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The Varieties of Pain
The Varieties of Pain

For the Crozer Keystone Health System



Arthritis demonstrates the million varieties of pain.

Idiosyncratic and quirky, the disease strikes many people in many different ways. Its causes remain largely mysterious.

More than 100 different types of arthritis exist. All of them bring pain, stiffness and sometimes swelling in or around joints. Researchers believe three factors greatly influence the oncoming and persistence of arthritis: genetics, individual history, and environment. The importance of these factors varies for every type of arthritis.

One of the most common forms, rheumatoid arthritis, causes inflammation of joint linings, and usually affects many different joints. It can last a long time or behave sporadically, with long periods of remission between episodes. Symptoms include inflammation of joints, swelling, difficulty moving and pain. Loss of appetite, fever, loss of energy and anemia.

Yet most varieties of arthritis have symptoms that can be controlled or alleviated.

"Arthritis patients can have a very good quality of life," says Dr. Martin Bergman, F.A.C.R., F.A.C.P., Chief of Rheumatology at Taylor,

"We now have better ways of treating both the underlying conditions and the pain itself.

We can't get rid of all pain, but we can do pretty well."

The use of a class of drugs called opioids has substantially benefited pain alleviation. Doctors can now use opioids and other drugs in new forms and with better delivery systems and longer-acting forms, to maintain precise dosages to relieve pain.

"There have been a lot of new findings that have shown we can block the inflammation pathway itself," says Dr. Bergman. "Which means we can stop the progression of the disease along with the pain.

"The overall message I have," says Bergman, "is that there is no disease called arthritis. The most important thing anyone can do is get the right diagnosis for the type of arthritis it is."

Getting Back to Work

Two Taylor patients have gotten firsthand knowledge of the recent advances in arthritis treatment.

For almost 20 years, Kit Leonardo lived with arthritis resulting from an accident suffered as a young woman. For most of that time she resigned herself to living with the pain--and the endless operations needed for her knee and back.

"The pain was excruciating through my back and leg," says Leonardo. "I couldn't get out of bed because of my back.

"No one really seemed to care about the pain until I met Dr. Bergman. I'm stone serious about that. He checked me in every way he could, figured out what the trouble was and put me on time-release medication that has finally got me functioning again."

Leonardo still suffers with pain, though with the exercise and medication regimen directed by Dr. Bergman she's remained more than equal to the challenges of her auto detailing business.

Nancy Achiepo, too, had almost resigned herself to living with pain, and mysterious pain at that. Achiepo hadn't guessed arthritis as the cause of her suffering. This made life especially tough for, as a pricing coordinator for Giant Foods, she needed freedom of movement.

"The doctors I visited through I had tendonitis," Achiepo says. "I couldn't move my hands, I couldn't work. My shoulders were locked up. They were telling me to rest."

An examination by Dr. Bergman gave the pain a different diagnosis: Bergman called it rheumatoid arthritis. Life for Achiepo soon began to change.

"When I walked into him I couldn't hold my toothbrush," Achiepo says. "He got me on a medication program, and not long afterwards I called him up to say I could do a deep knee bend."

Stay Active With Arthritis

Keep in mind these tips for staying mobile through arthritis:

Keep exercising. With or without arthritis, joints and muscles benefit from regular workouts. Joints require movement to stay limber and maintain their supply of nutrients from the blood. "With joints it's truly use it or lose it," says Dr. Bergman.

Maintain a healthy weight. Your joints were designed to bear only so much pressure.

"The simple math I use," says Dr. Bergman, "is that for every extra pound you carry on your waist, your knees feel five and your hips 10. So if you are 100 pounds overweight, your hips think they are carrying another half ton.

 "So every little bit helps. Just a couple simple pounds can make a big difference to the health of your joint."





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