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Have degenerative arthritis of neck and shoulders. Painful wrists and taking hydrocodone. Still painful. What do you recommend?

Jul 2013
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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 1996
Answered : 2148 Questions
I have degenerative arthritis of the neck and shoulders, that radiate down the arms. The wrists are now afflicted with lots of pain. I have been prescribed hydrocodone w/acetiminophen since last November, 2012. It does help with the pain. What's your take?
Posted Wed, 20 Nov 2013 in Bones, Muscles and Joints
Answered by Dr. K. Naga Ravi Prasad 12 minutes later
Brief Answer: Conservative management is the initial option. Detailed Answer: Hi, thanks for writing to XXXXXXX For degenerative arthritis affecting any joint, conservative management is the primary option which comprises of - * PHYSICAL THERAPY : The mainstay of treatment in the early case is physical therapy, which should be directed at maintaining joint mobility and improving muscle strength. Exercise can strengthen your muscles, which can help keep your joints more stable, and the stronger muscles help to absorb energy and protect the joint surface. Stick to gentle exercises, such as walking, biking or swimming. Other measures, such as massage and the application of warmth, may reduce pain. * USE OF HEAT & COLD : Both heat and cold can relieve pain in your joint. Heat also relieves stiffness, and cold can relieve muscle spasms and pain. * OVER THE COUNTER PAIN CREAMS : Local massaging with creams and gels may provide temporary relief from osteoarthritis pain. Some creams numb the pain by creating a hot or cool sensation. Other creams contain medications, such as aspirin-like compounds, that are absorbed into your skin. Pain creams work best on joints that are close to the surface of your skin, such as your knees and fingers. * GLUCOSAMINE & CHONDROITIN SULFATE : Daily intake of Glucosamine & chondroitin supplements over a period of 3-4 months will help in reducing the arthritic pains and thereby decreases the necessity to take daily analgesic medications. Research suggests that vitamins C and D may help protect you against the progression of osteoarthritis. * ANALGESIC MEDICATION : Simple over the counter medications like acetaminophen is sufficient in most cases. If this fails to control pain, a non-steroidal anti-inflammatory drug may be better. It seems from your description that you also suffer from cervical spondylosis. The conservative management of this problem includes - Soft Collar: Soft collar allow the muscles of the neck to rest and limit neck motion. This can help decrease pinching of nerve roots with movement. Soft collars should only be worn for short periods of time, because long-term wear can decrease the strength of neck muscles. Medicines: Analgesic are needed in the acute phase. Muscle relaxants are essential for relieving muscle spasms once the acute pain subsides. Neurotropic vitamins like METHYLCOBALAMINE (activated Vit B12) or PREGABALIN will help in alleviating the neuropathic pain. Cervical traction: may enlarge the disc space, permitting the prolapse to subside. Intermittent cervical traction for not more than 30 minutes at a time. Physiotherapy: Once the acute phase of pain has subsided, Isometric strengthening exercises of the paravertebral muscles are started. Improving neck strength and flexibility with simple exercises may lessen discomfort and pain. Moist heat can be useful Hope I have addressed your query. Happy to help further Regards
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