All things arthritis
Since late stage Osteonecrosis leads to severe osteoarthritis I feel they are under the same umbrella although different in some ways and the same in other ways.
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Tag: treatment
Osteonecrosis and Organ transplant
Osteonecrosis is a well-recognized complication associated with organ transplantation.
It is a pathological condition characterized by the death of the cellular constituents of bone and marrow. The process of aseptic bone necrosis is associated with glucocorticoid use, and the mechanism by which glucocorticoids initiate the pathologic process has recently been elucidated.
Rates are particularly high in patients with systemic lupus erythematosus. The incidence of osteonecrosis also increases in patients on dialysis.
The exact prevalence of osteonecrosis after organ transplantation is, however, difficult to assess as many cases are clinically silent.
The most common symptom of osteonecrosis is hip pain that is usually deep in nature, localized to the groin with occasional radiation down the thigh to the knee.
Symptoms are usually exacerbated by physical activity and weight bearing and relieved by rest. In the late stages of osteonecrosis, pain is often present at rest, and patients may develop a limp, as they are no longer able to bear weight on the affected joint.
Osteonecrosis affecting the bone beneath a weight-bearing joint surface is associated with a significant risk of developing a subarticular fracture, which appears to initiate the symptoms.
Optimizing the dose of glucocorticoids has led to a significant reduction in the incidence of osteonecrosis post-transplantation. Substituting these agents entirely with calcineurin inhibitors may decrease this complication of the transplantation process even further. Early diagnosis using magnetic resonance imaging is essential for the success of available surgical interventions
Reference: https://www.sciencedirect.com/science/article/pii/B9780121835026500213
https://online.boneandjoint.org.uk/doi/full/10.1302/0301-620x.89b12.19400?journalCode=bjj&
Thank You Proud Moment
Thank you to Youngstown Ohio Mayor Jamael Tito Brown and Senator Michael Rulli and Senate President Larry Obhof
What an honor
Help me raise awareness today and please like and share this post.
Thank You.
1st annual
#AvascularNecrosis #Osteonecrosis
#AwarenessDay #November29
AvascularNecrosis/Osteonecrosis Support Int’l
https://www.vindy.com/news/local-news/2019/11/city-state-recognize-poland-woman-with-rare-disease/
What your eating can be worsening your pain
Your eating what?
Before you take one more bite of that fast food lunch or dinner consider how it affects your osteoarthritis.
I am posting this because many with Avascular Necrosis/ Osteonecrosis also end up with osteoarthritis.
Did you know that research shows that diets high in saturated fat – found in red meat, butter, cheese, lard and processed foods – can weaken knee cartilage, making it more prone to damage.
Yep so start eating more plants
There was a study in 2017 published in Arthritis Care & Research, researchers followed more than 2,000 patients with OA for up to four years, checking disease progression and diet at yearly intervals. Participants who ate the most fat, especially the saturated kind, showed increasing joint damage, whereas those who ate healthy fats like olive oil and avocados had little disease progression.
Another recent animal study showed that it even may harm the underlying bone, according to Yin Xiao, PhD, a professor at Queensland University of Technology in Australia and lead author of a 2017 study that looked at the effect of diet on OA.
“Our findings suggest that it’s not wear and tear but diet that has a lot to do with the onset of osteoarthritis,” he says.
Blame It On Inflammation
Fat’s not the only culprit, though. Sugar, refined carbs, red meat, processed food and corn and soybean oils can spark inflammation, too. Barry Sears, PhD, a long-time researcher in inflammatory nutrition, says eating them is “like throwing a match into a vat of gasoline.”
These foods also tend to pack on pounds, putting extra pressure on stressed joints. To make matters worse, body fat, especially the kind that collects around your belly, makes its own inflammatory proteins, perpetuating the cycle of inflammation even after you’ve sworn off junk food forever.
Fighting Back
The solution is to change the way you eat. Switching to an anti-inflammatory or Mediterranean-style diet can help you lose weight and significantly improve your joint, heart and brain health without sacrificing good taste.
An anti-inflammatory diet is heavy on fruits and vegetables, whole grains, fish and healthy fats like olive oil, avocados and nuts. Poultry’s allowed now and then and you can have one glass of red wine or beer a day. Off the menu, as you might expect, are sugar, red meat, and processed foods.
What sets this way of eating apart is that it actively fights inflammation, experts say.
“There are a variety of foods in the Mediterranean diet that are high in fiber, beta carotene, magnesium and omega 3s, all of which have been found to reduce inflammatory markers in human studies,” explains Michelle Babb, MS, RD, a Seattle-based nutrition educator.
“I’ve had [arthritis] patients who have been able to discontinue the use of non-steroidal anti-inflammatory drugs (NSAIDs) as a result of transitioning to a Mediterranean diet. Some even report a noticeable difference in pain in the first week.”
Even so, changing the way you eat can be daunting.
“Don’t expect your diet to change overnight,” advises Sotiria Everett, EdD, RD, an assistant professor at Stonybrook University Medical Center in New York. “Start by looking at what you’re eating now (a food diary is a great way to do this) and identifying areas where you can improve.”
But Babb doesn’t see a problem. Her patients “really enjoy this food plan and don’t feel it’s a hardship to follow it,” she says.
She admits it takes more work and advance planning than the drive-through and recommends prepping some food for the week in advance.
I personally can agree with this as when I stopped eating so much red meat and cut out sugar and most processed junk I felt much better .
And when I eat things that are not as healthy as they should be I feel more pain.
So try a plant based diet or as they suggest Mediterranean
You will be so glad you did.
This taken from article Arthritis Foundation Blog
Joint Pain
Congratulations ! If you’re like me you are one of the 30 million adults in the United States who suffer with joint pain, you know the pain often is debilitating. It can keep you from staying active and limits your mobility and it even makes daily chores seem impossible. What you might not know is that many doctors can treat joint pain with more than just pills or surgery. Beware though some doctors will tell you about one procedure and then change it once they know your insurance example Medicare I felt one doctor thought less of me as a patient because I am disabled so he changed or tried to change the procedure. It pissed me off because I was all set to get the procedure we discussed and then he changed it.
Both procedures were covered under Medicare so I felt betrayed as if I wasn’t good enough for the other injection.
Newsflash …..people on Medicare pay for the insurance they have. It’s not free , hell I pay more for insurance than when I was working.
But thankfully Medicare is good coverage. Low deductible.
It’s some doctors that treat you like a second class citizen.
Make sure this doesn’t happen to you.
Depending on the severity of your pain, injections can be another option for easing your joint pain and help to get you moving again.
Doctors use these injections to try to reduce inflammation and pain in your joints some come with side effects and some risks.
The injections range from corticosteroids, which have been around for decades, to newer ortho-biologic injections like platelet-rich plasma (PRP) , Stem Cell and placental tissue matrix (PTM)
You and your physician will decide which one is best based on your individual needs. The issue is finding doctors qualified to do these.
Not every injection is right for every patient, in my case I hate steroid injections, not only did it make my pain worse it also comes with the risk of developing osteonecrosis. Something I already have. I have noticed that it seems like doctors are quick to prescribe and inject steroids. I stand my ground and refuse. But that’s me.
So here are some facts to help you know more about the options.
Corticosteroid injections
Use: This injection is the first line of defense against osteoarthritis symptoms and other joint pain in shoulders, knees and hips. Corticosteroids can offer relief for two to three months, and reduce inflammatory cell activity in the joint. In some people.
Side effects and Risks : As with all injections, there’s a small chance of infection about one in 1,000 as well as Joint infection.
Nerve damage.
Thinning of skin and soft tissue around the injection site.
Temporary flare of pain and inflammation in the joint.
Tendon weakening or rupture.
Thinning of nearby bone (osteoporosis)
Osteonecrosis lack of blood supply to the bone
Raised blood sugar level
Whitening or lightening of the skin around the injection site
Cost: Most insurance covers the $100 -$200 usd cost of these injections. Your insurance provider may require that you try at least one corticosteroid injection first to see whether it works. If not, you may move on to a different therapy.
Hyaluronic acid injections
Use: Hyaluronic acid (HA) injections often are used when corticosteroid injections don’t work. But they usually are approved only for use in the knee.
In some instances, doctors consider an HA injection first if you don’t have obvious signs of inflammation. HA also is a better option if you have diabetes, as corticosteroids can raise blood sugar levels.
Also known as gel injections, HA injections are chemically similar to your natural joint fluid.
When you have osteoarthritis which is different than osteonecrosis lucky me I have both, the joint fluid becomes watery.
So, this injection helps to restore the fluid’s natural properties and works as a lubricant and a shock absorber.
HA is a cushion or a buffer against inflammatory cells in the joint. In some cases, it can stimulate the knee to start producing more natural HA.” Some physicians also believe that HA helps reduce pain by coating nerve endings within the joint.
One treatment, which may consist of between one and three injections, usually offers symptom relief for four to five months, but sometimes up to one years. However, pain and stiffness will return. Most insurance companies only approve one HA injection every six months.
In knees with osteoarthritis, the joint fluid (called synovial fluid) can break down and not provide the cushioning your knee needs
Durolane
Euflexxa
Hyalgan
Orthovisc
Monovisc
Supartz
Synvisc, Synvisc-One
Depending on which type your doctor uses, you may get a single shot. Or you’ll get three to five injections spaced a week apart.
Side effects: There’s a 1-in-100 chance of an inflammatory reaction, The most common short-term side effects are minor pain at the injection site and minor buildup of joint fluid. These get better within a few days.
Cost: HA injections cost more — about $300 to $850 per injection, but most insurance companies cover the cost for knee injections.
Platelet-rich plasma (PRP) injections
Use: Platelet-rich plasma (PRP) injections can treat osteoarthritis joint pain, and are being thoroughly researched to understand their effects.
These injections use your own blood and platelets to promote healing. Platelets contain growth factors and proteins that aid healing in soft tissues. Research shows PRP injections can alter the immune response to help reduce inflammation,
Side effects: Side effects include a very low risk of infection and pain at the injection site. You must stop oral anti-inflammatory medications for a short amount of time if you get a PRP injection.
Cost: Insurance companies don’t generally cover PRP injections and you will pay between $400 and $1,300 per injection out-of-pocket.
Stem Cell Injections
The world’s most advanced regenerative injection treatments for treating knee pain due to arthritis, meniscus tears, traumatic ligament injuries, overuse conditions and other degenerative conditions.
Side effects : mild discomfort associated with the procedure. There is a very small risk of infection whenever aspirations and injections are performed. Nerve damage, vessel damage, and injury to other important structures are exceedingly rare
Placental tissue matrix (PTM) injections
Use: Placental Tissue Matrix (PTM) injections can very profoundly decrease the pain related to osteoarthritis.
These are injections of placental tissue, which is obtained after a healthy baby is delivered from a healthy mother. Research has discovered that there is a large number of growth factors in placental tissue that promote healing, Dr. Genin says.
Side effects: Side effects include a low risk of infection and pain at the injection site. The placental tissue is “immune privileged,” which means the body would not have an adverse reaction to it.
Cost: Insurance companies don’t generally cover PTM injections; you will pay around $1,800 -$2500 per injection out-of-pocket.
Many of these injections often are effective in reducing or stopping your joint pain, but it’s important to remember that they may not keep the pain from returning, Dr. Schaefer says. In fact, they’re most effective when used with other therapies.
As a patient who has Osteonecrosis, Osteoarthritis, and other stuff I consider surgical options as a last resort only if other treatment options have failed. Unfortunately some treatments I cannot even afford to try. I wish the FDA would get a move on and approve some things so insurance companies can have this as a form of treatment.
Stem Cells
BONE MARROW AND FAT CELLS
The stem cells used in this point of care clinic are Autologous Cells that we take from your own body. These cells are taken from your own Bone Marrow or Fat Cells. The cells are your own Stem Cells and will not be rejected by your body.
Taking the Bone Marrow or Fat Cells from your body is relatively painless as a mild local anesthetic is used prior to harvesting. These cells are processed to receive the most stem cell gain and then injected into the area of your body where you need the growth factors to go to work the quickest. Your blood is also drawn and your platelet rich plasma is added to the Stem Cells taken from your Bone Marrow or Fat Cells to increase the activity of the growth factors.
It is important that these cells are used the day they are extracted from your body in order to insure they remain alive and active. Our clinic does not grow extra stem cells from your Bone Marrow or Fat Cells to ensure that they are alive and active. It is an FDA requirement that you receive your cells the same day they are harvested.
You get only the stem cells we extract from your body and there is no other manipulation used except extraction and preparation of the samples taken from your own body. The cells are taken in a procedure that creates only mild discomfort or none at all. Ninety nine percent of our patients experience no pain obtaining bone marrow or fat cells.
CORD STEM CELLS:
Embryo and Placenta stem cells can create certain types of cancers. The cord blood Stem Cells should only be used if they are obtained from a healthy relative and you are a good match. Cord Stem Cells that are used outside of the country or shipped to this country are illegal. The FDA has found diseases in these grown cells and states that most of them are dead. Even though the physicians supplying these Cord Cells claim they are safe to use, you should use extreme caution before considering these procedures.
ARE YOU A CANDIDATE FOR THESE STEM CELL PROCEDURES
REBUILDING JOINTS & SPINE: The Stem Cells that are obtained from your body are placed into all joints and spine to rebuild and regenerate new tissue growth as determined by the clinic physician. There has been clinical evidence that new cartilage can be grown within your joint provided you are determined a candidate by the clinical physician. Not all patients will be a candidate and may require joint replacement.
TORN TENDONS: If the patients tendons are not completely torn this procedure will produce new tissue growth to regenerate torn tendons. Our clinic physician can only determine this with an initial visit and evaluation.
How Does PRP Therapy Work?
To prepare PRP, a small amount of blood is taken from the patient. The blood is then placed in a centrifuge. The centrifuge spins and through a multi-functional process separates the plasma from the blood producing the PRP. This increases the concentration of platelets and growth factors up to 500% also increasing hMSC (human stem cells) proliferation as a function of 8-day exposure to platelet released concentrations 10x. (x= increase above native levels)
When PRP is injected into the damaged area it stimulates the tendon or ligament causing mild inflammation that triggers the healing cascade. As a result new collagen begins to develop. As this collagen matures it begins to shrink causing the tightening and strengthening of the tendons and ligaments of the damaged area.
What is Platelet Rich Plasma?
Platelet Rich Plasma or PRP is blood plasma with concentrated platelets. The concentrated platelets found in PRP include growth factors among the huge reservoirs of bioactive proteins that are vital to initiate and accelerate tissue repair and regeneration. These bioactive proteins increase stem cell production to initiate connective tissue healing, bone regeneration and repair, promote development of new blood vessels and stimulate the wound healing process.
PRP Regenerates Tendons & Ligaments
Tendons connect the muscle to the bone making it possible for you to do many everyday physical activities. Overuse or damage to the tendon over a long period of time causes the collagen fibers in the tendons to form small tears, a condition called tendonitis. Damage to tendons most often occurs in the knees, ankles, hips, spine, elbows, shoulders, and wrists.
Ligaments are composed of collagen fibers that hold one bone to another, stabilizing the joint and controlling the range of motion. When a ligament is damaged, it is no longer able to support the bones in the joint, which often leads to pain symptoms. The instability causing the pain in your joints does not always show up on high tech imaging equipment. Through a thorough neurological and orthopedic evaluation Dr. Baum can determine which ligaments and tendons are unstable due to injury, wear or tear.
Tendons and ligaments have a poor blood supply and they do not usually heal from damage. Combined with the stress of day-to-day activities tendons and ligaments become inefficient causing degeneration of the joint which leads to chronic pain and weakness. Patients who experience chronic pain may not even remember when the injury occurred.
How Does PRP Compare With Cortisone Shots?
Studies have shown that cortisone injections may actually weaken tissue. Cortisone shots may provide temporary relief and stop inflammation, but may not provide long term healing. PRP therapy is healing and strengthening these tendons and ligaments and in some cases thickening the tissue up to 40%.
Treatment Plan
PRP injections with guided ultrasound can be performed on tendons and ligaments all over the body. Cervical, thoracic and lumbar spine, degenerative disc disease, arthritic joints shoulder pain, hip pain, and knee pain, even the smaller joints of the body can all be treated effectively with PRP. Dr. Baum will determine whether prolo solution, Platelet Rich Plasma or a combination of both will be the most effective form of treatment for you during his initial consult and evaluation.
Frequency Of Treatments
While responses to treatment vary, most people will require 3 to 6 sets of injections of PRP. Each set of treatments is spaced 4 to 6 weeks apart.
Is PRP Right For Me?
If you have degenerative spine or joint disease, a tendon or ligament injury, laxity or tear and traditional methods have not provided relief then PRP therapy may be the solution. It will heal tissue with minimal or no scarring and alleviates further degeneration and builds new tissues. There will be an initial evaluation with Dr. Baum to see if PRP therapy is right for you.
What Can Be Treated?
Platelet Rich Plasma injections helps regenerate all areas of the body including the cervical, thoracic and lumbar spine, wrists, elbows, shoulders, hips, knees and ankles as well as tendons and ligaments all over the body. Dr. Baum is one of the few physicians performing PRP procedures to all areas of the spine. Our clinic treats patients with sports injuries, arthritic and degenerative joints and degenerative disc disease. More specific injuries including tennis elbow, carpal tunnel syndrome, scoliosis, ACL tears, shin splints, rotator cuff tears, plantar faciitis and iliotibial band syndrome may all be effectively treated with PRP.
What Are The Potential Benefits?
Patients can see a significant improvement in symptoms as well as a remarkable return of function. This may eliminate the need for more aggressive treatments such as long-term medication or surgery.
Special Instructions
You are restricted from the use of non-steroid anti-inflammatory medications (NSAIDs) one week prior to the procedure and throughout the course of treatments.
Initially the procedure may cause some localized soreness and discomfort. Most patients only require some extra-strength Tylenol to help with the pain. Ice and heat may be applied to the area as needed.
How Soon Can I Go Back Regular Activities?
PRP therapy helps regenerate tendons and ligaments but it is not a quick fix. This therapy is stimulating the growth of new tissue requiring time and rehabilitation. Under Dr. Baum’s supervision patients will begin an exercise program immediately following the first procedure. During the treatment program most people are able to resume normal activities and exercise.
Platelet Rich Plasma (PRP) Matrix Graft by David Crane, MD and Peter A.M. Everts PhD
PRP application techniques in musculoskeletal medicine utilize the concentrated healing components of a patient’s own blood—reintroduced into a specific site—to regenerate tissue and speed the healing process
PRP INJECTION APPLICATION SITES
Spine
Cervical/Thoracic/Lumbar/Sacral
Shoulders & Elbows
Wrist & Hand
Hip/Pelvis
Knee & Lower Leg
Ankle & Foot
Fingers & Toes
Arthritic Joints
Osteoarthritis
Some Osteonecrosis
Information
http://www.prolotherapy.com/PPM_JanFeb2008_Crane_PRP.pdf
https://drjamesbaum.com/wp-content/uploads/stemcells2002-0109.pdf
Important Videos Everyone Should watch on Biologics
https://drjamesbaum.com/2013/07/the-science-of-mesenchymal-stem-cells-and-regenerative-medicine/
Scientific Papers on Research of Stem Cells
https://drjamesbaum.com/stem-cells/scientific-papers/
I will be posting this in my other blog section also
Tired of Doctors? I am also.
If you are like me,your sick of seeing doctors , some see so many my heart breaks for them, pcp, orthos, hematologist, cardiologists, pain management, endocrinologist dentists, optometrist whatever it just gets tiring. then you might get so nervous at your appointment you forget to ask specific questions.
Or maybe your anxiety has gotten you to a place where your heart is beating out of your chest, and your voice quivers or you just become blank.
Either way, having a list of things you mean to ask will help not only you but your doctor be able to better communicate.
So here we go:
1. What is the exact name of whatever is wrong with me? 1a if Osteonecrosis what stage is it? 1-2-3-4-5-5a-6
2. Is this something that is treatable and may possibly go away, or heal on its own or is this something that is chronic?
3. What are the short-term and long-term prognoses?
4. What are the short-term and long-term goals with treatment?
Example : Prp injections- physical therapy- hyperbaric oxygen-water therapy- stem cell treatments- joint replacement .
5. Is this something that genetically I can pass down to my child(ren)?
5a. Will you check me for underlying clot issue like Factor V Leiden-MTHFR-eNOS
6. What do you recommend as far as treatment?
7. What are the medications you recommend? I heard and read statins like Zocor and Lipitor can help lower lipids (fat) in the blood which can help blood flow better. I personally took simvastatin for 6 m and it helped me. I also during that time changed how I ate to consume less fatty meat cheeses etc
To lower my cholesterol on my own and I must say I am grateful I tried this.
Not only do I love eating REAL food but my blood work shows fantastic results and my pain is less.
So it’s good to talk to your doctor about this stuff also. Of course your doctor is not a specialist in nutrition which is kinda sad , you’d think they would teach that in medical school. But a good plant based diet was a great change for me.
8. How will this condition and/or medications affect my life?
9. Is there a specialist I can see? So I may try to avoid a joint replacement?
10. Will this condition or medications affect my ability to exercise? Walk-Bike- Swim.
Will this be temporary?
11. Is there a special diet that might ease symptoms or improve this condition?
For me personally it is plant based. I will eat meat (beef) rarely . Chicken or fish 1x a week but I am all about plant based.
My pain is lessened by over 60percent. I still have pain I’m not cured but I’m not in constant misery anymore. I rarely take a pain pill.
Never start or stop anything without talking to your doctor.
As always, if you have any concerns about your health, it’s always best to consult your primary care physician.
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Specific Questions To Ask Your Otho
What stage is osteonecrosis?
Will I be checked to make sure it also is not affecting other joints since I have pain in other bones/joints?
What is your treatment plan for Osteonecrosis ?
Why is this procedure being recommended? Are there alternatives?
What are the benefits of this procedure in terms of pain relief, functioning/mobility? How long will the benefit last?
What are the risks involved?
What is the success rate for this procedure?
What is the procedure called? How is it done?
How many patients with osteonecrosis do you see a year?
If Surgery Will this surgery solve the problem? Will any more surgery be required in the future?
How many of these procedures are annually performed at this hospital?
How many patients with osteonecrosis do you see a year?
What percentage of patients improve following the procedure?
What will happen if I don’t have the surgery now?
If I want a second opinion, whom can I consult?
Will I need any tests or medical evaluations prior to the surgery?
What kind of anesthesia will be used?
Are there possible after effects or risks?
Will I meet with the anesthesiologist in advance? Will her or she know my needs/allergies?
What kind of implant or prosthesis will be used? What are the outcomes using this device?
How long will it last?
Will I have pain following the procedure? What pain relief or pain control measures will I be given?
How long will the recovery take? What are my limitations during recovery?
Will I need assistance at home afterwards? For how long?
What will discharge instructions be?
Will I have any disability following surgery? Will I need physical therapy?
When can I return to work? When can I drive my car? When can I have sexual activity?
Are there any materials about this surgery that I can review?
What will I have for pain management?
Are their any patients I can ask about their experience?
Here is some info you may be interested in.
Clinical Trials
Atorvastatin to Prevent Avascular Necrosis of Bone in Steroid Treated Exacerbated Systemic Lupus Erythematosus
https://clinicaltrials.gov/ct2/show/NCT00412841
Statin therapy decreases the risk of osteonecrosis in patients receiving steroids.
https://www.ncbi.nlm.nih.gov/m/pubmed/11347831/
Aseptic osteonecrosis of the hip in the adult: current evidence on conservative treatment
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4832407/
Non -Surgical Treatment’s of Avascular Necrosis – Osteonecrosis
Non -Surgical Treatment s of Avascular Necrosis – Osteonecrosis
If osteonecrosis is diagnosed while damage is limited to a small area of bone sometimes doctors can try PRP injections, A2M injections, or Stem cell injections which is said to be the gold standard of injections.
I will get into those treatment options another day . And it may also be effective in up to stage 3 of AVN-ON but the faster you get it treated the better the outcome. It also depends on how you got your avn that will determine the outcome.
Let’s be real here
Avascular Necrosis –Osteonecrosis can be incredibly painful. And only those who have it understand the pain.
Medication to treat osteonecrosis may not be effective in people who have medical conditions that require treatment using corticosteroids, immunosuppressant medications, or chemotherapy. These medications may counteract osteonecrosis treatment.
During treatment with medication to stop the progression of osteonecrosis, your doctor monitors bone damage by taking periodic images of the affected bone for six months to a year or more. Some doctors may also recommend using crutches or a brace to remove stress from the affected bones.
As the bone starts to heal, physical therapy can help you maintain joint mobility, strengthen muscle groups that support the joint, and make changes to the way you walk to protect the affected bones. If the disease does not progress and putting weight on the joint becomes less painful, nonsurgical treatment may be all that is needed to recover from osteonecrosis.
Bisphosphonates
Bisphosphonates are prescription medications that reduce bone loss by destroying cells that contribute to the degeneration of bone. This helps preserve healthy bone tissue.
Your doctor may recommend that you take this medication by mouth or injection for six months or more, depending on the size of the osteonecrosis lesion or lesions and whether symptoms improve during the first six months. If an injected form of medication is prescribed, your doctor may give the injection in his or her office or show you how to administer your injections at home. Some bisphosphonates are taken by mouth or injection once a week or once a month, others less frequently.
Your doctor will continue to evaluate the effectiveness of treatment, using periodic X-rays or MRI that can reveal changes in the bone’s health. The doctor also looks for signs of side effects from bisphosphonates, which may include bone fractures outside the affected joint, and conducts regular blood tests.
Long-term use of bisphosphonates should be monitored by your doctor. And also may cause avn-on in jaw if you need on going dental work.
Nonsteroidal Anti-inflammatory Drugs
Bone loss due to osteonecrosis may be painful, especially in the hip and knee joints, which bear much of the body’s weight. Nonsteroidal anti-inflammatory drugs, or NSAIDs, sometimes work by reducing inflammation in the soft tissues surrounding the joint, relieving pain and swelling. These over-the-counter pain relievers include ibuprofen, naproxen, and aspirin. It may help in the short term but again talk to your doctor.
Long-term use of NSAIDs can cause side effects, including upset stomach or ulcers. If joint pain persists for more than a month, talk to your doctor before continuing use.
Statins
Statins are medications that lower cholesterol levels by reducing the amount of fatty substances called lipids in the bloodstream. If statin’s remove lipids from blood vessels leading to a diseased bone, more blood can reach the bone, allowing it to rebuild bone tissue. This may slow or stop the progression of osteonecrosis.
Statins can cause liver abnormalities and muscle damage, so your doctor takes your overall health and medical history into consideration before prescribing them for long-term use.
Medical Marijuana
No other pain relieving medication is less toxic than cannabis, even aspirin or Tylenol. This is why cannabis as medicine can be an excellent choice for pain. A proper cannabis recommendation requires more than just a few minutes of a doctor’s time, and includes information on cannabinoid content, strain selection, and delivery methods. If you’re not getting this information from your doctor, you’re not getting a real cannabis consultation and are missing information on the full value and healing potential of the plant. Cannabidiol, a nonpsychotropic component of marijuana, may enhance the healing process of bone fissures, according to a new study.
CBD oil is an entirely different compound, and its effects are very complex. It is not psychoactive, meaning it does not produce a “high” or change a person’s state of mind. Instead, it influences the body to use its own endocannabinoids more effectively and can ease pain.
Pain medication
Most pain medications for bone cancer are taken by mouth, in pill or liquid form. If swallowing is difficult, pain medication can also be delivered through a patch placed on the skin, an injection,talk to your doctor or see a pain management specialist if needed . No one needs to suffer in pain
Physical Therapy
When prescribed in addition to medication, physical therapy may slow down the progression of osteonecrosis and provide some pain relief. During the early stages of treatment, if the disease has affected the hip or knee, physical may suggest using crutches or a cane to help you move around without putting any weight on the affected joint.
You may use crutches or a cane for six weeks or more, depending on your age, the location of the lesion, and the severity of the disease. This gives the lesions time to heal and may prevent further joint damage.
Rehabilitation experts also offer heat and ice therapy, which may provide temporary pain relief deep within the joint, as well as acupuncture and acupressure, in which very thin needles or massage are used to stimulate blood flow and reduce inflammation.
After you can put weight on the affected joint without pain, physical therapists can customize a routine of simple, low-impact exercises to maintain range of motion in the affected joint as well as build strength in muscles that surround and support the joint. For example, stretching exercises and movements such as leg lifts or squats can prevent the joint from becoming stiff.
In addition, adding exercise such as tai chi or or my favorite is qi gong , or using a stationary or recumbent bike another favorite of mine or add swimming to your regular workout routine can help you maintain flexibility in the joints without putting too much stress on the bones. These exercises may prevent the disease from limiting your ability to walk and participate in everyday activities. They also improve blood flow throughout the body, which may help the bone heal more quickly.
A physical therapist can also help you alter the way you walk to avoid limping or putting too much stress on the affected joint. This helps ensure that you are able to use the joint without feeling pain for the long term.
The duration of physical therapy varies depending on the location of a lesion and how quickly your body responds to medication and physical therapy. After four to eight weeks, your therapist and physician assess your progress and determine whether additional treatment is required.
The most important thing you can do is have a good ortho , talk to him or her openly and honestly about your condition, your pain, your limitations etc…. together you can work together to find the best treatment plan for you . And also remember if you are unsatisfied you can always get a second opinion and or new ortho.
All content found on this Website, blog,, including: text, images, audio, or other formats were created for informational purposes only.
The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
Never disregard professional medical advice or delay in seeking it because of something you have read on this website,blog,page.
If you think you may have a medical emergency, call your doctor, go to the emergency department, or call 911 immediately.
I do not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on here .
Reliance on any information provided by this website , blog is solely at your own risk.
I discuss and educate.
I tell my story.
Avascular Necrosis – Osteonecrosis eBooklet © ™️®️
Click link below
To access link on cell press on above link and you will be re-directed to Booklet.
If on computer just click above link.
🌻 Hi, I’m Deborah Andio
I wrote this booklet in 2016 to help patients like myself and their families understand avascular necrosis- osteonecrosis and give helpful ideas to patients and help our doctors understand the pain we often feel.
My goal is throughout this booklet is to first let you know you are not alone .
Those who also have been diagnosed with avn know exactly how your feeling,scared, afraid, searching for knowledge and resources and coming up with very little.
That’s why I started a support group and wrote this booklet.
Disclaimer
- This booklet is not intended as a substitute for the medical advice of physicians. The reader should regularly consult a physician in matters relating to his/her health and particularly with respect to any symptoms that may require diagnosis or medical attention.
- No part of this eBook may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without written permission from the author.
- The information provided within this eBook is for general informational purposes only.
- Copyright © protected
- While I try to keep the information up-to-date and correct, there are no representations or warranties, express or implied, about the completeness, accuracy, reliability, suitability or availability with respect to the information, products, services, or related graphics contained in this eBook for any purpose. Any use of this information is at your own risk.
I give an actual copy to members of my support group. But many felt the information was so helpful, I wanted to share it with everyone.
I have recently completed a better spell check and next print will have all errors corrected.
No-one can use any contents of this booket words or graphics
Also booklet will be updated every 2 years
2014 check
2016
2018
2020
I am continually writing to our Senators state by state asking for an awareness day proclamation.
So AVN-ON can get the recognition it deserves.
Supprt Group Link Avascular Necrosis/ Osteonecrosis Support Int’l
Wishing you all a pain free and relaxingI am
God Bless
Debbie
ChronicallyGratefulDebla2018© ™️
Debla©2014-2019 ™️
All rights reserved. Thia booklet on line or in print may not be reproduced in any form, stored in any retrieval system, or transmitted in any form by any means—electronic, mechanical, photocopy, recording, or otherwise—without prior written permission of the publisher, except as provided by United States of America copyright law. For permission requests, write to the author on this web site.
©Debla2014
Avascular Necrosis-Osteonecrosis Education and Resources 