Arthritis treatment needed for pain in hands
DEAR DR. ROACH: I would like to know how to treat arthritis. I have been using Voltaren per my doctor's orders, but it does not seem to be helping much. I have also been taking ibuprofen, but I am afraid of stomach bleeding. The arthritis is in my wrists and thumb. I can hardly open a doorknob or lift any small objects. Does turmeric help?
I would appreciate any advice you can give me. It is hard to do any cooking or housework using my hands. They ache and throb all day. -- M.V.
ANSWER: There are several different types of arthritis of the hand, and it sounds as though your doctor has made the diagnosis of osteoarthritis, which is the most common type. Rheumatoid arthritis and psoriatic arthritis are inflammatory varieties that require very different therapies. Blood testing and X-rays help separate the different types of arthritis from one another if your history and physical exam indicate the need.
If you have osteoarthritis, oral anti-inflammatory medicines like Voltaren or ibuprofen (but NEVER both -- taking two different NSAIDs orally adds only toxicity, not effectiveness) are common and often effective treatments. Voltaren is also available as a gel, and it's OK to use both Voltaren gel and a different oral NSAID such as ibuprofen. The gel is poorly absorbed into the body and is very unlikely to have systemic side effects.
However, remember that exercise improves pain and function. One set of exercises specifically for hand arthritis from the Mayo Clinic can be found at tinyurl.com/mayo-hand.
You asked about turmeric. There are studies showing benefit for turmeric and it has little toxicity, so I think it is worth a try. Similarly, Boswellia supplements have shown benefit in some people with osteoarthritis.
DEAR DR. ROACH: I am a senior citizen with a history of glaucoma. My right eye has clouded up over time, but I still have vision in it. Is there any way I can cut down or eliminate the cloudiness? My doctor says there is not. Second opinion, please! -- D.S.
ANSWER: Glaucoma is a disease of the retina. There are several different types of glaucoma, and I am only going to consider open-angle glaucoma in adults.
The major risk factor for open-angle glaucoma is elevated pressure inside the eye, although glaucoma can happen even with normal intraocular pressures. Glaucoma is more common in older people, Black people, those with diabetes or high blood pressure and those with a family history. Without treatment, glaucoma will lead to vision loss, initially in the peripheral vision, and may eventually lead to total blindness. Glaucoma is the second leading cause of blindness in the world (after cataracts).
Treatment for open-angle glaucoma is to reduce the pressure, usually through medication applied to the eye via drops.
In general, vision loss from glaucoma is irreversible. That's why it is so important to diagnose and treat glaucoma early, ideally before much damage is done to the retina. Treatment is aimed at preventing or at least reducing further damage. A regular eye exam can identify people with elevated intraocular pressure. Those people can then be closely monitored, or even treated, to prevent or delay damage to the retina.