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Pseudogout (Imitation Gout) |
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What can you do about pseudogoutIf your doctor thinks you have pseudogout, he or she will usually refer you to a rheumatologist (pronounced room-a-tol-o-jist). A rheumatologist is a doctor who has received special training in the diagnosis and treatment of problems with joints, muscles and bones.
There is no cure for pseudogout but there are things you can do to lessen your pain and maintain your movement and function.
Learn as much as you can about this disease. Speaking with people who are specialists in arthritis care can provide you with the information you need.
Establishing the correct diagnosis is very important because something can be done to manage most forms of arthritis, and most therapies work best when started early in the disease. Your doctor may be able to diagnose that you have pseudogout based on a review of your medical history and a physical examination. Certain other tests may be ordered by your doctor to confirm the diagnosis, to determine if joint damage exists, or to distinguish between different types of arthritis. These tests may include x-rays, blood tests, or joint fluid tests. There is no cure for pseudogout but there are steps you can take to reduce pain and stiffness and make movement easier. Active involvement in your prescribed treatment plan is essential.
Medicine
Non-steroidal anti-inflammatory drugs (NSAIDs - pronounced en-seds) are often used to treat pseudogout. These are a type of medication that helps reduce pain and swelling of the joints and decrease stiffness. However, they do not prevent further joint damage.
When the calcium crystals cause swelling and tissue damage within a joint, your doctor may prescribe non-steroidal anti-inflammatory drugs (NSAIDs), which can provide long-term relief from chronic pain and inflammation. NSAIDs reduce pain when taken at a low dose, and relieve inflammation when taken at a higher dose. NSAIDs such as ASA (Aspirin, Anacin, etc.) and ibuprofen (Motrin IB, Advil, etc.) can be purchased without a prescription. Examples of NSAIDs that require a prescription include Naprosyn, Relafen, Indocid, Voltaren, Feldene, and Clinoril. The various NSAIDs and Aspirin¨, if taken in full doses, usually have the same levels of anti-inflammatory effect. However, different individuals may experience greater relief from one medication than another. Taking more than one NSAID at a time increases the possibility of side effects, particularly stomach problems such as heartburn, ulcers and bleeding. People taking these medications should consider taking something to protect the stomach, such as misoprostol (Cytotec).
For severe pain and swelling, your doctor may remove fluid from the affected joint. He or she may also inject cortisone into the affected joint. Cortisone is a steroid that reduces inflammation and swelling. An occasional cortisone injection into an infected joint or tendon brings short-term relief.
By removing fluid from the affected joint your doctor can remove some of the crystals that cause the swelling. However, some crystals will still remain in the joint. Your doctor may also inject a powerful anti-inflammatory drug, called a corticosteroid, directly into the affected joint. Cortisone is a steroid that reduces inflammation and swelling. It is a hormone naturally produced by the body. Corticosteroids are man-made drugs that closely resemble cortisone. An injection can provide almost immediate relief for a tender, swollen and inflamed joint. However, this treatment can only be used rarely, since corticosteroids can weaken the cartilage and remove the minerals from (and therefore weaken) the bone, resulting in further joint weakness.
Exercise
Exercise helps keep the muscles strong around a joint. Not using a sore joint will cause the muscles around it to become weak, resulting in pain.
Exercise can also help you maintain a healthy weight, which puts less strain on your joints.
Once the swelling of pseudogout has settled down you should do stretching exercises to help keep the muscles strong.
Low impact exercises such as swimming, bicycling, water aerobics and walking will give you energy, strengthen your heart and help you control your weight.
Muscles and the other tissues that hold joints together weaken when they aren't moved enough, so the joint loses its shape and function. Moderate stretching exercises will help relieve pain and keep the muscles and tendons around the affected joint more flexible and strong. Low-impact exercises like swimming, walking, water aerobics and stationary bicycling can all reduce pain while maintaining your strength and flexibility. Always consult your doctor before beginning an exercise program.
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Heat/Cold
Applying heat helps relax aching muscles, and reduces pain and soreness. For example, take a hot shower.
Applying cold helps to lessen the pain and swelling. For example, put an ice pack on the area that is sore.
Heat or cold application can provide temporary relief of pain. Heat helps to reduce pain and stiffness by relaxing aching muscles and increasing circulation to the area. There is some concern that heat may worsen the symptoms in an already inflamed joint. Cold helps numb the area by constricting the blood vessels and blocking nerve impulses in the joint. Applying ice or cold packs appears to decrease inflammation and therefore is the method of choice when joints are inflamed.
Protect Your Joints
Be kind to your body. After doing heavy work, or doing the same task over and over, stop. Slow down by doing an easy task, or by taking a rest.
Use your back, arms and legs in safe ways to avoid putting stress on joints. For example, carry a heavy load close to your body.
Use helpful devices such as a cart to carry your grocery bags, or an enlarged handle that fits over a knife handle so you can hold it easily. A cart will help you to walk more safely. A grab bar, which attaches to a shower, will help you to get in and out of the tub more easily.
Maintain a healthy weight to avoid putting extra stress on your joints.
To protect your joints means using them in ways that avoid excess stress. Benefits include less pain and greater ease in doing tasks. Three main techniques to protect your joints are:
Pacing, by alternating heavy or repeated tasks with easier tasks or breaks, reduces the stress on painful joints and allows weakened muscles to rest.
Positioning joints wisely helps you use them in ways that avoid extra stress. Use larger, stronger joints to carry loads. For example, use a shoulder bag instead of a hand-held one. Also, avoid keeping the same position for a long period of time.
Using helpful devices, such as canes, luggage carts, grocery carts and reaching aids, can help make daily tasks easier. Small appliances such as microwaves, food processors and bread makers can be useful in the kitchen. Using grab bars and shower seats in the bathroom can help you to conserve energy and avoid falls.
Staying at your recommended weight or losing weight helps reduce the stress placed on weight-bearing joints that are sometimes affected by pseudogout, such as the knee and ankle. If you plan to lose a lot of weight, discuss the best program for you with your doctor and a dietician.
Relaxation
Relaxing the muscles around an inflamed area reduces pain.
There are many ways to relax. Try deep breathing exercises. Listen to music or relaxation tapes. Meditate or pray. Another way to relax is to imagine or visualize a pleasant activity such as lying on a beach, or sitting in front of a fireplace.
Developing good relaxation and coping skills can give you a greater feeling of control over your arthritis and a more positive outlook.
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