By Dr. Nathan Wei
Regardless of the type of arthritis, the goals of arthritis treatment are similar.
These include the following:
• Relieve pain/inflammation• Minimize risks of therapy• Retard disease progression• Provide patient education• Prevent work disability• Enhance quality of life and functional independence
While the goals are similar they are achieved using different approaches depending on the diagnosis. The effective management includes a combination of conventional medicines, effective alternative treatments, changes in diet and food, rest, exercise, lifestyle changes (e.g., weight loss if needed), and joint protection.
Factors involved in decision making include the diagnosis, the severity of disease, and the patient’s response to previous therapies.
The decision making doesn’t end there either. As a patient is followed over time, things change. What initially was felt to be an effective arthritis treatment may no longer be effective...and side-effects may occur.
Additions and deletions of medications need to be considered. Drug interactions with other therapies are a concern.
Co-morbid conditions (other medical illnesses) enter into the equation. Newer therapies, when they arrive, may change the picture.
Patient preference, when it can be accommodated, should also be considered. And this dovetails with a patient’s lifestyle... The right therapy for a working man of 35 may not be the right therapy for a retired woman of 80. The correct arthritis treatment for a hard-driving executive may not be ideal for a laid back person who wants to use as many natural remedies as possible.
Finally, the ever-changing landscape of insurance issues plays a role... in my opinion, way too big a role in decision making. In fact, I feel patients should not- not ever- make a decision to see a rheumatologist based on whether the physician “participates in their insurance plan” or not. The reason is that insurance plans do not pay a good physician what they are worth. If you value your health enough to get better, to feel less pain, to avoid crippling, then you owe it to yourself to see the best specialist, not the cheapest, and not just the one who “participates in your insurance plan.”
Dr. Wei (pronounced “way”) is a board-certified rheumatologist and Clinical Director of the nationally respected Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine and has served as a consultant to the Arthritis Branch of the National Institutes of Health. He is a Fellow of the American College of Rheumatology and the American College of Physicians. For more information on arthritis and related conditions, go to: http://www.arthritis-treatment-and-relief.com
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