Arthritis

What types of joints are available for a knee replacement?

DEAR DOCTOR K: I am going to have my knee replaced. What types of artificial knee joints are available?

DEAR READER: The knee is a joint formed by the bottom end of the thigh bone and the top ends of two bones of the lower leg. When the ends of the bones that form the joint become damaged, they can be removed and replaced. That's total knee replacement, and it is major surgery.

Any advice to help me stay independent in spite of my arthritis?

DEAR DOCTOR K: Age and arthritis have done a number on my hands. I'd like to continue cooking, eating and dressing independently, but it's getting harder. Any advice?

DEAR READER: Many years ago I had a patient who taught me the importance of what I'm about to tell you. She was in her late 70s, retired, widowed and lived alone. She had been extremely independent all of her life. However, with age her dexterity and fine motor skills had diminished. In addition, the combination of arthritis and a small stroke had made cooking and grooming difficult.

Does the weather affect arthritis symptoms?

DEAR DOCTOR K: I swear my arthritis pain gets worse on cold, wet days. My husband is skeptical. Is it possible that the weather could affect my symptoms?

DEAR READER: I hear from my patients all the time that the weather affects their arthritis symptoms. But is it true? If so, how does that work? And is there any scientific evidence to explain it?

Could hypnotherapy help relieve my chronic pain?

DEAR DOCTOR K: I am in near-constant pain because of arthritis. My doctor suggested that I try hypnotherapy. My first reaction was that it sounds like hokum, but now I'm wondering if it could help. What do you think?

DEAR READER: Hypnotherapy may in fact help with pain management. These days it is used to treat many mental and physical health problems. I spoke to my colleague Dr. Max Shapiro, a psychologist with Harvard-affiliated Massachusetts General Hospital. He explained that hypnotherapy is most effective in treating problems that require stronger control over the body's responses. Pain is a good example; insomnia is another.

Would I be better off with hip resurfacing or a hip replacement?

DEAR DOCTOR K: My hip has bad arthritis, and my doctor says I need either a hip replacement or something called "hip resurfacing." Which one is best?

DEAR READER: I once had to ask myself that same question, when my right hip became so painful from arthritis that something needed to be done. Let me first explain what each type of surgery is, and then how to think about the choice between them.

What are some effective treatments for osteoarthritis?

DEAR DOCTOR K: I have osteoarthritis of my hands. Are any treatments particularly effective for this condition?

DEAR READER: Osteoarthritis causes stiffness and pain in the joints. It develops when cartilage -- the tissue that covers the ends of bones -- deteriorates. In the hand, osteoarthritis usually strikes the joint at the base of the thumb and the last joints before the tip of the fingers.

Is exercise good or bad for osteoarthritis?

DEAR DOCTOR K: I like to exercise, but people in my family tend to get osteoarthritis. Is exercise good or bad for my joints?

DEAR READER: A joint is a place where two or more bones come together. Your question has a simple and a more complicated answer. The simple answer is: For most people, regular exercise is good for the joints. The more complicated answer is that certain types of exercise can put pressure on the joints.

I might have RA, how should I prepare for an appointment with a rheumatologist?

DEAR DOCTOR K: My doctor suspects I have rheumatoid arthritis. He wants me to see a rheumatologist. How should I prepare for this appointment?

DEAR READER: Rheumatoid arthritis (RA) is a long-lasting inflammatory disease that causes painful, stiff, swollen joints. If you do have RA, it's best to diagnose the condition early. Disease-modifying treatment, started as soon as possible, can slow or prevent the disease from wreaking havoc on your joints. Either your primary care doctor or a rheumatologist (a doctor who specializes in arthritis) will evaluate you.

What is pseudogout?

DEAR DOCTOR K: What is pseudogout? Is it related to gout?

DEAR READER: Pseudogout is a form of arthritis triggered by deposits of calcium crystals in the joints. As crystals accumulate in the affected joint, they can cause a reaction that leads to severe pain, redness, warmth and swelling. The attack often lasts several days, and can last weeks. As the name suggests, pseudogout can cause symptoms similar to those of gout. Gout is caused when another type of crystal, uric acid, accumulates in a joint. Gout commonly affects just a single joint -- most often the big toe. Pseudogout also can resemble osteoarthritis or rheumatoid arthritis, in making multiple joints ache simultaneously. It most often occurs in the knee, wrist, shoulder, ankle or elbow.