Transcript Bone and joints - The Center of Healing
The Itis Family
• Osteo • Rheum • Psoriatic • Reactive • Juvenile rheumatoid • Gouty
Osteoarthritis
• OA, the most common arthritis,
affects more than Americans and is a leading cause of disability.
21 million
• At present, there is
no available therapy that can reverse the damage of OA in the joint, but many studies are underway.
Rheumatoid arthritis
• a chronic disease that causes pain,
stiffness, swelling, and limitation in the motion and function of multiple joints.
• rheumatoid nodules beneath the skin in
areas such as the elbow and hands
• low-grade fevers, loss of energy, loss of
appetite
• RA is the most common form of
inflammatory arthritis usually female and 4 th -5 th decade
Psoriatic arthritis
• body's immune system goes into
overdrive and causes excessive inflammation
• between ages 30 to 50, but can begin
in childhood
• Only about 15 percent of people with
psoriasis develop the disease
Reactive arthritis
• Swollen, painful and stiff joints, often
involving the knees and/or ankles
• Reaction to an infectious agent are typically
male, between the ages of 20-50
• Self limiting • Although many infections, including viruses,
can result in a reactive arthritis, the term usually applies to symptoms occurring after an infection of the bowel or genitals
jra
• Joint inflammation and begin before
the age of 16
• Systemic onset, Pauciarticular and
Polyarticular
• Not regarded as hereditary • Research points to exposure to an
infectious trigger
• JRA targets the lining of the joint
gout
• Gout occurs when excess uric acid
accumulates in the body, and crystals deposit in the joints.
• about 1 in 100 people and as many as
6 – 7 percent of older men
• Gout is strongly associated with
obesity hypertension, hyperlipidemia and diabetes
PMR
• Aching and stiffness affecting the
upper arms, neck, buttocks, and thighs.
• Rarely in people younger than 50 • Rarely causes swollen joints • Respond promptly and completely to
low doses of corticosteroids
Early ra
Early ra
Moderate ra
Severe Ra
•
PAIN
• Biggest symptom • Chronic (greater than 6 weeks) • Escalating (after, with, before, at
rest)
• Occasionally migrating • Growing unresponsive to remedies • Effecting ADL
’ s
Associated symptoms
• Stiffness • Joint noise • Heat • Weakness • Sleep disorder • Emotional change • Trigger points
Testing testing……..
• Xrays • Mri’s • Joint fluid • Biopsy • Blood = rheumatoid factor, sed rate, cbc,
uric acid, ana, c-reactive protein, hlab27, anti-cyclic citrullinated peptide
Time for a treat
• Electrical, needle • Antiinflammatories- NSAID, Steroid • Muscle relaxers • Pain control agents • Mood altering • Injections- Steroids, HA • DMARD’s • Topicals, herbals
antiinflammatories
• Motrin, advil, ibuprofen, aleve,
naprosyn, nuprin, aspirin
• Feldene, orudis, dolobid, voltaren,
cataflam, indocin, clinoril, daypro
• Toradol • Lodine, Relafen, mobic • Celebrex, vioxx, bextra • Prednisone, medrol
Muscle relaxers
• Skelaxin • Flexeril • Soma
• Vicodin • T 3 • Darvocet • Percocet • Dilaudid • Opiates
Narc’s
Mood altering
• SSRI’s • Tricyclics • Antidepressants
DMARD’s
• Disease Modifying Agents of
Rheumatology
• Cytoxan, imuran, cyclosporine,
methotrexate, leukoran, plaquenil
• Humira, remicade, orencia,
Herbal supplements
• Capsicum • White willow bark • Turmeric • Ginger • Devils claw • Burdock • Boswelia
Alternative supplements
• Omega 3 fish oil(
eicosapentanoic acid, docosahexaenoic acid)
• Glucosamine sulfate • Shark cartilage • Plant based bioflavinoids (limbrel)
Diet no
• No dairy • No refined sugar • No intoxicants • No Sweets • No excess meat or protein from any
source
Diet yes
• Fruits veggies and their juices • Seaweeds • Sprouts of seed, grains, legumes • O-3 foods and oils • Cooked grains, lightly cooked veg and
sprouts
• Raw veg sprout salad
The consultants
• Rheumatology • Physical medicine and rehabilitation • Orthopedic surgeons • Sportsmedicine specialists • Primary care • Chiropractor • Naturopath
Hands on
• Physical therapist • Chiropractor • Massage therapist • Acupuncturist • Tai chi intructor • Yogi • Reiki therapist • Reflexologist • Iridologist, craniosacral therapist, ayurveda
therapist
Counseling
• Nutrition / dietary • Spiritual / prayer • Herbalist • Aromatherapy blender • Naturopath • Homeopath • Human resources / disability
Dr Saguil’s approach
• Cool down the worse joints (meds/herbs) • Rule out big disease • Get the patient to function daily • Get the patient to rehab or flexibility
school
• Antiinflammatory diet • Wean off meds • Wean on herbs
Dr saguil’s shortcut
• Cool down • Get moving • Build up • Get off meds (or shorter term goals) • Maintain • “Cut it out”