There are several ways to naturally increase blood platelets except in severe cases whereplatelets drop rapidly. Regular screening and blood test is important to determine the numbers ofplatelets. If the levels of platelets in the blood are slightly on the lower side, there are natural foods to help them increase. It is also advisable to consult a doctor to check the condition. The platelet count in the blood should always be within the normal range. If it is too high, it could lead to severe blood clots, which could result in a stroke. In cases of thrombocytopenia which are accounted on dengue cases, patients with low platelet could suffer from prolonged bleeding problems, blood in the urine or stools, bleeding gums and nose (epistaxis). To avert further decrease of platelet, a person should avoid refined foods, foods that contain sugar, soft drinks and other processed foods. Better switch to berries, oranges, tomatoes, green leafy vegetables, papaya leaf juice, kiwi fruit, flax seed and sweet lime juice. Other natural ways to increase blood platelets is get adequate sleep and rest. Also increase the consumption of beetroots, apples, potato skins and bitter gourd. Consume at least one serving of green leafy vegetables in a day. Make it a point to consume all of them on a daily basis. Once your blood count starts going up, complex foods can be added to your diet. No junk foods along the process. Take a lot of vitamin C supplements. You can obtain vitamin C from fruits and vegetables. Because vitamin C is water soluble, it can be easily absorbed by the body and will immediately help in restoring the body’s platelet count. The most common home remedy is to drink the bitter extract from a papaya leaf. Two leaves without the stalk can yield approximately two tablespoons of the extract. On the other hand, a group of pharmacy students from the University of Sto. Tomas have studied the efficacy of herbal plant Tawa-tawa extract that said increase platelet properties. The researchers, Jeriz Anne Natividad, Hazel Lopez, Toni Ann Marie Luna, Rachelle Manalo, Jeriz Natividad and Clarisse Ngo subjected tawa-tawa’s leaves to boiling. Tawa-tawa’s platelet-increasing activity was tested on laboratory rats - Sprague-Dawley. Results of the study showed that the tawa-tawa extract was effective in increasing the platelet count of rats without notable effects in red blood cell and white blood cell counts. Omega 3 fatty acids are also considered for battling low platelet counts. And this includes cod liver oil, flax seed oil, tuna, wild salmon, and free range eggs that human body alone cannot biologically produced. It also boosts and strengthens the body’s immune system. Vegetables like broccoli, dark leafy greens, malungay, kangkong, kale and spinach help raise the platelet count and stimulate the body’s internal mechanism. Increasing platelet count is very important, especially if the problem is internal bleeding. Serious medical conditions related to platelet count drop should be reported to your doctor immediately and given medical intervention. In minor cases, you can help your body get back to its normal state of equilibrium by ingesting healthy foods to increase platelet count and keeping your body functioning at its peak efficiency. Journal.com How to raise blood platelet level naturally? If you suffer from low blood platelet amounts, you may be putting your body at risk if you have a cut or break in your skin. Platelets are the tiny cells that help to form a clot in your blood, thus stopping the cut from bleeding. Each platelet sticks to another platelet as well as the damaged blood vessel's wall, which forms a clot. A normal platelet amount is anywhere from 150,000 to 450,000 units per cubic millimeter of blood. If you have a sufficient number of platelets, you are at a lower risk of hemorrhaging. Although there are pills, and medications you can take and procedures you can undergo, you can also learn how to raise blood platelet level naturally. Consume the correct types of food. Try to eat fresh fruits and vegetables, and organic options are better for you and your platelet count. Berries, green leafy vegetables, oranges, tomatoes and kiwis can help increase your platelet levels. Wikihow.com

Dengue

Dengue fever facts • Dengue fever is a disease caused by a family of viruses that are transmitted by mosquitoes. • Symptoms such as headache, fever, exhaustion, severe joint and muscle pain, swollen glands (lymphadenopathy), and rash. The presence (the "dengue triad") of fever, rash, and headache (and other pains) is particularly characteristic of dengue fever. • Dengue is prevalent throughout the tropics and subtropics. Outbreaks have occurred recently in the Caribbean, including Puerto Rico, the U.S. Virgin Islands, Cuba, and in Paraguay in South America, and Costa Rica in Central America. • Because dengue fever is caused by a virus, there is no specific medicine or antibiotic to treat it. For typical dengue fever, the treatment is purely concerned with relief of the symptoms (symptomatic). • The acute phase of the illness with fever and myalgias lasts about one to two weeks. • Dengue hemorrhagic fever (DHF) is a specific syndrome that tends to affect children under 10 years of age. It causes abdominal pain, hemorrhage (bleeding), and circulatory collapse (shock). • The prevention of dengue fever requires control or eradication of the mosquitoes carrying the virus that causes dengue. • There is currently no vaccine available for dengue fever. What is dengue fever? Dengue fever is a disease caused by a family of viruses that are transmitted by mosquitoes. It is an acute illness of sudden onset that usually follows a benign course with symptoms such as headache, fever, exhaustion, severe muscle and joint pain, swollen glands (lymphadenopathy), and rash. The presence (the "dengue triad") of fever, rash, and headache (and other pains) is particularly characteristic of dengue. Other signs of dengue fever include bleeding gums, severe pain behind the eyes, and red palms and soles. Dengue (pronounced DENG-gay) can affect anyone but tends to be more severe in people with compromised immune systems. Because it is caused by one of four serotypes of virus, it is possible to get dengue fever multiple times. However, an attack of dengue produces immunity for a lifetime to that particular serotype to which the patient was exposed. Dengue goes by other names, including "breakbone" or "dandy fever." Victims of dengue often have contortions due to the intense joint andmuscle pain, hence the name breakbone fever. Slaves in the West Indies who contracted dengue were said to have dandy fever because of their postures and gait. Dengue hemorrhagic fever is a more severe form of the viral illness. Symptoms include headache, fever, rash, and evidence of hemorrhage in the body. Petechiae (small red or purple splotches or blisters under the skin), bleeding in the nose or gums, black stools, or easy bruising are all possible signs of hemorrhage. This form of dengue fever can be life-threatening and can progress to the most severe form of the illness, dengue shock syndrome. Reviewed by Melissa Conrad Stöppler, MD on 9/9/2011 Dengue Fever Prevention Neither vaccine nor drugs for preventing infection are available. The bite of one infected mosquito can result in infection. The risk of being bitten is highest during the early morning, several hours after daybreak, and in the late afternoon before sunset. However, mosquitoes may feed at any time during the day. Aedes mosquitoes typically live indoors and are often found in dark, cool places such as in closets, under beds, behind curtains, and in bathrooms. Travelers should be advised to use insecticides to get rid of mosquitoes in these areas and to select accommodations with well-screened windows or air conditioning when possible. Additionally, travelers should take measures to avoid being bitten by mosquitoes. Long-term travelers and expatriates can take extra precautions to reduce mosquito-breeding sites around their accommodations by emptying and cleaning or covering any standing water (such as in water storage tanks and flowerpot trays). How is dengue fever contracted? The virus is contracted from the bite of a striped Aedes aegypti mosquito that has previously bitten an infected person. The mosquito flourishes during rainy seasons but can breed in water-filled flower pots,plastic bags, and cans year-round. One mosquito bite can cause the disease. The virus is not contagious and cannot be spread directly from person to person. There must be a person-to-mosquito-to-another-person pathway. What are dengue fever symptoms and signs? After being bitten by a mosquito carrying the virus, the incubation period ranges from three to 15 (usually five to eight) days before the signs and symptoms of dengue appear in stages. Dengue starts with chills, headache, pain upon moving the eyes, andlow backache. Painful aching in the legs and joints occurs during the first hours of illness. The temperature rises quickly as high as 104 F (40 C), with relatively low heart rate (bradycardia) and low blood pressure(hypotension). The eyes become reddened. A flushing or pale pink rash comes over the face and then disappears. The glands (lymph nodes) in the neck and groin are often swollen. Fever and other signs of dengue last for two to four days, followed by a rapid drop in body temperature (defervescence) with profuse sweating. This precedes a period with normal temperature and a sense of well-being that lasts about a day. A second rapid rise in temperature follows. A characteristic rash appears along with the fever and spreads from the extremities to cover the entire body except the face. The palms and soles may be bright red and swollen. How is dengue fever diagnosed? The diagnosis of dengue fever is usually made when a patient exhibits the typical clinical symptoms of headache, fever, eye pain, severe muscle aches and petechial rash and has a history of being in an area where dengue fever is endemic. Dengue fever can be difficult to diagnose because its symptoms overlap with those of many other viral illnesses, such as West Nile virus and chikungunya fever. In 2011, the U.S. Food and Drug Administration (FDA) approved a blood test to diagnose people with dengue fever, called the DENV Detect IgM Capture ELISA. The FDA notes that the new test may also give a positive result when a person has a closely related virus, such West Nile disease. What is the treatment for dengue fever? Because dengue fever is caused by a virus, there is no specific medicine or antibiotic to treat it. For typical dengue, the treatment is purely concerned with relief of the symptoms. Rest and fluid intake for adequate hydration is important. Aspirin andnonsteroidal anti-inflammatory drugs should only be taken under a doctor's supervision because of the possibility of worsening bleeding complications. Acetaminophen(Tylenol) and codeine may be given for severe headache and for joint and muscle pain (myalgia). What is the prognosis for typical dengue fever? Typical dengue is fatal in less than 1% of cases. The acute phase of the illness with fever and myalgias lasts about one to two weeks. Convalescence is accompanied by a feeling of weakness (asthenia), and full recovery often takes several weeks. What is dengue hemorrhagic fever? Dengue hemorrhagic fever (DHF) is a specific syndrome that tends to affect children under 10 years of age. It causesabdominal pain, hemorrhage (bleeding), and circulatory collapse (shock). DHF is also called Philippine, Thai, or Southeast Asian hemorrhagic fever and dengue shock syndrome. DHF starts abruptly with high continuous fever and headache. There are respiratory and intestinal symptoms with sore throat, cough, nausea, vomiting, and abdominal pain. Shock occurs two to six days after the start of symptoms with sudden collapse, cool, clammy extremities (the trunk is often warm), weak pulse, and blueness around the mouth (circumoral cyanosis). In DHF, there is bleeding with easy bruising, blood spots in the skin (petechiae), spitting up blood (hematemesis), blood in the stool (melena), bleeding gums, and nosebleeds(epistaxis). Pneumonia is common, and inflammation of the heart (myocarditis) may be present. Patients with DHF must be monitored closely for the first few days since shock may occur or recur precipitously (dengue shock syndrome). Cyanotic (bluish) patients are given oxygen. Vascular collapse (shock) requires immediate fluid replacement. Blood transfusions may be needed to control bleeding. The mortality (death) rate with DHF is significant. With proper treatment, the World Health Organization estimates a 2.5% mortality rate. However, without proper treatment, the mortality rate rises to 20%. Most deaths occur in children. Infants under a year of age are especially at risk of dying from DHF. How can dengue fever be prevented? The transmission of the virus to mosquitoes must be interrupted to prevent the illness. To this end, patients are kept under mosquito netting until the second bout of fever is over and they are no longer contagious. The prevention of dengue requires control or eradication of the mosquitoes carrying the virus that causes dengue. In nations plagued by dengue fever, people are urged to empty stagnant water from old tires, trash cans, and flower pots. Governmental initiatives to decrease mosquitoes also help to keep the disease in check but have been poorly effective. To prevent mosquito bites, wear long pants and long sleeves. For personal protection, use mosquito repellant sprays that contain DEET when visiting places where dengue is endemic. There are no specific risk factors for contracting dengue fever, except living in or traveling to an area where the mosquitoes and virus are endemic. Limiting exposure to mosquitoes by avoiding standing water and staying indoors two hours after sunrise and before sunset will help. The Aedes aegypti mosquito is a daytime biter with peak periods of biting around sunrise and sunset. It may bite at any time of the day and is often hidden inside homes or other dwellings, especially in urban areas. There is currently no vaccination available for dengue fever. There is a vaccine undergoing clinical trials, but it is too early to tell if it will be safe or effective. Early results of clinical trials show that a vaccine may be available by 2015. Where can people get more information on dengue fever? "Dengue," Centers for Disease Control and Prevention http://www.cdc.gov/Dengue/

http://arthritistreatmentsecrets.weebly.com/ The dangers of arthritis

09/05/20090 Comments It’s bad enough arthritis causes much physical pain and suffering. Even worse, it destroys the quality of life—rendering some of your favorite activities as past history. However, it doesn’t necessarily stop there. Arthritis can be downright dangerous. You probably know what some of the most common symptoms are. They include pain and limited function of joints. Also, inflammation of the joints are indicated by joint stiffness, swelling, redness, and warmth the joints. Well obviously, this is bad enough. Can it get any worse? Unfortunately, arthritis can become even more dangerous. Many of forms, because they are rheumatic diseases, often cause serious symptoms affecting the various organs of the body. These symptoms include fever, gland swelling (lymph node), weight loss, fatigue, feeling unwell, and even symptoms from abnormalities of organs such as the lungs, heart, or kidneys. You’re no doubt wondering about the potential dangers of you arthritis symptoms. Is it possible it will worsen? Well, I have some good news for you. Dr. Nathan Wei is on the job—ready to help you conquer arthritis and give you back your peace of mind. Click here, discover his arthritis treatment secrets—and get relief, quickly and easily, and, most importantly safely

orthop.washington.edu Arthritis

Frequently Asked Questions about Arthritis Overview Frequently Asked Questions Conclusion This article answers some general questions about arthritis including how arthritis affects the body and some statistics on who gets arthritis. What is arthritis? The word arthritis literally means joint inflammation ("arthr-" means joint; "-itis" means inflammation). It refers to more than 100 different diseases. These diseases usually affect the area in or around joints such as muscles and tendons. Some of these diseases can also affect other parts of the body including the skin and internal organs. There are many types of arthritis. Most forms of arthritis are chronic which means they may last a lifetime. Who gets arthritis? Nearly 40 million Americans or one in every seven people have arthritis. It affects people of all ages but it most often comes on as a person gets older. How does arthritis feel? Arthritis usually causes stiffness pain and fatigue. The severity varies from person to person and even from day to day. In some people only a few joints are affected and the impact may be small. In other people the entire body system may be affected. The joints of the body are the site of much of the action in arthritis. Many types of arthritis show signs of joint inflammation: swelling stiffness tenderness redness or warmth. These joint symptoms may be accompanied by weight loss fever or weakness. When these symptoms last for more than two weeks inflammatory arthritis such as rheumatoid arthritis may be the cause. Joint inflammation may also be caused by infection which can lead to septic arthritis. Degenerative joint disease (osteoarthritis) is the most common type of arthritis; joint inflammation is not a prominent feature of this condition. While normal joints can support a vast amount of use mechanical abnormalities of a joint make it susceptible to degeneration. It is healthy for you to keep active and move your joints. If you do not move a joint regularly the muscles around it weaken and/or become tight. The joint can stiffen or even freeze. When you do try to move the joint and muscles hurt because they have been still for so long. Many things affect how your joints and muscles feel. Pain may be caused by swelling joint damage muscle tightness or spasm. Muscles hurt after doing exercise or activities you aren't used to; sometimes when the joint is damaged simple activities stress the joint. When your joints are inflamed or damaged you need to take certain precautions as you do all your daily activities. Your doctor or therapist can teach you exercises and the correct use of heat and cold to decrease pain. You can also learn how to use your body with the least stress to your joints for less pain easier movement and even more energy. Arthritis can make it hard to do the movements you rely on every day for work or taking care of your family. Can arthritis cause numbness? Numbness is often a symptom of nerve involvement. For instance numbness in the arm may be related to nerve irritation in the neck. In such a situation turning or bending the head to the involved side may increase the symptoms. For example a pinched nerve in the right side of the neck may cause numbness in the arm and hand when a person attempts to look back over the right shoulder. If nerve irritation becomes more severe the arm and hand may become weak. A physical examination X-rays and an MRI of the neck and electrodiagnostic tests may be useful in establishing the diagnosis. Why do joints make popping and cracking noises? Joints can make different noises--some are serious and some are not. Some people learn how to "pop their knuckles." By pushing or pulling a joint in a certain way an air bubble can suddenly appear in the joint with a "pop." Once the bubble is there the joint cannot be popped again until the air has been reabsorbed. Some joints crack as the ligaments and tendons that pass over them slide past bumps on the bones. Individuals who "crack their neck" make noise in this way. Other joints lock up intermittently--often with a loud pop--because something gets caught in between the joint surfaces. A torn cartilage in the knee or a loose piece of bone or cartilage in the joint can do this. Once a joint is stuck in this way it may need to be wiggled around to unlock it. This may also cause a pop. Finally joints that are arthritic may crack and grind. These noises usually occur each time the joint is moved. This noise is due to the roughness of the joint surface due to loss of the smooth cartilage. Can cracking knuckles cause arthritis? There is no evidence that cracking one's knuckles can cause arthritis directly. However repeated injury of a joint or repeatedly causing it to swell can injure the cartilage and potentially lead to degenerative joint disease. What are the warning signs of arthritis? Pain from arthritis can be ongoing or can come and go. It may occur when you're moving or after you have been still for some time. You may feel pain in one spot or in many parts of your body. Your joints may feel stiff and be hard to move. You may find that it's hard to do daily tasks you used to do easily such as climbing stairs or opening a jar. Pain and stiffness may be more severe during certain times of the day or after you've done certain tasks. Some types of arthritis cause swelling or inflammation. The skin over the joint may appear swollen and red and feel hot to the touch. Some types of arthritis can also cause fatigue. What causes arthritis? There are more than 100 different types of arthritis. What causes most types is unknown. Because there are so many different types there are likely to be many different causes. Scientists are currently researching what roles three major factors play in certain types of arthritis. These include the genetic factors you inherit from your parents what happens to you during your life and how you live. The importance of these factors varies for every type of arthritis. How is arthritis diagnosed? It's important to find out if you have arthritis and what type it is because treatments vary for each type. Early diagnosis and treatment are important to help slow or prevent joint damage that can occur during the first few years for several types. Only a doctor can tell if you have arthritis and what type it is. When you see your doctor for the first time about arthritis expect at least three things to happen. Your doctor will ask questions about your symptoms examine you and take some tests or X-rays. You can help your doctor by writing down information about your symptoms before your appointment. Bring your answers when you see your doctor. Arthritis may limit how far or how easily you can move a joint. Your doctor may move the joint that hurts or ask you to move it. This is to see how far the joint moves through its normal range of motion. Your doctor may also check for swelling tender points skin rashes or problems with other parts of your body. Finally your doctor may conduct some laboratory tests. These may include tests of your blood muscles urine or joint fluid. They also may include X-rays or scans of your body. The tests will depend on what type of arthritis your doctor suspects. They help confirm what type of arthritis your doctor suspects based on your medical history and physical exam and help rule out other diseases that cause similar symptoms. The overall results from your medical history physical exam and tests help your doctor match your symptoms to the pattern for a specific type of arthritis. It may take several visits before your doctor can tell what type of arthritis you have. Symptoms for some types of arthritis develop slowly and may appear similar to other types in early stages. Your doctor may suspect a certain type of arthritis but may watch how your symptoms develop over time to confirm it. What type of doctors treat arthritis? Part of your treatment plan may involve working with different health-care specialists. Some common health-care professionals and their role in your treatment are described below. Most doctors make referrals to one of a group of health professionals with whom they work. But you too can ask your doctor to request medical services you think might help you. Your family doctor may be an excellent source of medical care for your arthritis. Besides having your medication records your family doctor already has your medical history is familiar with your general physical health and knows of any past illnesses or injuries. All these facts will give your family doctor a head start in prescribing a treatment plan most suited to your needs. If your arthritis affects many joints or other parts of the body or seems resistant to treatment you may benefit from seeing a rheumatologist. This is a doctor with special training and experience in the field of arthritis. Your family doctor the local chapter of the Arthritis Foundation or the county medical society can refer you to a rheumatologist. You can also search for a rheumatologist on the American College of Rheumatology web site. Family physicians and general practitioners provide medical care for adults and for children with different types of arthritis. These doctors also can help you find a specialist if necessary. Internists specialize in internal medicine and in the treatment of adult diseases. They provide general care to adults and often help select specialists. Internists should not be confused with interns who are doctors doing a year's training in a hospital after graduating from medical school. Rheumatologists and orthopedists specialize in treating people with arthritis or related diseases that affect the joints muscles bones skin and other tissues. Most rheumatologists are internists who have had further training in the care of people with arthritis and related diseases. Some rheumatologists also have training in pediatrics. Orthopedists can offer treatment methods including surgery. Ophthalmic specialists provide eye care and treatment. Pediatricians treat childhood diseases. Physiatrists are doctors who specialize in physical medicine and rehabilitation. They may be asked to evaluate your conditions and may direct or prescribe your physical therapy and rehabilitation. Podiatrists are experts in foot care. If arthritis affects your feet a podiatrist can prescribe special supports and shoes. Psychiatrists treat mental or emotional problems that need special attention. Nurses trained in arthritis care assist your doctor with your treatment. They also help teach you about your treatment program and can answer many of your questions. Nurses also provide care during hospitalization. Occupational therapists can teach you how to reduce strain on your joints while doing everyday activities. They can teach you how to manage stress more effectively recommend and show you how to use self-help devices suggest ways to make everyday and work activities easier and teach you how to reduce strain on your joints and conserve energy. They may also provide you with splints and other joint protection devices. Pharmacists fill your prescriptions for medicines and can explain the drugs' actions and side effects. Pharmacists can tell you how different medicines work together when and how to take your medications and can answer questions about over-the-counter medicines. Physical therapists can show you exercises to help keep your muscles strong and your joints from becoming stiff. They can help you learn how to use special equipment to move better. Some physical therapists also are trained to design personal fitness programs such as prescribed muscle strengthening and range of motion exercises for cardiovascular health maintenance and weight control. They can also show you non-medication ways to control pain. If you've had surgery they can give you pre- and post-surgical care and show you the correct use of devices such as walking aids. Psychologists can help you solve emotional or mental problems. They can offer counseling for individual or family support and help you discover effective ways to cope with the emotional aspects of having arthritis. Social workers are specially trained to understand situations that may be difficult to deal with or to talk about. People often meet with a social worker to discuss personal family social or financial issues that occur as a result of having arthritis. They often suggest appropriate community resources. Certified dietitians (nutritionists) can help by teaching you about any special dietary programs or about healthier ways to eat. X-ray and laboratory technologists perform tests which help your doctor make a diagnosis or follow the effects of certain medications. What is the patient's role in treating or managing arthritis? The patient is the most important member of the health care team. The patient plays an important role in his or her medical care. The patient can contribute to the success of a treatment plan by: learning about arthritis following through with treatment reporting progress and setbacks to health team keeping a positive attitude developing relationships with the rest of the health care team Keeping a positive attitude though sometimes difficult is an important ingredient in overcoming arthritis. Asking questions and finding out as much as you can about of arthritis and its treatment is important. So talk over your concerns with your doctor. If you still need more information (or if you have difficulty talking to your doctor) ask the nurse physical therapist social worker occupational therapist to help you find answers to your questions. What are the types of arthritis? Arthritis most often affects areas in or around joints. Joints are parts of the body where bones meet such as your knee. The ends of the bones are covered by cartilage a spongy material that acts as a shock absorber to keep bones from rubbing together. The joint is enclosed in a capsule called the synovium. The synovium's lining releases a slippery fluid that helps the joint move smoothly and easily. Muscles and tendons support the joint and help you move. Different types of arthritis can affect one or more parts of a joint. This often results in a change of shape and alignment in the joints. Certain types of arthritis can also affect other parts of the body such as the skin and internal organs. There are more than 100 different types of arthritis. It is important to know which type of arthritis you have so you can treat it properly. If you don't know which type you have call your doctor or ask during your next visit. Some common types of arthritis are described below. Osteoarthritis The most common type of arthritis is osteoarthritis. It affects many of us as we grow older. It is sometimes called degenerative arthritis because it involves the breakdown of cartilage and bones. This causes pain and stiffness. Osteoarthritis usually affects the fingers and weight-bearing joints including the knees feet hips and back. It affects both men and women and usually occurs after age 45. Treatments include pain relievers or anti-inflammatory drugs exercise heat or cold joint protection pacing your efforts self-help skills and sometimes surgery. Fibromyalgia Fibromyalgia affects muscles and their attachments to bone. It results in widespread pain and tender points which are certain places on the body that are more sensitive to pain. It also may result in fatigue disturbed sleep stiffness and sometimes psychological distress. Fibromyalgia affects mostly women. It is common and often misdiagnosed. Treatments include exercise relaxation techniques pacing your activities and self-help skills. Rheumatoid arthritis In rheumatoid arthritis a fault in the body's defense or immune system causes inflammation or swelling. Inflammation begins in the joint lining and then damages both cartilage and bone. Rheumatoid arthritis often affects the same joints on both sides of the body. Hands wrists feet knees ankles shoulders and elbows can be affected. Rheumatoid arthritis is more common in women than in men. Treatments include anti-inflammatory and disease-modifying drugs exercise heat or cold saving energy joint protection self-help skills and sometimes surgery. Gout Gout results when the body is unable to get rid of a natural substance called uric acid. The uric acid forms needle-like crystals in the joint that cause severe pain and swelling. Gout usually affects the big toe knees and wrists. More men than women have gout. Treatments include anti-inflammatory and special gout drugs and sometimes a diet low in purines. Foods such as organ meats beer wine and certain types of fish contain high levels of purines. Low back pain Low back pain results from a back injury or certain types of arthritis. Back pain is one of the most common health problems in the United States. It can occur at any age in both men and women. Treatments include pain relievers or anti-inflammatory drugs exercise heat or cold joint protection pacing your activities and self-help skills. Bursitis and tendinitis Bursitis and tendinitis result from irritation caused by injuring or overusing a joint. Bursitis affects a small sac that helps muscles move easily; tendinitis affects the tendons that attach muscle to bone. Treatments include anti-inflammatory drugs heat or cold and exercise. Other types There are many more types of arthritis and related diseases including ankylosing spondylitis juvenile rheumatoid arthritis polymyalgia rheumatica and lupus erythematosus. See the Arthritic Conditions page for a list of the types of arthritis described in this web site. What are bone spurs? Bone spurs are of two basic types. One is the kind that arises near a joint with osteoarthritis or degenerative joint disease. In this situation the cartilage has been worn through and the bone responds by growing extra bone at the margins of the joint surface. These "spurs" carry the formal name "osteophytes." They are common features of the osteoarthritic shoulder elbow hip knee and ankle. Removing these osteophytes is an important part of joint replacement surgery but removing them without addressing the underlying arthritis is usually not effective in relieving symptoms. The second type of bone spur is the kind that occurs when the attachment of ligaments or tendons to bone become calcified. Thus can occur on the bottom of the foot around the Achilles Tendon and in the coroacoacromial ligament of the shoulder. Thus spurs often look impressive on X-rays but because they are in the substance of the ligaments rarely cause sufficient problems to merit excision. What are common arthritis treatments? There are many things that help reduce pain relieve stiffness and keep you moving. Your care may involve more than one kind of treatment. Your doctor may recommend medications but there are many things you can do on your own to help manage pain and fatigue and move easier. Finding the right treatment takes time. It can involve trial and error until you and your healthcare team or therapist find what works best. Be sure to let your doctor know if a treatment is not working. Your treatment may also change as your arthritis changes. Treatments for arthritis can be divided into several categories: medication exercise heat/cold pacing joint protection surgery and self-help skills. You can do things in each of these areas to help yourself feel better and move easier. Medication Many different drugs are used to treat arthritis. Some are available without a prescription; others must be prescribed by your doctor. You should always check with your doctor before taking any medication even over-the-counter drugs. Your doctor can tell you how much and when to take them for best relief as well as how to avoid any drug-related problems. These are some of the common medications used to treat arthritis. Your doctor may prescribe other medication to treat specific forms of arthritis or in specific situations. Anti-inflammatories reduce both pain and swelling. These medications are called nonsteroidal anti-inflammatory drugs (NSAIDs). Some NSAIDs such as aspirin ibuprofen and naproxen sodium are available without a prescription; others are only available by prescription. The most common side effect of these medications is stomach upset. Call your doctor if stomach pain is more than mild and lasts. Aspirin is commonly used to treat many forms of arthritis. Aspirin-free pain relievers may be recommended by your doctor if you just need pain relief are allergic to aspirin or have had an ulcer. Acetaminophen gives temporary relief of common arthritis pain but does not reduce swelling. It is available without a prescription. Corticosteroids are prescribed to reduce severe pain and swelling. They are given by injection or in pill form. Injections can bring quick relief but can only be used several times in one year because they weaken bone and cartilage. Because of potentially serious side effects corticosteroids must be prescribed and monitored by a doctor. Disease modifiers tend to slow down the disease process in rheumatoid arthritis. Researchers do not know how this happens. These drugs are available only by prescription and may take several weeks or months to work. Your doctor will carefully monitor you for side effects. Sleep medications may promote deeper sleep and help relax muscles. These drugs may help people with fibromyalgia sleep better. They are available by prescription and are used in very low doses at bedtime. Questions you should ask about your medications: What is its name? How much do I take? How and when do I take it? How long will it be before it works? What benefits can I expect? When should I contact my doctor if I don't get relief? What side effects should I watch for? What other drugs should I not take with it? Exercise Regular exercise is important to keep you moving and independent. Exercise helps lessen pain increases movement reduces fatigue and helps you look and feel better. Three types of exercises can help people with arthritis. 1.Range-of-motion exercises reduce stiffness. They keep your joints flexible by moving them to their fullest extent. Most people should do these exercises daily. 2.Strengthening exercises increase or maintain muscle strength. Strong muscles help keep your joints stable and make it easier to move. Most people should do these exercises daily or every other day. 3.Endurance exercises build fitness. They help keep your heart healthy and control your weight. You should exercise for a total of 20 to 30 minutes three times a week at a pace that raises or sustains your heart rate. Most people can build your endurance by exercising for shorter periods of time several times a day. Plan your exercises at times of the day when you have less stiffness or pain. Start slowly. Build up the amount of time you exercise and the number of repetitions you do. Exercise at a level that allows you to talk comfortably during the activity. If pain from exercise lasts more than two hours you may have done too much. Reduce your level of activity next time. Stop exercising right away if you have chest pains severe dizziness or shortness of breath or if you feel sick to your stomach. Heat and cold Using heat or cold over joints or muscles may give you short-term relief from pain and stiffness. You can also use heat or cold to help prepare for exercise. Some people feel better using heat; others prefer cold. Heat helps relax aching muscles. Sources of heat include heating pads hot packs hot tubs or heated pools. Cold numbs the area so you don't feel as much pain. You can apply cold with ice cold packs or even bags of frozen vegetables. It's important to use heat and cold safely. Don't use either treatment for more than 20 minutes at a time. Let your skin return to normal temperature between applications. Don't use heat with rubs or creams since this can result in skin burns. For more information on using heat and cold correctly talk to your physical therapist. Pacing yourself Pacing yourself saves energy by switching periods of activity with periods of rest. Pacing helps protect your joints from the stress of repeated tasks and helps reduce fatigue. Alternate heavy or repeated tasks with easy ones. Change tasks often so you don't hold joints in one position for a long time. Plan rest breaks during your daily activities. Joint protection You can protect your joints by using them in ways that avoid excess stress. Protecting your joints makes it easier to do daily tasks. Joint position means using joints in the best way to avoid excess stress. Use larger or stronger joints to carry things. For instance carry your grocery bags using your forearms or palms instead of your fingers. Walking or assistive devices can keep stress off certain joints. Your doctor may suggest using a cane crutches or a walker to reduce stress on your hips and knees. Many assistive devices have special features that help make tasks easier. Special aids with larger handles such as extra-thick pens make it easier to hold and write. Longer handles and reachers give you better leverage. Lightweight items such as plastic dishes are easier to carry. Weight control involves staying close to your recommended weight or losing weight if you are overweight. Weight control helps reduce your risk for developing osteoarthritis in the knees or gout. If you already have knee osteoarthritis losing weight may lessen pain by reducing stress on your joints. Exercise and reducing calories will help you lose weight. If you need to lose a lot of weight work with your doctor and a registered or licensed dietitian to find the best weight-loss program for you. Surgery Most people with arthritis will never need surgery. However surgery can help in some cases when other treatments have failed. It can reduce pain increase movement and improve physical appearance. Two kinds of surgery help people with arthritis. The first kind repairs the existing joint by removing debris fusing or correcting bone deformity. The second replaces the joint with an artificial joint. If your doctor suggests surgery you may want to ask another doctor for a second opinion. Orthopedic surgeons are the doctors who perform most joint replacements. Plastic surgeons may help with hand surgery. What's new in arthritis research? Progress is so fast in some areas of arthritis research today that the media often report new findings before the medical journal with the information reaches your doctor's office. As a result you need to know how to evaluate reports on new arthritis research. Arthritis researchers are looking at four broad areas of research. These include causes treatments education and prevention. Researchers are learning more about certain conditions. For example in osteoarthritis researchers are looking for signs of early destruction of cartilage and ways to rebuild it. For rheumatoid arthritis and other types that involve inflammation researchers are trying to understand the steps that lead to inflammation and how it can be slowed or stopped. An initial study suggests that fibromyalgia affects more older people than originally thought and often may be overlooked in this group. Your doctor can tell you about other new research findings. If you would like to take part in arthritis research ask your doctor for a referral to a study in your area. Many people help make arthritis research possible. The federal government through its National Institutes of Health is the largest supporter of arthritis research. Drug companies do the most research on new medications. Credits Some of this material may also be available in an Arthritis Foundation brochure. Contact the Washington/Alaska Chapter Helpline: (800) 542-0295. If dialing from outside of WA and AK contact the National Helpline: (800) 283-7800. Adapted from several pamphlets originally prepared for the Arthritis Foundation one of which is by Beth Ziebell Ph.D. This material is protected by copyright.