Arthritis

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.

Does stretching help relieve arthritis pain?

DEAR DOCTOR K: Will stretching exercises help to relieve my arthritis pain?

DEAR READER: Yes, they will. That may seem strange. After all, arthritis affects the joints -- the ends of two adjacent bones and the space between them. In contrast, stretching involves muscles. But the joints and the muscles around those joints are intimately connected. A joint with arthritis hurts when it is asked to move. It is the muscles that move the bones that form a joint. When movement is painful, as it so often is for people with arthritis, it's natural to limit movement. For example, if you straighten a leg, and feel pain owing to arthritis in a knee, you'll tend to keep that knee bent.

What is the best way to treat ankylosing spondylitis?

DEAR DOCTOR K: I have ankylosing spondylitis. Can you discuss this condition and the best way to treat it?

DEAR READER: Ankylosing spondylitis is a form of arthritis in which the spine and other joints become inflamed and stiff. A person with this condition usually feels pain or stiffness in the lower back, especially in the morning or after inactivity. Pain tends to begin in the two joints between the spine and the pelvis (the sacroiliac joints) and be felt in the buttocks. It then works its way up the lower spine.

What are alternative therapies for rheumatoid arthritis pain?

DEAR DOCTOR K: I have rheumatoid arthritis. Medications have helped, but only up to a point. Can you discuss alternative therapies that might help to further relieve my discomfort?

DEAR READER: Rheumatoid arthritis (RA) is a long-term disease in which the body's immune system attacks healthy tissue lining the joints. This causes swelling, pain, redness and stiffness in joints throughout the body. Drug treatments slow the effects of the disease, but alternative approaches can also help to reduce inflammation and relieve pain.