Doctor Biehl

Arthritis

spine_arthritis

Osteoarthritis (OA)

Doctor Biehl has been treating arthritis for years. Osteoarthritis is the most common form of arthritis and a leading cause of disability worldwide. OA affects more women than men and is more common in older age groups. In OA, the cartilage covering the bone ends gradually wears away. In many cases, bone growths called "spurs" can develop in osteoarthritic joints. The joint inflammation causes pain and swelling. Continued use of the joint produces pain. It is often more painful in weightbearing joints such as the knee, hip, and spine than in the wrist, elbow, and shoulder joints. All joints may be more affected if they are used extensively in work or sports, or if they have been damaged from fractures or other injuries. There are several differences between an OA joint and an aging joint. The water content of cartilage in an aging joint does not change significantly. In a joint with OA, the water content increases early in the disease process. The biological changes in the cell that occur with OA cause physical, chemical and other changes that are not seen in the aging joint. OA causes changes in the bone below cartilage (subchondral bone) that do not occur in an aging joint. It's still not clear whether OA is a single disease or many disorders with a similar final outcome. Osteoarthritis in all its various forms appears to have a strong genetic connection. There are other risk factors as well that can increase a person's risk of developing OA. These include:
1) Obesity. Generally, the more weight a person carries, the greater the pressure on weight-bearing joints of the body.
2) Aging. As people age, cartilage normally is less able to repair itself.
3) Nutrition. Calcium and vitamins C and D are needed to build strong bones. Investigators are researching whether an insufficiency of these vitamins may contribute to developing OA in later life..
4) Injury or deformity in a joint. There is an increased risk of developing OA in a joint that is not properly aligned or one that has been injured.
5) Occupational factors. Repetitive tasks, overworking the joints and overtiring muscles that protect a joint increase the risk for OA in that joint.


Rheumatoid Arthritis

rheumatoid_handsRheumatoid arthritis is a long-lasting disease that can affect many parts of the body, including the joints. In rheumatoid arthritis, the joint lining swells, invading surrounding tissues, and producing chemical substances that attack and destroy the joint surface. This commonly occurs in joints in the hands and feet. Larger joints such as hips, knees, and elbows also may be involved. Swelling, pain, and stiffness are usually present even when the joint is not used. Rheumatoid arthritis can affect people of all ages, even children. However, more than 70 percent of people with this disease are over 30 years old. Many joints of the body may be involved at the same time.

How is athritis diagnosed?

Doctor Biehl is an expert in the diagnosis and treatment of arthritis. He will evaluate symptoms, perform a physical examination, and X-rays, which are important to show the extent of damage to the joint. Blood tests and other laboratory tests may help to determine the type of arthritis. At present, most types of arthritis cannot be cured. Researchers continue to make progress in finding the underlying causes for the major types of arthritis. In the meantime, orthopedic surgeons, working with other physicians and scientists, have developed many effective treatments for arthritis. Dr. Biehl's goals for treatment are: to provide pain relief, increase motion, and improve strength. There are several kinds of treatment:
Medications - Many over-the-counter medications, including aspirin, ibuprofen, and naproxen (common nonsteroidal anti-inflammatory drugs, NSAIDS) may be used to effectively control pain and inflammation in arthritis. Acetaminophen (Tylenol) may be used to effectively control pain. Prescription medications also are available if over-the-counter medications are not effective. Dr. Biehl chooses a medication by taking into account the type of arthritis, its severity, and the patient's general physical health. Injections of liquid cortisone directly into the joint may temporarily help to relieve pain and swelling. If cortisone fails he may try viscosupplementation injections.
Joint protection - Canes, crutches, walkers, or splints may help relieve the stress and strain on arthritic joints. Learning methods of performing daily activities that are the less stressful to painful joints also may be helpful. Certain exercises and physical therapy (such as heat treatments) may be used to decrease stiffness and to strengthen the weakened muscles around the joint.
hip_replacementSurgery - In general, Dr. Biehl will perform surgery for arthritis when other methods of nonsurgical treatment have failed to give relief. Dr. Biehl and the patient will choose the type of surgery by taking into account the type of arthritis, its severity, and the patient's physical condition. Surgical procedures include: arthroscopy, realignment of the joints, total joint replacement, and fusion of the bone ends of a joint to prevent joint motion and relieve joint pain.

In most cases, persons with arthritis can continue to perform normal activities of daily living. Exercise programs, anti-inflammatory drugs, and weight reduction for obese persons are common measures to reduce pain, stiffness, and improve function. In persons with severe cases of arthritis, orthopedic surgery can often provide dramatic pain relief and restore lost joint function. A total joint replacement, for example, can usually enable a person with severe arthritis in the hip or the knee to walk without pain or stiffness. Some types of arthritis, such as rheumatoid arthritis, are often treated by a team of health care professionals. These professionals may include rheumatologists, physical and occupational therapists, social workers, rehabilitation specialists, and orthopaedic surgeons. Doctor Biehl is a medical doctor, board certified, board re-certified fellowship trained orthopedic surgeon with extensive training in the diagnosis and nonsurgical and surgical treatment of the musculoskeletal system, including bones, joints, ligaments, tendons, muscles and nerves.

Test Your Arthritis Knowledge

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