Osteoarthritis (OA) is the most common form of arthritis and affects more than 20 million Americans. Commonly associated with aging, OA affects weight-bearing areas of the musculoskeletal system such as the neck, low back, hips, and knees. It also affects joints that are highly mobile such as the base of the thumb and the big toe joint.

While OA was considered to be primarily a condition affecting the elderly, it is now believed that OA can begin early- within the second decade of life. OA is a disease that affects cartilage, the gristle that lines the ends of long bones.

Cartilage consists of a matrix that is composed of a mixture of collagen and proteoglycans. Within this matrix, cells that make new cartilage, called chondrocytes, sit… much like grapes inside jello.

Biochemical changes occur that lead to alterations in the matrix of cartilage making it more susceptible to early degeneration. As a result, the cartilage begins to wear away prematurely. Small cracks- called fissures- begin to form. The fissures eventually grow to the point that the cartilage actually flakes away. At the same time, inflammation develops and this accelerates the wearing away of cartilage.

It is difficult to estimate the number of people who have OA but who are not yet symptomatic. However, as we learn more about this disease, it is clear that cartilage changes and symptoms do not necessarily go hand-in-hand.

The treatment of OA then needs to take into consideration both the symptoms of pain that occur along with the biochemical changes that lead to cartilage deterioration.

A number of investigators have devoted much time and effort towards developing medicines called disease-modifying osteoarthritis drugs… or DMOADS.

Unfortunately, DMOAD discovery is extremely difficult since cartilage damage is hard to quantitate. Scientists have used many different methods to measure cartilage thickness in response to drugs including magnetic resonance imaging, ultrasound, standard x-ray, and arthroscopy. Arthroscopic retrieval of cartilage specimens offers the most hope as far as a definitive marker of effect but is technically difficult.

Currently, the treatment of osteoarthritis is primarily symptomatic. Rheumatologists generally start with non-drug therapies including patient education, dietary counseling, and specific exercises.

Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (eg, Advil) or naproxyn (eg, Aleve) and analgesics such as acetaminophen (eg, Tylenol) sometimes are effective.

Most patients with more than mild OA will require prescription medications such as prescription NSAIDS (Motrin, Naprosyn, Lodine, Relafen, Daypro, Mobic, and Celebrex, to name a few.) These medicines are usually effective but also carry with them potential side-effects including damage to the gastrointestinal system, kidney damage, and an increased risk of cardiovascular events such as heart attack and stroke.

A food-based anti-inflammatory compound called flavocoxib (Limbrel) appears to be effective for some patients and appears to be safer than traditional NSAIDS.

Prescription analegesics such as tramadol (Ultram) may be useful. However, the use of stronger narcotics sometimes is called for in severe cases.

Topical agents such as Myorx (an OTC preparation), Voltaren gel, and patches such as Flector (a patch containeing Voltaren) and Lidoderm (a patch containing lidocaine, a local anesthetic) can also be useful adjuncts.

Since OA tends to affect weight-bearing joints the most, the hip and knee are often the symptomatic areas that bring patients in to see the rheumatologist.

Injections of corticosteroid (“cortisone”) or viscosupplements (lubricants derived from rooster combs or other sources… examples being Hyalgan, Supartz, Synvisc, Euflexxa)) can be helpful for symptomatic relief.

The most exciting and promising therapy aimed at both pain relief as well as cartilage regeneration appears to be the use of combined treatment using stem cells and platelet rich plasma. The technique involves the use of autologous stem cells, meaning cells that are harvested from the patient, and given back to the patient… therefore mitigating the ethical concerns associated with fetal stem cells.

Stem cells are harvested using a biopsy needle from the iliac crest (pelvic bone) of the patient. At the same time, blood is drawn and the blood is spun down to produce platelet rich plasma. Platelets are cells in the blood that contain many growth and healing factors. A small gauge needle is then inserted into the joint (knee or hip) using local anesthetic and the area of concern (cartilage, bone spur, and tendon attachments) are mildly irritated with the needle. The stem cells and platelet rich plasma are then injected into the joint.

Preliminary results appear very promising not only for symptom relief but also for chondrocyte and cartilage regeneration.



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Copyright (c) 2008 Stephen Lau

Pain is not localized because it is the outcome of a series of reactions in the body and the mind. Pain is felt and experienced only when the injured area sends signals through your nervous system to your brain, which receives and interprets these signals.

Pain is always connected with inflammation. When the injured area becomes inflamed, the inflammatory response intensifies, and so does your perception of pain.

What should you do when dealing with pain? Most people’s first reaction in dealing with pain is to stop the pain with a painkiller – it is understandable. However, this may not be the best option for dealing with pain, because it only temporarily relieves the pain but does not prevent the pain from happening again.

If you have chest pain, which may portend an imminent heart attack; your priority is to avoid the heart attack rather than the pain itself. In fact, sometimes pain may be a positive sign of warning of the imminence of a disease. Therefore, in dealing with pain, it is important to prevent a health crisis rather than just suppressing the pain.

Take another example: if you are prone to migraine attacks, your priority in life is to prevent a migraine episode from happening, rather than dealing with the pain that results from the crisis. Migraines are not caused by trauma, but by chemicals in your body that control pain and inflammation. Accordingly, to deal with migraines is to anticipate and control the inflammation, rather than the resultant migraine pain. Like the common cold, once it has started, taking vitamin C or a cold tablet will not stop the cold – you just have to let it run its course. Any cold medication may only further weaken your immunity down the road, just as a painkiller may make your body more toxic, and thus more susceptible to pain in future.

Therefore, dealing with pain is not to influence your perception of pain, but to stop the damage from causing the pain in the first place.

Using diet is the most effective way in dealing with pain (see my previous article), not only by preventing the occurrence of pain but also by combating the pain itself. For example, hot chili peppers contain a chemical called capsaicin, which is effective in blocking your nerves from transmitting pain messages to your brain. Capsaicin is one of the most important active ingredients in ointments used for arthritis, shingles, and post-mastectomy pain.

Apart form diet, exercise also helps you boost your pain resistance. Your body makes natural painkillers – enkephalins and endorphins. Exercise may activate these chemicals in your body. This is best explained by pain tolerance in competitive athletes. In vigorous competitive sports, the body releases endorphins to block out pain perception. The kind of exercise that stimulates endorphin release is aerobic – bicycling, running, and walking – exercise that pumps your heart and works out your lungs, as opposed to weight lifting that targets only your muscles.

Acupuncture is another way to deal with pain.

For thousands of years, acupuncture has been used by the Chinese to decrease pain by increasing the release of endorphins. Many acu-points are located near nerves. When stimulated, these nerves cause a dull ache or feeling of fullness in the muscle. The stimulated muscle then sends a message to the central nervous system (the brain and spinal cord), causing the release of endorphins. The theory is based on the belief that there is “qi” (vital life energy) coursing through your body, and that diseases are caused by lack of balance between the positive and negative energies in an individual. Acupuncture not only generates its analgesic effects through sensory stimulation, but also removes the problem that causes the pain.



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Are you tired of putting chemicals in your body every time you have an ache and again pop a pill to try to feel better? Do you wish there were some natural pain relief techniques, ones that don’t involve a trip to the doctor, the pharmacist, and using your wallet? You’ve come to the right place. There are many pain relievers you can try – if you only know about them!

Managing Pain The Natural Way

Did you realize that practicing yoga can help with pain relief? Those who do yoga regularly find that it is a great way to de-stress and get rid of cramps and knotting up of muscles. Don’t overdo it at first, when you’re beginning to learn the positions and the limits of your current body, but enjoy stretching and tuning in to your body. The relaxation aspect of yoga can also help with relieving headaches.

Two traditional “friends” from grandma’s first aid box – heat and cold. Remember, put on cold first, to help reduce inflammation just after an injury occurs. Then later, after the injury is past being likely to swell, heat can help soothe the injury. The natural pain relief technique of using heat and cold appropriately cannot be overestimated.

Grandma would also be the first to remind you that if you have a sore throat you should gargle with warm salt water. Though as kids we thought it disgusting, it is a natural pain relief technique or method that really works. The warmth soothes the throat while the salt helps kill the germs, and you will get relief from the pain.

Specific Situations – Name ‘Em!

You’ve got menstrual cramps? There are some natural techniques for pain relief you should try. First, use a heating pad or one of those new heated patches that affix to the skin and stay hot for hours. Massage also helps a lot, if the cramps are in a muscle that can be massaged, like the thighs or calves. If you’re suffering from leg cramps (which are often associated with menstrual cramps) try going for a walk. The walking will stretch out the muscles and help them relax so that you can get some sleep and respite from the aches and pains of an intense period. These techniques, while natural, can give pain relief for menstrual (and other) cramping.

Urinary tract infections? Avoid them by drinking cranberry juice periodically. If you do end up with an infection, common wisdom is to drink more cranberry juice so that the urine created by the juice goes through your urinary tract. Also, some people swear by drinking a glass of water with two Alka-Seltzer tablets dissolved in it just as soon as you begin getting symptoms of an infection.

Do you have restless leg syndrome? Forget the doctor visit and expensive medications. First, try the time-honored remedy of putting a bar of soap underneath the sheet while you sleep. For whatever reason, many people report that this works.

Finding pain relief through natural techniques is something accessible to everyone. Better than rushing to the doctor or the medicine cabinet, and just as effective in most cases…worth a try!

For more information from Bill Johnson about Tramadol and pain relief please check http://www.tramadolhome.com



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Headache is known as Shiro Roga in Ayurveda. Literally it means ‘disease of the head’. Headache is not a single type of disorder; but it is a name given to several problems of the head. There are 11 types of headache in Ayurveda. They can be caused due to a various number of causes. Some of them are:-

- Trauma

- Inflammation of the meninges

- Encephalitis

- Cerebral abscess

- Migraine

- Hypertension

- Cerebral hemorrhage

- Vasodilator drugs

- Alcohol hangover

Apart from these there are several other factors such as fevers, metabolic disorders and diseases of the eye, ear and nose which can cause headaches.

Though pain is predominantly vitiation of the vata dosha, vitiation of the pitta and kapha doshas can also cause headaches. The chief symptoms of the three different doshic types of headaches are:-

1. Vata type of Headache – The pain is intermittent, i.e. of a hammering type. There is constipation, insomnia and depression. These pains are compounded by mental tensions.

2. Pitta type of Headache – The pain is usually felt on half of the head. It is accompanied by a burning sensation and wateriness in the eyes. The person is generally scared of light.

(1) Useful Herbs in the Treatment of Headache

1. Betel (Piper betle)

The leaves of the betel have analgesic and cooling properties. When a paste of them is applied to the center of the headache, then immediate relief is obtained.

2. Bishop’s Weed (Trachyspermum ammi)

Bishop’s weed can keep severe headaches away. It is most effective in headaches that occur due to migraine. The fumes of the lighted bishop’s weed seeds are used for the treatment. These fumes are smoked or the seeds are sniffed directly.

3. Clove (Syzygium aromaticum)

The aroma of the clove has a headache-allaying effect. It can soothe the nerves and bring it back to a pacified state.

4. Garlic (Allium sativum)

Garlic has almost miraculous properties in relieving headaches, of whatever type they are. Their juice slowly permeates the head region and acts as a painkiller.

5. Ginger (Zingiber officinale)

Ginger has painkilling properties. Due to this property, it is used as an external application on the affected head region. This gives relief from the headache.

6. Henna (Lawsonia inermis)

Henna flowers have the capacity to reduce headaches if they are caused by excessive heat. The henna flowers are applied externally on the head with vinegar to get the desired results.



(2) Dietary Treatments for Headache

Sweet and mild tastes are better in relieving headaches than other tastes. When there is a headache, consuming a sweet preparation or even a spoonful of sugar helps.

Milk and ghee are also beneficial in headaches. Preferably, the milk of a cow should be warmed and had when there is a headache.

Rice is the preferred carbohydrate to be taken in times of headache. The water left after cooking the rice should be had when it is warm, with a dash of ghee added in it.

Spicy and fried foods must be avoided when there is a headache.



(3) Ayurvedic Treatment for Headache

Since there are many different types of headaches, there are different treatments for them in Ayurveda. Ayurveda does not treat all headaches with uniformity. The following are the different treatments prescribed:-

1. If the headache is of vata type, then Triphala choorna is first prescribed to clear the digestive system. Then Shirashooladivajra rasa must be taken, or Mahavata Vidhwansana rasa must be taken twice a day in dosages of 125 milligrams in warm water.

2. If the headache is of pitta type, then amalaki is prescribed, or Triphala which contains amalaki can also be given. Half a gram of Shatavari is to be taken twice a day for a month.

3. If the headache is of kapha type, then anu taila is applied first to clear the nostrils. Then medicines such as Shoola Gajakesari rasa are given in dosages of 125 milligrams thrice or four times a day.

(4) Home Medications

a. A paste of clove and salt crystals is prepared in milk. The main curative ingredient in this is salt, which, being hygroscopic, absorbs the fluids in the head and decreases the tension.

b. Early morning after waking up dab an apple with salt and eat it. After that, drink some warm water or milk. Continuing this for ten days will reduce the problem of continuous headaches.

c. Peel a piece of garlic. Put it in the mouth and chew it slightly. Let its juices spread around the mouth region and upwards into the head. Keep on chewing the garlic mildly and allow the juices to spread. Within some minutes the headache would disappear. This treatment works even for the most persistent of headaches.

d. For headaches that are caused due to common colds, drinking a decoction of coriander and sugar helps tremendously. One more method to clear common cold related headaches is to place both feet in warm water for about half an hour.

e. For headaches that are caused due to excessive gas in the stomach, drinking a glass of warm water with a fresh lemon squeezed in it brings the headache as well as the gas problem down.

f. Grind some cinnamon and make it into a paste with water. Apply this on the head. This reduces headaches.

g. Soak some almonds in water overnight. In the morning, grind them into a paste and warm them slightly in ghee. Mix this in water and drink. This helps in treating headaches that have been going on since a long time.

h. Drinking a glass of water in which jaggery has been mixed helps in reducing headaches.



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