The primary purpose of an analgesic is to relieve pain. Some patients use aspirin, an analgesic that also reduces joint inflammation. The most commonly used analgesic, acetaminophen, is relatively effective and has few side effects. Acetaminophen does not contain aspirin, however, so it doesn’t relieve joint inflammation. For this reason, acetaminophen is less likely to be used with rheumatoid arthritis and other types of arthritis that cause inflammation, and more likely to be used to treat osteoarthritis and fibromyalgia.

The main side effect of analgesics is a slight risk of dependency that can occur if the drugs are used for long periods of time.

Corticosteroids are similar to the hormone, cortisol, which occurs naturally in the body. Corticosteroids reduce painful inflammation in joints, but because of potentially serious side effects, they are rarely used as a first choice for long-term treatment.

Corticosteroids are almost never used to treat osteoarthritis, and when they are prescribed for rheumatoid arthritis, it is generally to relieve severe symptoms while waiting for another drug, such as an NSAID, to reach an effective level. If they are used for a longer period of time, they are generally used in lower doses.

Arthritis patients have found that they may benefit from a number of other pain management techniques that do not involve medication. The most popular are:

Sleep

Exercise

Stress Management

Massage Therapy

Relaxation Therapy

Biofeedback

Hot/Cold Treatment

Arthritis is the number one cause of chronic disability in the United States. Affecting nearly 40 million Americans, it refers to more than 100 diseases that cause pain, stiffness and swelling from the inflammation of a joint or the area around joints.

Osteoarthritis is the most common type of arthritis affecting about 16 million Americans, usually middle-aged and older people. This is a noninflammatory degenerative joint disease characterized by the breakdown of the joint’s cartilage. The exact cause of osteoarthritis is unknown.

Fibromyalgia is the second most common type of arthritis affecting 3.7 million Americans, mostly women; 70 to 90 percent of people who develop this disease are women aged 20 to 50. Fibromyalgia is a disease involving pain in muscles or joints with no clinical signs of infection. It is often misdiagnosed as chronic fatigue syndrome, and usually does not require surgery.

In some types of arthritis, such as rheumatoid arthritis, the synovium becomes inflamed. This inflammation causes chemicals to be released that thicken the synovium and damage the cartilage and bone of the affected joint. This leads to inflammation of the synovium causing pain and swelling.

The causes of the 100 types of arthritis are unknown. Because there are so many different forms of arthritis, the causes are likely to vary. Scientists are currently examining how the roles of major factors including genetics and lifestyles affect the development of arthritis.

Pain from arthritis can be continuous or intermittent. Pain may occur after activity or exercise but it may also happen even if you’ve been resting and still for a period of time. Pain may be concentrated in one spot or you may feel it all over your body. Joints may feel stiff and difficult to move. Daily chores such as climbing stairs and opening cans may become a challenge. You may notice that pain is more severe during certain times of the day or after performing certain tasks. Some kinds of arthritis cause swelling or inflammation. The skin over the joint may appear swollen and red, and feel hot when touched. Arthritis may also cause fatigue.

In a total hip replacement surgery, the painful parts of the damaged hip are replaced with artificial hip parts called a prosthesis, a device that substitutes or supplements a joint. The prosthesis consists of steel components: a socket, ball, and stem. The outer shell of the socket is usually made of metal and the inner shell consists of plastic, or the entire socket may be plastic. When the metal ball is joined with the socket, the new hip can allow for smooth, nearly frictionless movement.

If you and your surgeon decide that total hip replacement is right for you, a date will be scheduled for your surgery. Several things may be necessary to prepare for surgery. For example, your surgeon might ask you to have a physical examination by your primary care physician. This will help to ensure that other health problems you may have, such as diabetes or high blood pressure, will be identified and treated before surgery.

You doctor may suggest that you lose weight and initiate an exercise program. If you smoke, be sure to speak with your doctor about it, as smoking can dangerously increase surgical risks and slow down the healing process.

You should also finish any dental work that may be underway to prevent germs in your mouth from entering the bloodstream and infecting the joint.

Taken in smaller doses than for depression, these drugs can give patients the type of deep sleep they need, which contributes to pain relief and increased energy. Muscle relaxants can also promote sleep and ease painful muscles. Possible side effects vary depending on which type of medication is taken. You should discuss with your doctor the side effects of the drug prescribed for you.

When you are back in your hospital room you will begin a gentle rehabilitation program to help strengthen the muscles around your new hip and regain your range of motion. On the day of surgery you may be asked to sit on the edge of the bed and dangle your feet. You will also learn how to protect your new hip while doing daily activities.

As soon as possible, usually within the next 24 hours, your physical therapist will help you start walking a few steps at a time. As you heal you will progress from walker to crutches and then a cane. Before you are dismissed from the hospital, an occupational therapist will also show you how to perform daily tasks at home with your new hip. For example, he or she will instruct you on how to go to the bathroom, how to dress yourself, how to sit or stand, how to pick up objects and many others.

After about two to four days, or when your surgeon determines that you have recovered sufficiently, you will be discharged. You may be transferred to a rehabilitation facility for a few more days, as determined by your surgeon. Upon returning to your home, you will need to continue taking your regular medications and continue exercising as directed by your surgeon or physical therapist. Walking, remaining active and practicing the required exercise are the quickest ways to full recovery.

In elbow replacement surgery, the painful surfaces of the damaged elbow are replaced with artificial elbow parts. One part fits into the humerus (upper arm), and the other party fits into the ulna (forearm). The two parts are then connected and held together by a pin. The resulting hinge allows the elbow to bend.

If you and your surgeon decide that total elbow replacement is right for you, a date will be scheduled for your surgery. Several things may be necessary to prepare for surgery. For example, your surgeon might ask you to have a physical examination by your primary care physician. This will ensure that other health problems you may have, such as diabetes or high blood pressure, will be treated before surgery. Your doctor, or a staff member, will advise you about the things you can do to prepare for your hospital stay, and your rehabilitation after surgery.

In total knee replacement surgery, the parts of the bones that rub together are resurfaced with metal and plastic implants. Using special, precision instruments, your surgeon will typically remove the damaged surfaces of all three bones. The replacement surfaces will then be fixed into place.

The surface of the femur is replaced with a rounded metal component that comes very close to matching the curve of your natural bone. The surface of the tibia is replaced with a smooth plastic component. This flat metal component holds a smooth plastic piece made of ultra-high-molecular-weight polyethylene plastic that serves as the cartilage. The undersurface of the kneecap may also be replaced with an implant made of the same polyethylene plastic.

If you and your surgeon decide that total knee replacement is right for you, a date will be scheduled for your surgery. Several things may be necessary to prepare for surgery. For example, your surgeon might ask you to have a physical examination by an internist or your regular doctor.

In shoulder replacement surgery, the painful surfaces of the damaged shoulder are resurfaced with artificial shoulder parts. The part that replaces the ball consists of a stem with a rounded metal head. The part that replaces the socket consists of a smooth plastic concave shell that matches the round head of the ball. When both sides of the joint are resurfaced, we call it a total shoulder replacement. However, your doctor may determine that only the humeral side of the joint (ball) should be resurfaced. We call this a partial shoulder replacement.

If you and your surgeon decide that total shoulder replacement is right for you, a date will be scheduled for your surgery. Several things may be necessary to prepare for surgery. For example, your surgeon might ask you to have a physical examination by your primary care physician. This will ensure that other health problems you may have, such as diabetes or high blood pressure, will be treated before surgery. Your doctor, or a staff member, will advise you about the things you can do to prepare for your hospital stay, and your rehabilitation after surgery.

The surgery will begin with an incision over the knee that will expose the joint. When the bones are fully visible to the surgeon, special, precision guides and instruments are used to remove the damaged surfaces and shape the ends of the bones to accept the implants.

The implants are then secured to the bones. It might also be necessary to adjust the ligaments that surround the knee in order to achieve the best possible knee function. When the surgeon is satisfied with the fit and function of the implants, the incision will be closed.

A special drain may be inserted into the wound to drain the fluids that naturally develop at the surgical site. A sterile bandage will then be applied, and you will be taken to the recovery room, where you will be closely monitored. Your surgery will likely take between one and three hours, depending on your individual circumstances.

As your anesthesia wears off, you will slowly regain consciousness. A nurse will be with you, and may encourage you to cough or breath deeply to help clear your lungs. You will also be given pain medication. When you are fully awake, you will be taken to your hospital room. Your knee will remain swollen and tender for a few days.