Arthritis

Are symptoms side effects of arthritis drug?

Q . I have arthritis in the lower back, I was taking diclofenic for a few years but found I was getting a lot of side effects- diarrhoea, itching etc. I was put on vioxx with the same results. Since I stopped taking them I am back to normal. I now have ringing in my ears and I am always sneezing and stuffy. Is this a side effect of the drugs?What can I do about it?

A. Arthritis and the side effects of the drugs used for treatment are as the devil and the deep blue sea. Like all drug treatments you are trying to balance the positive effects of reducing pain against the unwanted and often significant actions of the drug. Dizziness is recognised as an adverse effect of Vioxx but neither appear to cause tinnitus (ringing in the ears). Arthritis on the other hand may sometimes produce this irritating and distressing condition. Most drugs do not have permanent side effects and the adverse reaction usually disappears once the drug has been discontinued. A referral to the local ENT department could be useful to check out your sinuses as polyps can sometimes cause excessive sneezing and 'stuffiness'.

Arthritis with ischaemic heart disease

Q . I suffer from ischaemic heart disease and osteoarthritis mainly in my knees, but also on my wrists, but my knees cause the most pain. I have asked my doctors about replacement knee surgery but they say the anaesthesia would be very dangerous. Could this surgery be carried out by using an epidural injection?

A. You have two common conditions. The answer to the epidural anaesthetic question is that the evidence shows that side effects from a general anaesthetic or an epidural are the same but if it becomes absolutely essential to have a total knee replacement (TKR) then the epidural would be a likely option. BUT you should be able to help your knees by non-pharmacological means.

Firstly, buy some inner soles for your shoes called Sorbithane* which essentially act as shock absorbers. These can be obtained from sports shops (not shoe shops) and cost approximately £14. Use a walking stick in the hand which is on the opposite side of the body to your worst knee. These two measures will decrease your pain by at least

twenty-five per cent and allow some joint repair to take place. Please also do some exercise; do go out and walk as this will help both your joints and your heart.

*Sorbithane inner soles come in two types:

1. an arch support. This is fairly deep and cannot be accommodated in some shoes, as it may push your heel too far out of the shoe.

2. a thin support. This can usually be accommodated inside most footwear.