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Treatments of arthritis: gold therapy, treatment of osteo-arthritis TREATMENTS OF ARTHRITIS: GOLD THERAPY, TREATMENT OF OSTEO-ARTHRITIS
Gold therapy
Gold therapy basically involves the administration of gold salts (so that the gold is in a soluble form) into the system of the patient involved. The mechanism of the anti-arthritic effect has received considerable attention with several theories being put forward. The theories have been based on the bactericidal effect, the suppression of certain enzyme effects, and even the toxic effect of gold. So far the true mechanism is still not known but possibly the inhibiting effect in some enzymes is the most popular theory.
With regard to the effectiveness of gold therapy it was reported that over relatively short periods (about one and a half years) the treatment was quite effective but that a reverse trend occurred after that. The improvement in condition takes place slowly, unlike the therapies described earlier, and it can be necessary for a person to be on treatment for many months.
To complete the gold story the side-effects have to be considered and, once again, these tend to be rather unpleasant. Amongst the side-effects listed for gold are toxicity (it is known to be quite lethal but as it is only administered in small amounts this effect is minimized), dermatitis, loss of hair, mouth ulcers and the seemingly inevitable gastric problems.
Treatment of osteo-arthritis
Drug therapy forms a smaller part in the treatment of osteo- arthritis than in that of rheumatoid arthritis. It is not within the scope of the discussions here to go into therapies that involve the use of splints, surgical appliances, crutches am heat treatment. All of these, together with programmes of balanced physical exercise therapy, are used in the treatment and management of various forms of osteo-arthritis.
Drug therapy and diet are factors which should be ? interest to most of us as it will be this area in which we ourselves will be most able to be effective in choice. That die is effective in influencing osteo-arthritis one way or the other is still open to doubt on clinical grounds. However, in trial on the incidence of osteo-arthritis in mice being fed a diet rich in saturated fat, an increased frequency of osteo-arthritis was noted. If some of the saturated fat in the diet was substitute by unsaturated fatty acid, a significant decrease in the incidence of osteo-arthritis resulted. Contrary to common opinion, clinicians do not consider that osteo-arthritis is due to dietary factors causing too much or too little calcium in the bones. Thus, apart from the obvious effect obesity may have on this condition, which could be described as an indirect dietary effect, osteo-arthritis is not considered to be a condition susceptible to nutrition.
In common with rheumatoid arthritis, probably the most widely used drug therapy for osteo-arthritis is aspirin. The analgesic effect would generally be the most active in relieving the pain symptoms of the condition. And inflammatory properties can come into play however where synovial inflammation is occurring. Synovial inflammation means inflammation of the synovial which is a lining membrane in certain types of joints. This membrane is responsible for lining and producing synovial fluid, the lubricating fluid for these joints.
Most other non-steroidal anti-inflammatory drugs, as used for rheumatoid arthritis, are also used for osteo-arthritis. The side-effects are the same for all these preparations. In general, the use of these drugs in the treatment of different conditions usually involves the same side-effects.
Corticosteroid therapy is not favoured as an oral form of treatment for osteo-arthritis due to the comparative lack of efficacy and the risk of serious side effects following long-term administration. Direct injection of corticosteroids into the joints has been used quite widely with successful, though temporary, relief of symptoms in some cases of osteo-arthritis. From personal reports of people who have experienced this type of treatment, however, the injections themselves are rather an unpleasant experience. The adverse effects of corticosteroid therapy by direct injection are not restricted to the injection itself.
Experimental studies have demonstrated that these drugs can have deleterious effects on the joint cartilage which can assist further deterioration of the joint. Also inflammations and joint infections can follow due to injected steroid crystals. As a result of these factors, and its inability to help in severe cases its use is not widely recommended.
Other therapies exist, including a type of radiation treatment and, particularly with arthritis of the hip, surgery. Wonderful results are being achieved with hip, knee and hand replacement surgery nowadays using durable metal or plastic components.
Thus, there are various means of treating arthritic disorders with various degrees of effectiveness and also various degrees of risk from side-effects. Obviously the best treatment is one where there is the maximum effectiveness with the minimum risk of adverse side-effects covering the broadest range of symptoms.
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