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Pain Management in Rheumatic Diseases

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Acupuncture

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Traditional Chinese technique that may help relieve pain in some patients with rheumatologic conditions. Efficacy is variable.

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Acetaminophen

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Used for pain relief in osteoarthritis. Less effective for inflammation. Overdose can lead to liver damage.

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Hydrotherapy

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The use of water exercises to improve mobility and relieve pain. Beneficial in conditions like osteoarthritis and rheumatoid arthritis.

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Calcium Channel Blockers

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Primarily used in Raynaud's phenomenon to dilate blood vessels and reduce frequency and severity of attacks.

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Biologic Response Modifiers

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Target specific pathways in the immune system to control inflammatory processes in diseases like rheumatoid arthritis. Risk of infection.

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Corticosteroids

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Potent anti-inflammatory agents used for flare-ups in rheumatoid arthritis and lupus. Long-term use can lead to significant side effects.

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Mindfulness and Meditation

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Stress-reduction techniques that can help patients cope with chronic pain in rheumatic diseases.

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Heat Therapy

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Application of heat can relieve stiffness and pain, particularly in osteoarthritis. Must be applied carefully to avoid burns.

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NSAIDs

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Reduce inflammation and alleviate pain in conditions like rheumatoid arthritis and osteoarthritis. Risk of GI bleeding must be considered.

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Antidepressants

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Certain antidepressants like tricyclics can be used off-label for pain control in fibromyalgia and neuropathic pain in rheumatic conditions.

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Yoga

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Can help manage pain and improve flexibility and strength in patients with rheumatic conditions. Should be performed with proper guidance.

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Cold Therapy

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Application of cold can reduce swelling and numb pain. Particularly useful during inflammatory rheumatic disease flares.

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Glucosamine and Chondroitin

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Dietary supplements used in the management of osteoarthritis. Evidence of benefit is inconclusive.

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Joint Injections

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Injection of corticosteroids or hyaluronic acid directly into the joint can provide pain relief in conditions like osteoarthritis.

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COX-2 Inhibitors

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Provide anti-inflammatory effects similar to NSAIDs but with less gastrointestinal side effects. Used for patients with high risk of GI issues.

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Biofeedback

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Technique that trains individuals to control physiological processes. Can help manage pain through relaxation and stress-reduction.

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DMARDs

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Disease-modifying antirheumatic drugs used to slow disease progression in rheumatoid arthritis. Regular monitoring needed due to potential toxicities.

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Cognitive Behavioral Therapy (CBT)

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A psychological intervention that helps patients manage chronic pain by changing thought and behavior patterns.

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Opioids

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Used for severe pain management when other treatments fail. Risk of dependence and side effects.

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TENS

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Transcutaneous electrical nerve stimulation can reduce pain by interrupting pain signals. Useful adjunct in osteoarthritis and fibromyalgia.

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Topical Analgesics

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Local application can provide pain relief with minimal systemic side effects. Used in osteoarthritis and localized musculoskeletal pain.

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Muscle Relaxants

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Used to relieve muscle spasms which can contribute to pain in rheumatic conditions. Drowsiness is a common side effect.

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Capsaicin Cream

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Provides a mild to moderate analgesic effect by depleting substance P in nerve endings. Useful in hand and knee osteoarthritis.

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Tai Chi

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A gentle form of martial arts that can help improve balance, flexibility, and pain management in rheumatic conditions.

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Physical Therapy

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Improves joint movement and strength to reduce pain and increase function in rheumatic diseases like osteoarthritis.

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