Morning stiffness

Gold suppresses or prevents but, but does not cure, arthritis and synovitis. The therapeutic effects from gold compounds occur slowly. Early improvement is often limited to reduction in morning stiffness. The full effects of gold therapy are not known for 6 to 8 weeks or in some cases after 6 months of therapy. 

Morning stiffness Usually greater than or equal to 60 minutes Usually less than 30 minutes... 

Before starting treatment for RA, assess the subjective and objective evidence of disease. For joint findings, this includes the number of tender and swollen joints, pain, limitations on use, duration of morning stiffness, and presence of joint erosions. Systemic findings may include fatigue and the presence of extraarticular manifestations. Obtain laboratory measurements of CRP and ESR. The impact of the disease on quality of life and functional status is also important. 

For knee OA, a patient must have knee pain and radiographic osteophytes in addition to one or more of the following (1) age greater than 50 years, (2) morning stiffness of 30 minutes or less duration, or (3) crepitus on motion, (4) bony enlargement, (6) bony tenderness, or (7) palpable joint warmth. 

Morning stiffness in and around tire joints lasting at least I hour before maximal improvement. 

Symptom improvement includes reduction in joint pain and morning stiffness, longer time to onset of afternoon fatigue, and improvement in ability to perform daily activities. 

A number of studies in humans show that PUFAs can generate significant immunomodulatory effects. Generally, these studies have utilized considerably lower amounts of fish oil to treat subjects than found in most animal studies. Numerous clinical trials have examined the effects of fish oil on rheumatoid arthritis and many have reported statistically significant benefits such as decreased morning stiffness and numbers of tender joints [57]. Several other studies have reported that PUFAs can provide therapeutic benefits for patients with IgA nephropathy, the most common primary human glomerulonephritis... 

In patients who have persistent night pain or morning stiffness, giving a large portion, up to a maximum of 100 mg of the total daily dose at bedtime, may help to relieve pain. The total daily dose should not exceed 200 mg. 

Rheumatoid arthritis Tender, swollen joints, visual analogue scale for pain acute phase reactants (ESR, C-reactive protein), duration of early morning stiffness, preservation of function... 

It is a NSAID with pronounced antirheumatic, antiinflammatory, analgesic and antipyretic properties. Inhibition of prostaglandin biosynthesis is fundamental mechanism of action. In rheumatic diseases, it leads to marked relief from pain at rest, pain on movement, morning stiffness and swelling of the joints, as well as by an improvement in function. 

Morning stiffness Morning stiffness in and around the joints, lasting at least 1 hr before maximal... 

Walsh JK, Muehlbach MJ, Lauter SA, Hilliker NA, Schweitzer PK. Effects of triazolam on sleep, daytime sleepiness, and morning stiffness in patients with rheumatoid arthritis. J Rheumatol 1996 23 245-252. 

The results of clinical studies suggest that therapy with dietary eicosapentaenoic acid decreases both morning stiffness and the number of tender joints in patients with rheumatoid arthritis and erythema associated with psoriasis. The efficacy of dietary eicosapentaenoic acid approximates that of the NSAIDs. These preliminary results and the near absence of significant adverse effects suggest that dietary alteration or supplementation to provide 1-4 g/d of eicosapentaenoic acid may be a beneficial addition to conventional treatment of rheumatoid arthritis. 

Overall, research with GLA-containing oils has shown that GLA provides benefit in the reduction of morning stiffness by about 73 minutes and exerts a NSAID-sparing effect. However, the dosage of GLA required for the treatment of arthritis is not well established as, in various studies, from 340-mg to 2.8-g GLA per day has been used. 

In a crossover study, 66 patients took 50 mg doxycychne or placebo twice a day for 12, 24, or 36 weeks (23). Patients assessments, swollen and tender joint counts, duration of morning stiffness, erythrocyte sedimentation rate, and the so-called modified disease activity score (25)... 

HPI SM is a 35-year-old woman with a diagnosis of rheumatoid arthritis (RA). She suffers from morning stiffness, fatigue, and generalized muscle and joint pain. She has had to limit her physical activity and is unable to wear her rings because of finger swelling. Her current treatment plan includes education and physical therapy. 

Which explanation do you think will help the patient to remember It is a fact that if a patient understands the reasons for doing something they are far more likely to be compliant. It is human nature. The pharmacist had planned what was to be said to the patient and the comment regarding morning stiffness showed that this pharmacist had taken the time to develop a rapport with the patient previously. 

Other symptoms—other common symptoms of FM include chest pain, morning stiffness, cognitive or memory impairment, dizziness, impaired coordination, numbness and tingling sensations, irritable bladder, twitching, dry eyes or mouth, and skin sensitivities. 

The method of summated ratings can be shown readily using the index of disease activity (IDA) for rheumatoid arthritis proposed by Mallya and Mace. Six aspects of the patient s condition are assessed (morning stiffness, pain, grip strength, articular index, haemoglobin and the one hour erythrocyte sedimentation rate) and points are assigned to the values of each of these on a scale of 1 (the best situation) to 4 (the worst possibility). 

Aching and morning stiffness of neck, shoulder, and pelvic girdle musculature and torso. 

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