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Wendy from the UK asks: Does the treatment of Polymyalgia Rheumatica with steroids prevent Giant Cell Arteritis?
Polymyalgia rheumatica (PMR) and giant cell arteritis, otherwise known as GCA or temporal arteritis, are distinct condition that may present at the same time. Many patients with GCA also will present with PMR, while a smaller proportion of patients with PMR present with GCA. While the treatment for both starts the same – glucocorticoids – the doses are very different. PMR is treated with low dose prednisone, while GCA initially requires high dose prednisone. That said, once on prednisone, the risk of developing GCA, and particularly loss of vision from GCA, drops significantly.
Donna from Calgary asks: I have been diagnosed with osteoarthritis, and experience a lot of pain in my shoulders , lower back , knees and hands. My question is what medications can I take that won’t harm my kidney? I’ve had a lot of cortisone shots but was told I may not be able to have that much longer. I just not sure what to do at this time.
The focus for management of osteoarthritis is around improving function and reducing pain. Of course, we want to reduce pain in the safest way possible, and the safest way is different for different people. For most people, acetaminophen (Tylenol) is one of the safest pain relievers. While most individuals will use acetaminophen when the pain is worst, for those with chronic pain, acetaminophen is more effective when used on a regular basis to prevent pain flares, never using more than recommended on the bottle. Anti-inflammatories (NSAIDs) arguably may be more effective, but do have other side effect concerns, and should be avoided for those with kidney problems. Topical anti-inflammatories are available which are likely safe even for those with kidney problems. Cortisone injections are a safe option as well and certainly there is no limit how long you can have cortisone injections, as long as they are effective.
Finally, often forgotten but perhaps most important is the role for physical and occupational therapy. Maintaining range of motion and muscle strength is an important part of management of osteoarthritis, and by its very nature is safe.
Patti from Sherwood Park asks: I have osteoarthritis of my thumb. I have tried NSAIDs and glucosamine, and am thinking about trying Sierra Sil. Any suggestions?
Osteoarthritis to the base of the thumb is a common spot to have osteoarthritis. Treatment is aimed at managing symptoms and improving function. Because of this, treatment options that works well for one person may not be as effective for the someone else. We cover many treatment options on our page for osteoarthritis, but one could consider acetaminophen, NSAIDs, a splint, physiotherapy, topical anti-inflammatories, and/or a cortisone injection, amongst other options. In terms of natural products, please visit our pages on glucosamine, Sierra Sil, and other available natural health products to review them for yourself.