Pain management

Zoomer | February 1st, 2002

When you live without pain, you take its absence for granted. You don’t have to think about it before you walk down the stairs, you don’t have to plan your day to avoid activities that make it worse, and you don’t need to think about what you can do to make it stop. For people who live with constant pain, however, planning your day becomes second nature.

Andrea Janes, 64, had learned to cope quite well with her pain. She was first diagnosed with osteoarthritis in her knee more than 20 years ago. “I suspected that I had arthritis, but that’s typical coming from Scotland,” says Andrea. “The dampness there and all. I was also a highland dancer, and the doctor told me  that may have played a part because of the repeated stress dancing put on my knee.” After her initial diagnosis, Andrea found her knee didn’t bother her too much, but over the course of 20 years, the cartilage began to wear down, finally disintegrating to the point that she was in constant, excruciating pain.

What Is Osteoarthritis?
Arthritis affects one in seven Canadians, and osteoarthritis is the most common form. It’s the erosion of joint cartilage, an elast material that acts as a shock absorber. When bits of the cartilage break up and float into the space between the joints, they cause pain and inflammation. As osteoarthritis progresses, the cartilage can deteriorate completely, leaving bones to rub against each other. Bone rubbing on bone is as painful as it sounds, limiting your activities, affecting everything you do, especially if the joint affected is your knee, as was the case for Andrea.

The Impact of Pain
“There was nothing left in my knee. The cartilage was all crumbly,” she says. The resulting pain kept Andrea awake all night, which left her drained and irritable. “I just couldn’t get comfortable no matter which way I lay. I tried everything including sleeping with a pillow between my legs. I was up every night crying it was so bad,” explains Andrea.

For people with severe arthritis pain, sleep problems are a common complaint. Depending on the joint or joints affected it may also have a huge impact on  mobility and even your sex life. Constant pain can also lead to feeling depressed and angry.

Treatment Can Save Quality of Life
Treating arthritis early can make all the difference when it comes to preserving your enjoyment of life. It can also help slow down the rate of progression. Medical treatments can include:

  • Non-steroidal anti-inflammatory drugs (NSAIDs). These drugs block the body’s inflammation process. NSAIDs can include aspirin, ibuprofen and naproxen.

  • COX-2 inhibitors. A new breed of NSAID that reduces pain and inflammation.

  • Arthroscopic surgery. A surgeon makes small incisions in the knee and cleans the cartilage debris from the joint.

  • Cortisone injections. A steroid injected to relieve inflammation.

  • Viscosupplementation. A clear gel injected into the knee. It lubricates the cartilage and reduces pain by restoring frictionless movement of the joints.

  • Joint replacement.

    After trying almost every treatment option, Andrea finally took drastic measures. “I was walking down the street and my knee went out on me,” says Andrea. “I decided then to have my knee replaced.”

    Following her surgery,  Andrea was prescribed a COX-2 inhibitor as well as physical therapy exercises that she does for an hour a day.

    Other lifestyle changes that reduce pain and inflammation include:

  • Regular exercise. Swimming and biking reduce joint pain.
  • Strength training and range-of-motion exercises. Helps by strengthening the muscles surrounding the joint. Range of motion exercises will improve flexibility and balance, critical when it comes to preventing falls that may cause more damage.
  • Weight loss. Reducing the pressure on your joints by losing weight minimizes the pressure on joints such as your knees.

    For Andrea, sleepless nights caused by nagging pain are a distant memory now. She currently takes a daily dose of an anti-inflammatory to keep the pain she still occasionally feels under control. “I have to say it’s been 100 per cent better,” says Andrea. With her days pain-free she can enjoy the busy life of travelling, shopping and socializing. As she and her husband pack up for their six-week stay in Florida, there is shopping to do, family to see and errands to run, and Andrea isn’t taking her ability to do all of this pain-free for granted.

    For more information on arthritis, treatment options and tips on living with the disease, call The Arthritis Society toll-free at 1-800-321-1433 or go to www.arthritis.ca.

    • This Special Sponsored Feature was produced by the editors of CARPNews 50Plus magazine and Merck Frosst.