Knee Replacement Infections Part Two

In part one of total knee replacement infections, it was mentioned the importance of pre-operative blood tests and the fact that you want an orthopedic surgeon with vast experience to help tremendously in keeping the possibility of an infection to a minimum immediately after surgery.

Later infections which can be more common will depend also on your overall health. Having been diagnosed with diabetes mellitus, rheumatoid arthritis, or smoking, and obesity are just a sample of where the incidence of infection can be higher. Your overall nutrition can also play an important factor.

Previous trauma to the joint that was replaced and other surrounding soft tissue injuries can be a factor as well.
Infections that develop later after surgery will be confirmed with a blood test or fluid in the surrounding joint will be drained for further testing.

Getting an infection treated will depend on the severity of it. In some case simple antibiotics taking orally will resolve the issue. If the infection is deeper or more involved then the possibility of surgical intervention will be required. Infections that are more aggressive will not only destroy surrounding bone but it also leads to the losing of the prosthetic components.

Removing the components and having an antibiotic spacer placed in your knee can be a six to eight week ordeal. During that time frame your affected leg is placed an in immobilizer and the leg will remain in a non-weight bearing status After the infection has cleared another set of components are replaced, then rehabilitation continues.

In general the incidence is very low. It will be important however to be sure after you have had your surgery that you take good overall care of your health. Your nutrition, sleep habits and overall lifestyle will be something to strongly consider.

After all, as we age that should be something we are all doing to live the optimal life anyway.

The Devil Gets the Best

The Council of the Continental University, Los Andes University, the UNCP University, the Journalist Professional Association and Cultural Center of Peru congratulates and recognizes

The Roman Empire under Trajan, 117 AD

A Short History of the times: it was a time, Arabs could travel from Tripoli to Tangier without ever moving from the shade of olive trees to comfort them; a time when towns and cities sprung up everywhere; a time of great architecture, and when literature found new voices. An era when the beauty of Rome sparkled from England, throughout Italy, and pert near all of Europe for the most part, along with parts of Africa, and Asia-; where forums, temples, aqueducts, and theaters reached the Roman world side to side, and revealed its wealth. A time of economic security, order, discipline-where in a short period thereafter, it would allow decay, chaos and negligence to ruin the roads, reservoirs, and canals. Ephesus was a first rate city, in Asia Minor, and was the city where a number of the apostles went, especially, John, who took care of Mary, mother of Christ, and had a brick house built on the hill top within the city's walls; where the Ephesians built long and winding marble corridors, which all seemed to lead to the marble façade of its towering library......and this is where our story takes place

ACT ONE o SCENE ONE

It is eleven-thirty in the evening, it is dark out except for a few lit torches scattered sporadically along the corridor which leads to the library at Ephesus, which is made out of marble. There is a large marble engraved sign on the archway next to the library, dedicated to the Emperor of Rome, Augustus (spelled improperly on the arch), that reads his name, but they are not there, they are all walking down the corridor; two girls with two Roman Soldiers, walking down the passageway to the library; the four are a little cock-eyed. The two soldiers are in uniform, they pass statues and accommodations for priests and soldiers, and temporary housing, small temples like sanctuaries along the corridor, many pillars. One of the girls stop and look at a marble refuge, she hears a mumbling voice, almost seductive...

1st Roman Soldier. Let's keep going. The night's getting late, and I got to inspect the guards in the morning.

Girl. I heard a voice in there, it sounded familiar.

(The other soldier and girl have gone on down the corridor towards the library)

1st Roman Soldier. Why should you care whose in there?

Girl. Well, I do care, let's take a look.

1st Roman Soldier. So it appears I got a noisy one. The hell with it, I got better things to do with you than fool around someone else's private affairs-inside whatever this structure is: a room or house or haven.

Girl. You are an ass!

1st Roman Soldier. That's not so bad, I've been called worse.

(He stands still, puts his hand over his mouth, as if thinking what next to say, shakily not wanting to sober up, yet not wanting to fall over)

Have I ever been nice? I mean you know who I am, what I do?

Girl. I don't care what you do when you're not with me, all you Roman soldiers are appalling when you're drunk, and rude when you're aren't. All I wanted was to see who was in there. If that's too much to ask the heck with it, let's just keep on moving to the dumb library so you can do whatever your heart desires, there inside, if we can get inside, you say you are a commander, I suppose we can then.

1st Roman Soldier. Okay, okay you win; I'll look inside and see. But I'll tell you plain, a woman brings two moments of happiness to a man: one when she makes love to him, the other, when she gets up out of bed, and leaves him to have peace and quiet.

(The girl smiles, a very big and bright looking smile, with a light chuckle, as if to say-well, I got my way)

Girl. I wish I had a marble sanctuary like this one; I'll buy me one someday.

CURTAIN

ACT ONE o SCENE TWO

Curtain rises at once on Scene II. Inside the room that is really a shelter for a statue of Dionysus, something of a sanctuary you might say, there is a cot, behind the statue inside the shrine, and there is a small table by the cot; a priest by the name of Demetrius is sitting on it, with a female named Lydia next to him, and he is talking about trade with Cayster and Maeander, along with religion and art, whatever the conversation is, you hear just gobbledygook for the most part, perhaps not making out anything that makes sense, if one was observant, it almost looks like a show put on for an audience. The woman is expensively gowned. Beside the bed is a lit candle which is glowing brightly. Lydia is a lovely tall brunette girl sitting on the edge of the cot. Behind her, and him, is a little square window, you can see the stars through it. There is a map on the wall made of leather, it has a drawing of the whole area on it, and all the corridors of marble in particular, leading to the library-and a devilish looking symbol. The Roman Soldier (Theodorus) is standing looking at them both, in particular Lydia, who only looks up from an ancient scroll she has on her lap-whom one might think she was reading it, but whose to say, she looks up slightly that is, as if she is disturbed from being bothered, says in a very refined voice:

Lydia (she notices the Roman Soldier is of a high rank). Sir, if there is something you wish, or want, please state what it is, other than that, please let us to our business, and do not disturb us any longer.

(The man, whose name is Theodorus, goes on looking at the two)

And please stop staring, it is most bothersome.

(Theodorus continues to look at her alone now)(The priest is short and thin; almost lame looking, if not nearly deformed, and somewhat disagreeable-uglier than a dead rat)

Lydia. Are you part of the sentry? (No answer is given by Theodorus)

((Theodorus, over six feet tall, two-hundred pounds, with a rough looking beard, now produces a ruthless, yet joker like look on his face, as if he was insulted, but neither the girl nor the man show any fear, or for that matter, reprisal.

Girl. Let's go look for Bupalus, I'm ambidextrous and I never miss my aim with either hand, and we have things to do at the library.

1st Roman Soldier. (Speaking to Lydia) What names do you go by?

Lydia. Many, but Lydia will do!

(With no retort he remains in a near trance, as if almost overtaken by her beauty and aching to have her. His mind full of folly and thought, you can see it in his self-possession and continence)

Lydia (her eyes, ever-changing as if into fire and water). It is distaining to expound my conclusions in intelligible words to a regular soldier.

Demetrius. (Speaking passionately) I assure you sir, we were not doing anything awful in this sanctuary, I am a philosopher and poet, as well as priest, and I am Lydia's teacher, and I teach many of the arts.

1st Roman Soldier. (Still staring at Lydia) So you do!

Demetrius. Perhaps we should move to the Temple of Artemis, it is more private there, Lydia?

Lydia. We should and we should not. Here our universe is vaster, becoming, more of a variety, change is from a condition of inferno, this soldier is of the many, and he lives in the very heart of the inferno, fire flickers restlessly inside of him. You Demetrius are the filling of life and good spirits.

1st Roman Soldier. What kind of dull jokes are these? I'm bored Lydia bitch.

Lydia. Don't call me names, to entertain your whore; you do not know the dangers in doing so.

1st Roman Soldier. Do you understand anything that's going to happen here, or what is happening here?

Lydia. No, I only understand a little bit about the universe, but not half as much as Demetrius; you as fire, are dreadful and a puzzle to me why you remain here-can you not sense the danger?

Demetrius. He is like volcanic soil making his island, wanting it to become a garden of orchards and vines; in essence, he wants to make love to you. He is conspiring with his dead-self, to recapture power you seemingly have taken away from him, as a man. But if he touches you, the rain of one who is stronger than Zeus will descend upon him, and from the high heaven.

1st Roman Soldier. My God is not Zeus, perhaps Neptune will swallow Zeus up, or his slave the Tiamat, and your god whom is you say, more powerful than Zeus.

Demetrius. Perhaps I will swallow them both, and Lydia you.

Girl. (In a trembling voice) I want to make love to you; I don't think all this is very sensible, really, let's get out of here.

(But Lydia's beauty was near paralyzing, and he didn't want to move-and he doesn't move, lest he lose his opportunity...)

1st Roman Soldier. No! I wish to stay here. It's amusing, and so much livelier than simply having sex. And you are acting like a child.

Demetrius. Is this the best medicine among Greek and Roman, to take what does not belong to you by force because no one can stop you, nor punish you?

1st Roman Soldier. Is that not what Plato, your philosophical god told you man is made of?

Demetrius. I see you are learned somewhat, but you must not yield your heart to anguish-save yourself and be gone.

Girl. But he seldom does. I wish you'd come (She starts to move towards the door to leave, her face is showing fear)

(There is a knock at the door)

I think our friends are here, looking for us, darling.

(The other Roman Soldier, subordinate to, hears voices inside the small refuge, and walks in; he is of a lesser rank, and a little plump, short, he speaks extraordinary well though.)

1st Roman Soldier. Oh, I see it's you.

2nd Roman Soldier. How're you doing, all right I hope? I was just down at the library, came back to see if you have any little thing of any kind or sort you don't want in your way. So is everything all right, your friends here are looking most comfortable?

1st Roman Soldier. Difficult to say in front of this lady of the arts, Lydia.

Demetrius. For grief will profit you no whit, my Roman friend, this is the last warning.

2nd Roman Soldier. (Speaking to Theadorus) I see you are up against a bright philosopher. They have the words, and wit, but not the sword, at such trying moments like this, my friend: his wit and words are like ice; they melt quickly, and leave a mess. Put him to the sword, and take his Sappho bitch, ring her up on a wooden cross.

Lydia. He will not!

2nd Roman Soldier. Then I will.

(Lydia, she unhooks her silk gown, and lets it fall to the marble floor, she blows out the candle, and it is now dark, very dark-even the moon's shadows cover the moon to darken the refuge, and the light outside the structure seems to be darkened somehow, as if a wind is covering it with a veil)

Lydia. I'm coming.

2nd Roman Soldier. I greatly prefer you come for both of us, before I pull out my sword.

(There is a sound in the darkness of a cat)

CURTAIN

ACT ONE o SCENE THREE

Curtain rises at once on Scene III. Inside the refuge, through the small back window one can see the moon, it is as if lurking, having seemingly leaping shadows about it, watching shadows as if Lydia herself had an audience, the moon even appears to have cold breath. There is a door between them, to the frame of the sanctuary, it is open now, and one can see shadows-by the reflection of a torch outside the door that was meant to light up the corridor. In the bed is Demetrius, he is near static standing on the bed watching everything, through the window comes sounds and voices, haunting voices from afar, there is a struggle going on inside the refuge on the floor...

(There is a purring of a large cat in the dark within the refuge, it seems to have lightening speed)

2nd Roman Soldier. It's horrifying, she's on her hands and knees, she has paws, long talons, she's crawling like a cat trying to gnaw at me, scratch me, maybe eat me-may the gods forbid (he cries)

1st Roman Soldier. I'm worse off than you, she bit me in the leg I'm bleeding, it's numb, I can't feel it completely-maybe she took a hunk out of it... She's unbelievable; she's turned into a cat like thing, a dreadful, she-devil. (And you can hear bones crack, as if teeth had broken them)

(The cat-woman, Lydia, is seemingly and constantly hungry-you can see a long thick tongue hanging out of her mouth, unable to understand the lack of food; the beautiful has turned into a yellow eyed beast, vexed to her finger tips, and then the candle is lit by Demetrius-as if he is missing something and wants to see all, the Girl is gone, and the two soldiers are eaten alive, nearly to their bones, shredded as if rats had pulled out their insides and eaten them hollow. Of course they are dead now. You see this as light appears in the refuge, as if Demetrius lights up the place himself by turning on the moon's light-yet he simply looks toward the moon, out the little square window)

Demetrius. (Speaking to Lydia, calmly; she is found naked sitting on the cot) What is on your mind?

Lydia. Always a little something.

Demetrius. Don't worry, I have it all set.

Lydia. You be careful, Demetrius, if you bury them, do it far-away, there are two whores that know what took place here, and people believe you are a priest.

Demetrius. (In a low near-joking voice) He fell in love just by looking at you. Your body and appearance, it was like sweet wine, and honey to him, and we stung him, for his curiosity-like a bee. We need simply go back to Pergamun, where my earthly throne-seat remains. Foolish are they to think Zeus and Neptune could have power over me, or even quote such feeble minded philosophers and poets like: Socrates, Plato, Sappho, as if they are impressive to me-the mischievous sprite, the evil force. If anything I am saddened they could not see the façade to who I am-for I am the Great Adversary in person, I was a bright star in the heavens once, I was the chosen one among the heavens by the Almighty Himself, out of all the angelic forces. I do realize it was to the misfortune of the Roman Soldier to have walked into our little bee hive, although nearly planned, if not he, then someone else would have, and the Girl likewise, but by some odd and unconscious omen she snuck away, I was able to sway her at first, her mind was open for it, and here she met the most famous ecstatic evil spirit on earth-she has a story to tell-if she only knew how to tell it, I do wish to meet her again though, perhaps more knowingly, than unknowingly.

. ((Thus, he-in modern terms: Lucifer himself, and his courtesan drachma, Lydia, whom can transform and shape-change at will, and loves warm blood of which is simply an extra treat, knew the Roman Soldier needed to provoked, both of them, before they could act with vengeance, and all turned out quit well for them, they were both very pleased.)

CURTAIN

Notes on the Play: "The Corridors at Ephesus" or "The Devil Gets the Best," written out, throughout the day, August, 29, 2009, in Huancayo, Peru, and revised and edited August 30, 2009. The play is produced here in full. The drawing, by the author, of which he has named: "The She-devil and the Serpent" was inspired by a painting the author saw done by Zu Xin Yang , in the Yang Yang, gallery in Roseville, Minnesota, 1999.

"Take my yoke upon you and learn of me; for I am meek and lowly in heart: and ye shall fine rest unto your souls." Matt. XI. Line: 29

Taken from the bible (the author purchased, in 1991), the writing dated 1846, to Amelia Hutchinson,

from her ever affectionate mother...

Copyright © August, 2009 by Dennis L. Siluk

All rights reserved. No part of this play maybe be reproduced in any form except by permission of the original copyright holder, Dennis l. Siluk (First appearing in a chapbook of 500-copies)

The Play may be modified to accommodate the theater,

actors and resources available

Arthritis Treatment: Surgical Treatment Options for the Young Patient With Knee Osteoarthritis

Osteoarthritis (OA) is the most common form of arthritis affecting almost 30 million Americans. While traditionally viewed as a disease of older adults, it is quite clear that younger people can also develop significant disease. This is a probably due to a combination of factors including genetics, previous trauma, as well as earlier detection.

While the standard types of conservative treatments may help, some patients do not respond to topical or oral anti-inflammatory drugs, steroid injections, lubricant injections, bracing, and physical therapy.

Weight reduction, activity modification, low impact aerobic exercise, and quadriceps strengthening exercises are also conservative measures that need to be tried.

So what happens if they fail?

Knee arthoscopy has been used by enthusiastic orthopedists for decades. A study in 2008 cast doubt on the efficacy of this procedure for OA. Since that time other studies have also shown that knee arthroscopy is relatively unsuccessful for this condition. Conditions that appear to particularly point towards a poor prognosis with arthroscopy are OA present for more than 2 years, obesity, the presence of large bony spurs, significant joint space narrowing, smoking, and cartilage defects exposing underlying bone.

If alignment of the knee is abnormal, then a procedure called osteotomy is often suggested. With this procedure, the surgeon removes a wedge of bone from the either the femur (upper leg bone) or tibia (the lower leg bone) to help the joint line up better. This is a temporary solution but sometimes successful.

Biological procedures that have been used in younger patients include osteochondral grafting where a bone and cartilage plug is taken from a non-weight-bearing area and plugged into the weight-bearing lesion. Autologous chondrocyte (a patient's own cartilage cells) implantation, and meniscus transplantation, have also been tried. A newer technique where allograft cartilage (donor cartilage) is minced and mixed with a fibrin glue and pasted into the lesion has also been used. All patients have been young with discrete cartilage defects. None have been older with the typical larger defects seen with long-standing osteoarthritis.

Another popular procedure orthopedists use is unicompartmental arthroplasty. This is a procedure where only the narrowed part of the knee is replaced. There is more rapid recovery as well as less blood loss, and fewer complications. The success of this procedure is highly dependent on the experience of the surgeon.

The procedure that appears to be most promising though for younger patients with OA of the knee is guided autologous stem cell layering.

How You Should Look at Knee Replacement

The average Joe or Jenny is incredible in the sense that he or she wants absolutely everything. I find it hard to believe the extent he or she believes himself or herself to be entitled to! I don't know if its expectations or ego or a combination of both.

Take for instance our bodies. We don't seriously expect to last forever or do we? But we expect the wear and tear on our bodies to be minimal. Well, here's the thing if you are playing heavy sports or are obese or for a number of other reasons you could need knee replacement.

Many people I have known personally have gone in for knee replacement surgery as if it were the solution to all their problems. I think I will leave the decision up to you. Knee replacement, very simplistically, replaces a part of the knee with an artificial joint after putting the blood vessels and nerves in place. It's not a pill you take which will work overnight and it certainly doesn't work like an injection of magic fluid which will have you prancing about as some people would have you believe!

The process does change lives of those who suffer from chronic pain but it is not reason enough to abuse your body. The post surgery recovery process is also gradual and takes place in phases. Most patients do see an improvement in their mobility about a month after the procedure.

The patient should be able to stand and move the joint the day following surgery. Most patients require rehabilitation and additional care and help with the use of walking devices and the like since full body weight is not put on the joint immediately.

This process may have to be repeated every five to seven years if the artificial joint wears out. So the quality of the joint and how much strain you put on it will determine how soon you'll get the joint replaced.

Personally, I think people have to accept that they will get old. They can't continue to do all the things that they did when they were younger and with the same intensity. There are a good many reasons for this and the most pressing reason would be that you want to avoid crippling injuries.

So I would suggest that a physician or surgeon should always be consulted about all the options available to the patient before going ahead with surgery. Furthermore, you should consider surgery as a final option when alternative and basic treatments have failed.

The Right Diet to Avoid Knee Surgery

Millions of people suffer from knee pain. When the condition deteriorates, one may think of knee surgery but many people are hesitant to opt for this method. Knee surgery has a very high success rate but is an expensive surgical procedure, and many people are still scared about the post-surgery affects. One can take precautions and check the eating habits that will not only help in decreasing the pain but also avoid the situation where one needs to go for knee surgery. Here are few food items that might be helpful for you.

Fruits have always been a packed source of vitamins and minerals. Their naturally occurring compounds also aid in reducing the knee pain. Include fruits with Vitamin C in your daily diets such as orange, papaya, kiwi, grapefruit and mango. Orange juice is a superior source of vitamin C, a nutrient that possibly safeguards against knee osteoarthritis. Drinking a glass of orange juice offers about 25 percent additional vitamin C than directly eating an orange.

A plateful of curry may possibly work well to relieve you from the knee pain since it has turmeric, a spice used in most of the Indian dishes. The turmeric contains curcumin, which has strong anti-inflammatory properties. The curcumin lessens the COX-2 enzyme that initiates swelling and pain in the knee.

Eat spinach with its rich antioxidants like zeaxanthin and lutein can ease your pain. When eating spinach, team it up with onions as they possess high amounts of quercetin, which is a flavonoid with anti-inflammatory agents. Also, consuming soy facilitates lessening of knee pain as it is rich in isoflavones, plant hormones which possess anti-inflammatory properties.

Many studies and research have revealed that fish offers relief from knee pain and stiffness, especially in case of rheumatoid arthritis. A recent study has discovered that the omega-3 fatty acids found in fish not only prevents and blocks chemicals that causes inflammation but also blocks a protein that is possibly wears down knee cartilage. Opt for two portions of oily fish, preferably salmon or mackerel on a weekly basis. As an alternative, take one gram of omega-3s in the form of capsules every day. These natural acids not only ease pain but also decrease the duration of stiffness that causes pain in knee joints. Fish with omega-3s include tuna, salmon, sardines, cod, herring and mackerel. Fish is also safer than the other anti-inflammatory medicines that might have side-effects.

Ginger is conventionally is used as a valuable medication to relieve upset stomachs, but researchers recently discovered apart from this it also helps in reducing knee pain by diminishing inflammation. A study conducted on a more than 250 individuals reveal that patients suffering from various levels of knee pain can get rid of it by using ginger extract. One can also use ginger in cooking which can enhance the flavors while decreasing knee problems at the same time.

In order to reduce knee pain, some studies have been conducted to ascertain that refined carbohydrates increases knee pain and inflammation. These may include pasta, white bread and other baked goods. Ignoring these food stuffs will help you to reduce your body weight.

Making alterations in your eating habits can be a simple and trouble-free process. This will help to alleviate knee pain and add to your good health.

Try A Natural Diet For Arthritis Pain Relief

I got rid of my arthritis and arthritis pain forever by eating a natural living food diet. I found relief from my arthritis pain, naturally, and you can do it too.

Arthritis concentrates in one or several joints where deterioration occurs. To get the arthritis pain relief you're seeking it's helpful to understand how arthritis works. The first step when looking for solutions to an arthritis pain problem is to understand how arthritis works.

The combination of the collagen meshwork and high water content tightly bound by proteoglycans creates a resilient, slippery pad in the joint, which resists the compression between bones during muscle movement. Collagen is the main protein found in all connective tissues in the body, including the muscles, ligaments, and tendons. The ability to make repairs to cartilage becomes limited as cartilage cells age.

Most experts now believe that osteoarthritis results from a genetic susceptibility that causes a biologic response to injuries to the joint, which leads to progressive deterioration of cartilage. Genetic factors are thought to be involved in about 50% of osteoarthritis cases in the hands and hips and a somewhat lower percentage of cases in the knee. An inflammatory response causes cytokines, to gather in injured areas and cause inflammation and damage to body tissue and cells; it's known to play a role in rheumatoid arthritis and other muscle and joint problems associated with autoimmune diseases.

Try massaging your fingers or other affected joints with coconut oil twice a day. Some foods and beverages to avoid that are inflammatory are: caffeine, salt, sugar, meat, dairy products, additives, soft drinks, white flour, white rice, alcoholic beverages, fast food, processed vegetable oils, refined, packaged and processed food. Studies done on antioxidant vitamins question the value of these supplements; it's clearly better to consume these antioxidants in living foods because they may also need to work with other nutrients present in the foods to work properly.

If you really want to get rid of your arthritis pain forever it may take a radical change in your diet and an ongoing commitment. Make smoothies with fruit only using a base of two bananas, adding a cup of frozen or fresh blueberries and mango chunks or substitute any other fruit and add an energy boost of two tablespoons of coconut oil; add one or two leaves of kale for another highly nutritional boost -- no one will ever know. Making a ginger tea, by adding a thin slice or two of fresh gingerroot to hot water, is helpful to many people I know.

Try avoiding the eight most allergic foods, wheat being the most allergenic; they are wheat, corn, eggs, milk, peanuts, fish, shellfish and some nuts, not all. One natural treatment method involves avoiding all inflammatory foods, that is, foods that are not alive.

I know quite a few people who are drinking tart cherry juice to relieve their arthritis pain; but is has to be the tart kind though. Some of the supplements commonly used for relieving arthritis pain, but I don't know if any of these work, are: glucosamine, chondroitin, bromelain, grapeseed extract, omega-3 and omega-6, cod liver oil, manganese ascorbate, MSM, boron, niacinamide, pantothenic acid, vitamin A, vitamin C, and vitamin E.

To be on the safe side always seek your doctor's advice before starting or changing your exercise program. A good exercise routine is the key to beating arthritis and relieving arthritis pain. If you have pain and swelling in your fingers, try squeezing Thera-putty made for this purpose or exercising with two Chinese chime balls called Taiji balls. Even the lightest exercise can go a long way to maintaining your joint mobility and overall health.

Your body has 147 different joints that are in motion every day of your life. Exercise your affected joints every day, to keep them flexible. Stretching and warming up the joints should always be the first step in your exercise routine to make your joints more flexible, just be careful you don't do further damage-proceed slowly..

Be aware that the use of NSAIDs or Cox-2 inhibitors do not halt the progress of osteoarthritis and may even hasten the onset.

Once you become more informed about arthritis you'll be able to plan an arthritis treatment program, natural or conventional or a combination of both. For conventional treatment of arthritis - if you do choose to take drugs or medications, be very careful and read the labels thoroughly.

Following these suggestions can help you get back in the swing of things fast and allow you to spend your days enjoying life once more. Arthritis pain relief is the ultimate goal - understanding arthritis is a good way to get there. Begin your treatment program with a diet change, exercise and weight loss plan to see incredible results and fast pain relief.

All You Need to Know About Arthritis & Rheumatism

Osteoarthritis, the most common chronic arthritis, accounts for half of all cases. Inflammation may occur, but OA is generally considered a non-inflammatory type of arthritis - referred to as degenerative joint disease or "wear-and-tear arthritis".

Osteoarthritis (OA) is most prevalent in the aged and is probably related to the normal aging process (although it is seen occasionally in younger people and some forms have a genetic basis).

The usual symptoms are deep aching pains localized to the joint(s) involved, stiffness after rest, joint swelling and tenderness, a grating sound when the joint is moved, and in later stages bone deformities. The pain is usually present with movement of the joint and relieved by rest. The pain arises in the joint capsule, ligaments, tendons, muscles and bone surrounding the damaged cartilage.

As the disease progresses, the exposed bone tissue thickens and forms bony spurs that enlarge the bone ends. The spurs encroach on the joint space and may restrict joint movement. Patients complain of stiffness on arising that lessens with activity. The affected joints may make a crunching noise as they move. This sound, called crepitus, results as the roughened articular surfaces rub together. The joints most often affected are those of the fingers, the base of the thumb, the big toe, the cervical and lumbar spine, and large weight-bearing joints of the lower limbs (knees and hips).

Current theory holds that normal joint use prompts the release of enzymes that break down cartilage. In healthy individuals, this damaged cartilage is replaced. In people with OA, more is destroyed than replaced. Although its specific cause is unknown, OA may reflect the cumulative effects of years of compression and abrasion acting at joint surfaces (accompanied by excessive amounts of the cartilage-destroying enzymes) which ultimately cause the once smooth articular cartilages to soften, roughen, fray, and erode - resulting in friction. The tendons, ligaments, and muscles holding the joint together become weaker, and the joint itself becomes painful and stiff. There is usually some pain, but little or no swelling.

Biochemically the disease can be initiated by excessive pressure being applied to the joint i.e. in sport or manual work. Inflammation of the cartilage may also be associated with infection, toxic irritation, or by poor nutritional status of bones and surrounding structures. Epidemiologists have also identified hereditary factors which predispose people to osteoarthritis. Other contributing factors include poor diet, obesity, diabetes, a sedentary lifestyle, hypertension, bowel toxicity, hyperuricaemia, hypothyroidism and other endocrine disorders, hyper-insulinaemia, and high estrogen levels. Allergies and chemical sensitivities may also predispose or aggravate osteoarthritis.

The primary chemical change observed is the loss of proteoglycans (a protein sugar or mucopolysaccharide) from the hyaluronic backbone, and is initiated by activation of degenerative enzymes associated with inflammation. These proteoglycans are responsible for cartilage resilience or bounce and their loss from the cartilage results in a stiffer material that is more easily damaged by "wear and tear". Proteoglycans account for 75-80% of normal cartilage, in osteoarthritis proteoglycans are reduced to 35-40%. The increased turnover and eventual loss of proteoglycans from osteoarthritic tissue is a consequence of an increase in chondrocyte metabolism.

At the same time there is some kind of matrix destabilization possibly the result of collagen fibers breaking. Collagen fibers provide the high tensile strength of cartilage. The physical properties are not unlike a mattress which can be compressed but not pulled apart sideways. The collagen/proteoglycan matrix provides the structural framework of the tissue and also forms a fluid compartment for the transport of nutrients, waste products, chemical messengers and hormones, to and from chondrocytes. Whether the breaking of the collagen fibers is a consequence of increased proteoglycan degradation is still not clear.

The degenerative enzymes can be modulated by Bromelain, Quercetin, Rutin, and EFA's. Zinc, Manganese, Magnesium, Calcium, Vitamin D, C, B6, E, Glucosamine, and DLPA are all useful to help with inflammation. This combination of nutrients increases protein, proteoglycan and amino acid synthesis, facilitates repair of ligament and connective tissue, improves and restores bone growth and muscle action, increases blood vessel integrity and supports immune system function.

An acid environment around the joint will also activate these enzymes and thus precipitate the loss of proteoglycan. Chondrocytes are cells within the joint that produce these proteoglycans. Stimulation of these cells by particular nutrients can forestall some of the degenerative changes associated with arthritis. Thus, improving the chondrocytes healing potential is essential in the treatment of osteoarthritis. Bone cells, the osteocytes and osteoblasts, become metabolically very active in osteoarthritis and bone remodeling is evident.

According to allopathy - the course of osteoarthritis is usually slow and irreversible and is thought to be medically untreatable as it was a result of "wear and tear". In most cases, you will be offered symptom control with a mild pain reliever like aspirin, along with moderate activity to keep the joints mobile. Osteoarthritis is rarely crippling, but it can be, particularly when the hip or knee joint are involved. Each year, thousands of people around the world die from the adverse effects of both the anti-inflammatory medications and steroids. To add insult to injury, some research suggests that there is mounting evidence that non-steroidal anti-inflammatory drugs actually cause certain features of osteoarthritis to progress faster - by inhibiting the synthesis of proteoglycans and thus damaging cartilage. Interestingly, Folic acid 6-6.4 mg and Vitamin B12 200ug reduces the need for NSAID's with improvements in hand grip and reduced tenderness in joints.

Osteoarthritis is now understood to be a disease due to the disordered synthesis of proteoglycan and collagen. Both biosynthetic pathways can be regulated by nutritional means, and manipulation with nutritive substances has been shown to have significantly beneficial results in regulating cartilage metabolism and the progression of the disease is slowed or reversed.

A new magnetic therapy is reported to provide significant relief to about 70% of the patients treated. The magnetic fields are assumed to stimulate the growth and repair of articular cartilage and to reverse the effects of OA. Another technique under investigation involves injecting hyaluronic acid into the affected joint cavities. Hyaluronic acid is a natural sulphated polysaccharide that lubricates and cushions the joint. Its viscoelastic nature (kind of like Silly Putty) enables it to bounce back to its original shape after being compressed. Hence, it protects the joint surfaces from further erosion and relieves discomfort.

Obesity increases the risk of developing osteoarthritis by putting undue stress on the joints - knees and hips, for example, will not cause as much discomfort when they have less weight to carry. Some form of gentle exercise, such as swimming, cycling or walking, together with a sensible diet that promotes fat loss, whilst preserving precious lean muscle, will therefore help to prevent osteoarthritis, or minimize symptoms if you already have the condition.

Furthermore, regular exercise can play a vital role in the prevention and treatment of all forms of arthritis. Exercise is essential for reducing pain and retarding joint deterioration and helps to prevent stiffness. But you also need to respect your body's limitations in order for exercise to be beneficial. Exercise helps to keep joints healthy by encouraging the flow of synovial fluid into and out of the cartilage, and strengthens the supporting, protecting structures (muscles, tendons, ligaments) and increases the range of motion, shock absorption, and flexibility of joints. Exercise is important in both the prevention and treatment of arthritis because unused joints tend to stiffen. Proper instruction is essential, since great harm can be done with what could be a normally easygoing activity. Swimming, water exercise, yoga and tai chi have been found to be slow and careful enough to loosen joints without causing additional discomfort.

An extract from New Zealand's green-lipped mussel has been found to contain a glycoprotein which may help treat arthritis. The presence of this compound is thought to indirectly prevent the inflammation which occurs when the body's immune system starts attacking healthy tissue. The glycoprotein achieves this by blocking certain actions of neutrophils, the white blood cells which alert the immune system.

Regenerating the joint cartilage is the first priority in the treatment of osteoarthritis. Liquid bovine tracheal cartilage may be used as it is an anti-inflammatory and aids connective tissue repair. For joint repair to take place the following nutrients are needed for the support of collagen, cartilage and bone: Glucosamine sulphate; Vitamin D; Calcium ascorbate; Manganese chloride; Magnesium hydroxide; MSM; and Zinc gluconate tri-hydrate. These nutrients help reduce inflammation and therefore joint pain, whilst also enhancing the growth and repair of bones. Also retards cartilage erosion and repairs damaged cartilage.

Glucosamine is an amino sugar, a major building block of proteoglycans, and is needed to make the glycosaminoglycans (GAGs), proteins that bind water in the cartilage matrix. Besides providing raw material for the synthesis of proteoglycans and GAGs, glucosamine's mere presence acts as a stimulant to the cells that produce these products, the chondrocytes. In fact, glucosamine has been found to be the key factor in determining how many proteoglycans are produced by the chondrocytes. If there is a lot of glucosamine present, then a lot of proteoglycans will be produced, and a lot of water will be held in its proper place. But if only a little glucosamine is available, fewer proteoglycans will be made, and less of the precious water will be attracted to the area. It appears that altered glucosamine metabolism is part of the background of arthritis. Glucosamine has also been shown to spur chondrocytes to produce more collagen and proteoglycans, and it also normalizes cartilage metabolism, which helps to keep cartilage from breaking down.

Extensive research has been conducted including double-blind studies - conclusions being drawn that glucosamine actually rebuilds the damaged cartilage. It has been proven to be a safe and effective treatment for osteoarthritis. By helping the body to repair damage to eroded cartilage, it helps quell pain and relieve swelling and tenderness, with minimal or no side effects. According to recent biochemical and pharmacological findings, the administration of glucosamine (1500mg) tends to normalize cartilage metabolism, so as to inhibit the degradation and stimulate the synthesis of proteoglycans and, finally, to restore, at least partially, articular function.

Where glucosamine helps to form the proteoglycans that sit within the spaces in the cartilage "netting", chondroitin sulphates act like "liquid magnets", attracting fluid into the proteoglycans - the fluid acts as a spongy shock absorber and sweeps nutrients into the cartilage (Articular cartilage has no blood supply, so all of its nourishment and lubrication comes from the liquid that ebbs and flows as pressure to the joint is applied and released. Without this fluid, cartilage would become malnourished, drier, thinner and more fragile). Besides drawing in precious fluid, chondroitin protects existing cartilage from premature degradation and stimulates the synthesis of new cartilage.

An excerpt from "The Arthritis Cure", by Dr Jason Theodosakis: "To put it briefly, in order to qualify as a truly chondro-protective agent, a compound must be able to

1. Enhance cartilage cell macromolecule synthesis (glycosaminoglycans, proteoglycans, collagens, proteins, RNA, and DNA)
2. Enhance the synthesis of hyaluron (the substance that gives the joint fluid its thick viscosity, providing lubrication between the synovial membrane and cartilage).
3. Inhibit the enzymes that degrade the cartilage cell macromolecules.
4. Mobilise thrombi, fibrin, lipids, cholesterol deposits in synovial spaces, and blood vessels in surrounding joints.
5. Reduce joint pain.
6. Reduce synovitis.

Clinical studies have shown that glucosamine can accomplish objectives 1,2,5, and 6, while chondroitin handles numbers 1,3,4,5, and 6. Their overlapping abilities explain why the glucosamine and chondroitin is such a powerful one-two punch against osteoarthritis."

Strengthening subchondral bone is also very important. Nutrient support for repairing subchondral bone tissue includes therapeutic levels of Microcrystalline hydroxyapatite and Calcium citrate (the most absorbable forms of Calcium) combined with balanced amounts of Magnesium diglycinate, Zinc diglycinate, Manganese diglycinate and other synergistic minerals. Ipriflavone is also valuable. It a form of isoflavonoid that has the ability to activate osteoblasts (bone building cells) and inhibit bone resorption, resulting in enhanced bone formation and increased bone density.

There are many ways to reduce inflammation. Turmeric, Indian Olibanum, and Ginger are a powerful combination of anti-inflammatory herbs, all with potent regulating activity on inflammatory eicosanoids. Turmeric also has a strong antioxidant action to reduce inflammatory triggers. One of the best formula for pain.

A broad spectrum antioxidant would provide the ascorbic acid necessary for collagen synthesis, which is in turn vital to joint repair. There is some evidence to show that antioxidants - Vitamin A, C, and E, plus Selenium - may have beneficial effects on arthritis. High potency marine lipids, Omega 3 essential fatty acids, have been demonstrated to exert anti-inflammatory effects in cases of osteoarthritis.

Meat has a form of fat that encourages inflammatory agents in the body. Fats can regulate eicosanoids, which control inflammation, pain, and other symptoms of arthritis. Reducing the omega 6 oils seems to help. Canola is the best fat to use, since it contains a balance of both omegas, although beware that most canola oil on the market now is genetically modified. Olive oil is also acceptable. Flax oil contains almost twice as much omega 3 fatty acids as does fish oil, and combinations are encouraged.

All tea, coffee, alcohol, and processed foods need to be eliminated. Reduce consumption of highly refined foods, saturated fats, sugar and salt. Increase consumption of whole grain cereals, hard nuts, and apple pectin. These foods are rich in silicon which have been found to be important in bone homeostasis. A healthy diet with fresh fruit and vegetables boosts the immune system and provides the sufferer with extra energy to fight the disease. Use Garlic (inhibits free radical formation) and Kelp (rich source of minerals) in cooking. A free form amino acid complex should be part of the program to help repair tissue. Some form of fiber, such as oat bran or rice bran, should be eaten daily, and the diet should be low in saturated fats. Foods that should be consumed include eggs; onions; garlic or asparagus whose sulfur content helps to remove metals; the amino acid histidine, which is also good for removing metals; green leafy vegetables, which are needed for Vitamin K; fresh vegetables; non-acidic fresh fruits; whole grains; oatmeal; brown rice; and fish.

A good multivitamin is essential to protect from free radical damage and to repair illness and cartilage. The free radical scavenger Super Oxide Dismutase (SOD) is useful both orally and in injection form for the relief of the stiffness, pain, and swollen joints in arthritis. SOD is a member of a group of enzymes found mainly in the fluids inside the cells - it protects against damage by free radicals. DMSO (dimethyl sulphoxide) is another free radical scavenger that relieves the stiffness and pain. Its effects are enhanced when taken with other vitamins and minerals such as A, B complex, C, E, Zinc, and Selenium. 50 % of patients given 600 IU of Vitamin E for a period of 10 days reported an analgesic effect. This effect my be due to may be due to Vitamin E's role in prolonging the life of fibroblasts, and to stabilizing lysosomal membranes, thus inhibiting the release of inflammatory mediators. Vitamin E's role as an antioxidant is also likely to play a significant role. DMSO has also been used topically to treat arthritis. Vitamin E is also good and helps to mobilize the joints. Calcium and Magnesium chelate are essential to prevent bone loss (Magnesium is also required to form the synovial fluid which surrounds the joints), and Silica is needed for Calcium absorption and the connective tissue.

Vitamin B3 increases the circulation to deep tissues by dilating small arteries, and may promote synovial regeneration thus contributing to the reversal of cartilage erosion and synovitis. Niacinamide alone or in conjunction with other water soluble vitamins can improve joint mobility and function. Severely damaged or ankylosed joints do not respond. Vitamin C plus Bioflavonoids is for structural integrity of capillaries and collagen formation, also is a powerful free radical destroyer. Germanium is a powerful antioxidant that also relieves pain. Bromelain, from pineapple, reduces inflammation and aids digestion. DLPA is good for relieving chronic pain. Osteoarthritis may be helped by lipotropes or SAM-e (important in lipid metabolism), which is active in cell membrane fluidity (it is thought that a fatty acid imbalance of the omega 3's and 6's may cause arthritis and other degenerative diseases).

A deficiency of Vitamin B5 results in pathological changes to the joint which closely resemble the changes of osteoarthritis, including the claudication of cartilage, and the formation of osteophytes. Supplementation of Vitamin B5, results in benefits in 7-14 days and cessation of the treatment results in a relapse of symptoms. The mechanism of action of B5 in osteoarthritis may relate to its requirement for the N-acetylation of glucosamine (which requires acetyl CoA) and thus for the synthesis of proteoglycans. Royal Bee Jelly, rich in pantothenic acid, is reportedly helpful.

Vitamin C and D reduce the risk of cartilage loss and disease progression. Deficiency of Vitamin C may be associated with defects in collagen proline hydroxylation, possibly creating repair problems in connective tissue. Thus, Vitamin C may be useful in regenerating cartilage in addition to neutralizing some of the hormones and enzymes associated with inflammation that cause leakage and damage.

For some people who develop arthritis, an allergy or intolerance to particular foods may be a contributing factor. An elimination diet is one of the best ways to identify problem foods, but pinpointing the culprit foods can be difficult and it is best to consult your qualified Health care Practitioner. Red meat, sugar products, citrus fruits, green peppers, eggplant, tomatoes, potatoes, paprika, cayenne pepper, tobacco and salt may all be problems. The nightshade family contain a toxic alkaloid called solanine that some people, particularly those suffering from arthritis, are highly sensitive to. Solanine interferes with enzymes in the muscles, and may cause pain and discomfort. Another group of foods known as salicylates also have been shown to increase inflammation in arthritics. Wheat and milk may also be culprits. Many arthritics seem to improve if digestion is augmented. This can be done by either taking digestive enzymes or apple cider vinegar with meals. Improving digestion and the acidity of the stomach ensures complete breakdown of any antigenic food protein that may exacerbate the condition.

Eating Nettles or drinking Nettle tea (3 cups a day) is an old remedy for arthritis - anti-inflammatory. Herbs that help to ease arthritis include Feverfew (good for pain and soreness), Meadowsweet, Celery seed, and White Willow. Dandelion root and Horsetail tea is recommended for degenerative arthritis. For inflamed hand joints, take a decoction or tincture of Devil's claw. Ginger, Coriander, Cinnamon and Aloe Vera can be used to treat arthritis. Angelica is a good tonic and is warming. Barberry taken as a tea or applied as a compress can be used. Basil can provide relief from the pain of arthritis. Other herbs such as Comfrey, Burdock, Black Cohosh, Valerian root, Chaparral leaves, Gotu kola, Chickweed, Dong Quai, and, Bog bean may help. Alfalfa leaves, Brigham tea, Parsley tea, and Yucca extract (used successfully at the Desert Arthritis Clinic) are also good choices.

For aching joints try a liniment made with Comfrey tincture and a few drops of Black Pepper essential oil. A bath of Arnica tincture, Rosemary, Basil and Lavender to promote relaxation and relieve pain. Slippery elm and Cayenne applied to affected joints as a poultice may provide relief. Rub Calamus oil into the affected joints to improve circulation and drainage. Camphor oil is indicated for the treatment of arthritis also.

Aromatherapy oils can provide soothing aromatic relief. Juniper essential oil in a bath or in a massage blend may be useful - it is stimulating and anti-rheumatic. Petitgrain massaged into the limbs may also be useful for osteoarthritis. Lemon and Cypress essential oils are detoxifying, and can be used in the bath or in a massage to help the body eliminate toxins. Chamomile, Lavender, and Rosemary are anti-inflammatory and pain-relieving; use in local massage or in a compress. Black Pepper, Eucalyptus, Marjoram and Benzoin will improve the circulation in the area. Coriander, Clary sage, Eucalyptus, Ginger, Marjoram, Vetiver, and Cedarwood may also provide relief. Skin brushing may help by stimulating the lymphatic system.

Tissue salts may be useful in conjunction with nutritional and herbal support. Ferr phos may be used in acute attacks with fever, inflammation of the joint which is swollen and red. Painful joints aggravated by motion may also benefit from this remedy. Nat phos when there are acid conditions. May be used alternatively with Nat sulph. Nat mur is if there is creaking of the joints. Mag phos may be of value, alternating with Calc phos, for the relief of pain in osteoarthritis.

Apis is for hot, stinging pain. Arnica may be useful for sprained joints that improve during movement, but worsen after prolonged movement or rest. It also helps with long term joint and muscle complaints such as osteoarthritis. Bryonia may be useful for joint inflammation such as osteoarthritis. It is indicated when stitching pains occur in swollen pale or red joints. Colchicum, when it is worse in warm weather, with inflamed joints, irritability, and sensitivity to touch. Pulsatilla is for when pain moves from one joint to another. Ruta grav is for the treatment of deep aching pain especially in the bones. Rhododendron is for when arthritis is worse in stormy weather. Rhus tox may be used for muscle and joint pain i.e. osteoarthritis, restless legs, stiffness in the lower back, and strains. Symptoms are made worse by cold and damp, and after rest - improving with movement.

Physical therapies such as massage, physiotherapy, osteopathic treatment, and magnetic induction therapy are useful adjuncts in the treatment of osteoarthritis.

Nutritional and Herbal support for Osteoarthritis includes:

Glucosamine 1200 Complex - Glucosamine is a natural substance found largely in cartilage, ligaments and tendons. This product was formulated to give the body the building blocks it needs to help repair cartilage, ligament & tendon damage, while offering an anti inflammatory action.

Omega 3 EFA's - High quality natural Fish Oil is an excellent source of Omega-3 acids, Vitamin A & D & the essential fatty acids EPA & DHA. Provides an anti inflammatory action in the body.

DLPA - Elevates the body's own natural pain killing hormones (endorphins). 400 mg 3-4 x daily for relief of chronic pain 3 wks.

Vitamin C, Quercetin and Bromelain - Bioflavonoids inhibit inflammation thus assisting in relief of chronic pain 3-4 x daily 3 wks.

Tryptophan - Increases pain threshold, may aid sleeping.

Some interesting points on Osteoarthritis:

Hot tubs and baths provide relief. Raw lemon rubs and hot castor oil packs are also extremely beneficial.

Drink steam-distilled water only.

Good posture is also important to prevent stiffness and crippling. Poor posture can cause body weight to be distributed unevenly, placing more stress on certain joints, resulting in unnecessary pain for the arthritic person. Overweight and obesity also affect the weight-bearing joints, which become irritated and stressed by having to carry too much of a load.

Alfalfa, Parsley, Celery seed, Ginger 1-2 grams per day (discourages inflammation and pain), hot Peppers, and Garlic make useful additions to the diet.

The bacteria responsible for Chlamydia non-specific urethritis has been linked as a cause of one form of arthritis in young women. In nearly half of the women with unexplained arthritis who were tested, Chlamydia was found in the joints. Seventy-five percent had raised antibody levels in the blood.

Copper has an anti-inflammatory effect when applied topically and is therefore helpful for arthritis. Copper bracelets leach the copper into the system through perspiration, therefore adding to Copper levels in the blood. Copper chelate rub applied to the affected joint may reduce the inflammation around the joint. Many osteoarthritic patients are Copper deficient and this may have a role in the pathogenesis of the disease as copper is required for the formation of sulfur cross linking in collagen formation. Manganese may repair worn-out cartilage. Zinc, an anti-inflammatory, may relieve some symptoms of arthritis.

Vitamin C is necessary to prevent the capillary walls in the joints from breaking down and causing bleeding, swelling, and pain. Folic acid, Vitamin B12, and Iron may be helpful in treating the anemia that may accompany arthritis. The frequency of liver disorders in arthritic patients may deter the conversion of carotene into Vitamin A. Difficulty in assimilating carbohydrates suggests a Vitamin B deficiency.

Wear correct fitting jogging shoes or massage sandals. This allows for better cushioning of knee an hip joints. Orthotics may be useful to support or correct alignment of ankles and thus posture.

Eat cold water fish (cod, tuna, salmon, trout, mackerel, and sardines) at least 3 times per week. These fish are rich in certain polyunsaturated fats called omega 3 fatty acids. Scientific evidence has now emerged to show that fish oils can prove helpful to arthritis sufferers, and may reduce inflammation if taken regularly. Inflammation is the body's natural reaction to arthritic diseases, causing pain, swelling, redness and heat. Fish oil may also be taken in capsule form. Signs of improvement are usually felt within 2-3 months. Vegetarians may choose Flaxseed oil (1-2 dessertspoons a day) to obtain their omega-3 fatty acids.

Coeliac disease results from a sensitivity to the protein gluten, contained in wheat, oats, barley and rye. Gastro-intestinal discomfort, wind and diarrhea are the usual manifestations although these symptoms need not be present and arthritis or eczema may manifest.