Transcript Bone and joints - The Center of Healing

The Itis Family
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Osteo
Rheum
Psoriatic
Reactive
Juvenile rheumatoid
Gouty
Osteoarthritis
• OA, the most common arthritis,
affects more than 21 million
Americans and is a leading cause
of disability.
• 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
4th-5th 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
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Associated symptoms
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Stiffness
Joint noise
Heat
Weakness
Sleep disorder
Emotional change
Trigger points
Testing testing……..
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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
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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
Narc’s
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Vicodin
T 3
Darvocet
Percocet
Dilaudid
Opiates
Mood altering
• SSRI’s
• Tricyclics
• Antidepressants
DMARD’s
• Disease Modifying Agents of
Rheumatology
• Cytoxan, imuran, cyclosporine,
methotrexate, leukoran, plaquenil
• Humira, remicade, orencia,
Herbal supplements
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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
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No dairy
No refined sugar
No intoxicants
No Sweets
No excess meat or protein from any
source
Diet yes
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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
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Rheumatology
Physical medicine and rehabilitation
Orthopedic surgeons
Sportsmedicine specialists
Primary care
Chiropractor
Naturopath
Hands on
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Physical therapist
Chiropractor
Massage therapist
Acupuncturist
Tai chi intructor
Yogi
Reiki therapist
Reflexologist
Iridologist, craniosacral therapist, ayurveda
therapist
Counseling
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Nutrition / dietary
Spiritual / prayer
Herbalist
Aromatherapy blender
Naturopath
Homeopath
Human resources / disability
Dr Saguil’s approach
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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
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Cool down
Get moving
Build up
Get off meds (or shorter term goals)
Maintain
• “Cut it out”
Be patient