With apologies to George Gershwin, I thought it might be nice to review with you the importance of the circadian rhythm in rheumatoid arthritis. I am often asked by my patients why they have more pain and stiffness in the morning. After all, I never ask about "evening stiffness." It's always morning stiffness on my mind when I ask a patient how he or she is doing. It appears that this is related to the circadian rhythm, which refers to the 24-hour biological cycles we all have, and which includes variations in hormone and nervous system activity. These variations in turn have a significant impact on disease, and thus the types of complaints a patient might have in the course of a day. In past blogs I have written about the anti-tumor necrosis factor (TNF) drugs such as Enbrel , Humira and Remicade . And I have written about the anti-interleukin (IL)-6 drug Actemra . TNF and IL-6 are biochemicals which cause inflammation that leads to rheumatoid a...
Stiffness in a joint; Pain - joints; Arthralgia
Follow prescribed therapy in treating the underlying cause.
For nonarthritis joint pain, both rest and exercise are important. Warm baths, massage, and stretching exercises should be used as frequently as possible.
Anti-inflammatory medications may help relieve pain and swelling. Consult your health care provider before giving aspirin or NSAIDs such as ibuprofen to children.
Call your health care provider if
Contact your health care provider if:
You have fever that is not associated with flu symptoms
You have lost 10 pounds or more without trying (unintended weight loss)
Your joint pain lasts for more than 3 days
You have severe, unexplained joint pain, particularly if you have other unexplained symptoms
What to expect at your health care provider's office
Your health care provider will perform a physical exam and ask you about your medica...
What can be done about joint stiffness after a total knee replacement (TKR)? When all else fails, the implant can be revised. But does this really solve the problem? That's what researchers at the Florida Orthopedic Institute report on in this study. Sixteen knees were revised based on patients' complaints of pain and stiffness. Everyone had efforts made to restore motion before revision, including a trial of physical therapy. Some had the joint stretched or manipulated under anesthesia. Several had release of scar tissue by arthroscopic surgery. In the end, implants in all the knees were changed. The surgeon decided at the time of the operation what to remove and what to use as a replacement. Dense scar tissue was seen in all the patients. Continuous passive motion machines were used after the revision surgery. And everyone had physical therapy. Data showed two-thirds of the patients were happy with the results. They had less pain, more motion, and greater knee function. The remaining p...
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