If you suffer with Arthritis, you will no doubt have heard of the drugs under the classification of Steroids, Narcotics, DMARDS and Biologics. All these types of medications are prescribed to those who suffer from the pain of arthritis and carry with them benefits and risks that patients and their doctors should discuss before a pain management plan is put into action.
Used to reduce swelling, inflammation and the associated pain, Steroids are a strong anti-inflammatory medication. Often sufferers of both osteoarthritis and rheumatoid arthritis may be given steroid injections directly into the painful joint to relieve pain in that joint. Steroids are commonly prescribed in tablet form to give temporary relief of the symptoms of "flare-ups" for rheumatoid arthritis sufferers. This medication is available in different strengths, with lower doses being taken over a longer term to help maintain the occurrence of inflammation and pain. The use of steroids can make a big difference in the quality of life especially for those suffering from rheumatoid arthritis.
The risks associated with long-term use of steroids need to be weighed up against the benefits. Effects such as increased risk of infections and an increase in blood sugar levels are quite common. Extended use of steroids can also result in thinning of the bones. Usually doctors will prescribe the use of steroid pills for short-term use to avoid these side effects. Steroid injections carry a lower risk for side effects and can be used for longer time periods.
Narcotics work by controlling pain by disabling the nerve cell pain receptors. Doctors may prescribe prescription narcotic pain relievers such as codeine, fentanyl, morphine or oxycodone for the relief of severe arthritis pain. Although Narcotics are not commonly prescribed for pain relief for arthritis suffers, in cases where the patient is so debilitated by pain that they are unable to move they may be the answer to assist with regaining mobility. Mobility is very important in the management of pain for arthritis sufferers. The reason narcotics are not used more often is that there are a lot of side effects when using them. Narcotics tend to cloud the thinking processes of people who take them. Constipation is another common side effect to narcotic usage.
DMARDs (Disease Modifying Anti-Rheumatic Drugs) are used to prevent the joint damage that inflammation causes in rheumatoid arthritis patients. Methotrexate is a commonly prescribed DMARD. These medications usually take weeks before there is any noticeable effect on the patient so it is usual for pain relievers like steroids to be prescribed until the DMARDs take effect.
The use of DMARDs can drastically improve the lifestyle of patients with rheumatoid arthritis.
As with most medications there is a risk with using DMARDs. DMARDs work by suppressing the immune system and as a result patients are more susceptible to infections while using this particular medication therapy. They are also at increased risk for liver issues, low blood count occurrences and a slightly increased risk of certain cancers. It is widely recommended that regular blood tests be done so the doctor can be aware of any changes in blood count and organ functions.
It is usual when undertaking any medication therapy that the doctor will explain the risks of such therapy to the patient and together they can weigh up the benefits against the risks. Other illnesses the patient may be experiencing will also be taken into consideration when using medication such as DMARDs. If the disease is progressive and creates a current or future risk of disability without the treatment than that is a major consideration. Quality of life is extremely important and the decision to proceed with DMARDs medication therapy must be weighed seriously against other pain management alternatives.
Biologics (Biological Response Modifiers) are a more aggressive medication therapy that is used to slow down the progression of rheumatoid arthritis. Biologics are used when DMARDs therapy is no longer helpful. There are a few Biologics approved for arthritis pain relief such as Enbrel, Kineret, Orencia, Humira, Rituxan and Remicade.
Biologics can affect part of the immune system unlike DMARDs that can affect the entire immune system. Biologics are designed to inhibit or supplement different components of our immune system.
Biologic medications are given by either injection or by intravenous infusion (IV). The IV method can take up to 2 hours to receive the entire dosage.
Long-term effects are unknown at present as results of studies have only been available for about 10 years. However, it is known that biologics can cause diseases that have been in remission to flare-up again such as tuberculosis and other chronic diseases. It is also unadvisable for people under the age of 50 to use this type of medication therapy.
In summary; although many of the types of medication discussed here can and do have their risks, it must be remembered that people suffering with the debilitating pain associated with many arthritis diseases, have very little choice when it comes to pain relief. Pain in itself can cause other problems such as depression, therefore the decision to undertake this type of medication therapy becomes the lesser of two evils. This is why it is so important to fully understand the benefits and risks associated with drug therapy and to discuss all options and concerns with a medical professional, thus enabling the patient to make an informed decision.