Archives for September 2017

Dealing with Arthritis Pain at Home

There are many different types of arthritis, but osteoarthritis (OA) is the most common form. Also known as degenerative joint disease (DJD), it is caused by “wear and tear” of the joints and can result in considerable chronic pain, which can then lead to disability. Some of the risk factors for developing OA include obesity, muscle weakness around the joint, repetitive activity, and previous joint injury. The pain associated with OA is caused by an erosion of cartilage, narrowing of the joint space, and deformity of the bone within the joint; and the most common sites of the body to develop OA include hands and fingers, the big toe, hips, knees and spine. If you experience pain in your joints, it is important to discuss this with your family medicine provider. Once diagnosed, the goal of treatment is to minimize pain and to help you maintain independence in performing your everyday activities. The following are some things that you can do at home to deal with arthritis pain, and to improve your quality of life.

Weight Control

Being overweight is a contributing factor to developing OA, and it will continue to worsen the condition over time. Any extra weight you might be carrying increases the load and stress on your joints, leading to further degeneration. Your overall good health is greatly affected by your intake of foods with high nutritional value. Your joints are no exception to this rule. Studies show that even a small amount of weight loss can improve your joint health, so increase the fruits and vegetables, whole wheat grains, and low-fat proteins in your diet, while decreasing the amount of simple sugars, starches and high fat foods; and watch your portion sizes. Remember that regardless of your food choices, if you take in more than you put out, you will gain weight. Ideally, you body mass index (BMI) should be between 18.5 and 24.9.

Exercise Balanced with Rest

Regular, gentle exercise is important to maintain joint function and will help with pain management. While physical therapy can be very beneficial, there are a lot of exercises that you can do at home. Water exercise is an exceptional way to increase joint movement, while minimizing stress on the joint. Bicycling is another excellent choice. Isometric exercises, which improve muscle strength and support joint function, involve contraction of muscles without joint movement. For instance, holding a plank position allows the contraction of multiple muscle groups, while avoiding undue stress on any one joint. Another important way to protect your joints is to strengthen the muscles around them by performing weight-bearing exercise. To start out, it is best that you perform exercises that use your own body weight, such as squats, calf raises, lunges or push-ups. It has been found that moderate to vigorous exercise, at least three times per week, can lead to marked improvement in joint pain. But remember, before starting any exercise program, you should discuss it with your family medicine provider.

As helpful as exercise is to joint health, it is important to not overdo it. Listen to your body. If something is painful, stop. Also, if you find your joint pain increases throughout the day as a result of normal activities, stop and take a break. Rest will often result in a decrease or resolution of pain. And, make sure you are getting adequate amounts of sleep at night.

Heat/Ice

The application of heat will often relieve the pain of arthritis. Try a hot shower or bath when your joints are aching. Gel pads that can be warmed in the microwave are available over the counter, but follow the directions carefully on the package and check the temperature with your wrist before applying it to your painful joints. However, electric heating pads should be avoided because of the risk of burns and fires. You might also try applying an over the counter liniment or preparation with camphor, eucalyptus, or capsaicin, which many people find does a good job in relieving arthritis pain.

Ice is another way to treat joint pain, although often not as effective as heat. In particular, if you are experiencing inflammation or swelling from overuse or injury, ice may be beneficial. When you use ice, make sure to not put the ice pack directly on your skin. Instead, place a small cloth or towel between the pack and your skin to protect your skin from injury. If you don’t have an ice pack, try a frozen bag of corn or peas.

Medication

The most important thing to remember is to discuss any medication you are taking with your family medicine provider. There are many products that you can obtain over the counter that may not be good to take over an extended period of time. For instance, NSAIDs such as ibuprofen or naproxen may be good for an acute injury, but taken on a regular basis, these drugs can cause kidney problems, heart problems, and stomach problems. They also increase your risk of bleeding. The number one drug of choice to control arthritis pain is acetaminophen. It is safe and effective for most people if taken as directed on the packaging. However, everyone is different so please discuss all over the counter medications with your family medicine provider before taking them.

To learn more about arthritis, its treatment, and what you can do to control pain and improve your joint function, call Advanced Medical PA at (561) 434-1935 to request an appointment, or request one online.

The Difference between an Internist and a Primary Care Provider

To understand the difference between an internist and a primary care provider, it is important to realize that one is a specialty, and the other is a role. An internist is a provider who specializes in internal medicine, and is an expert in the diagnosis and treatment of adult diseases. While an internist can function as a primary care provider, he or she may also focus their practice on hospital medicine, medical education and/or research. On the other hand, a primary care provider may be an internist, a pediatrician, a geriatrician, a family practitioner, a gynecologist or an obstetrician, because primary care involves the practice of promoting overall health for the entire individual within the specific population (geriatrics, pediatrics, etc.) of the provider’s specialty. Let’s first look at the specialty of internal medicine, and then examine how these and other providers practice in the primary care environment.

The Internist: The Internal Medicine Specialist 

Internists are providers who have specialized training in the diagnosis and management of illness in adult patients. This means that they are capable of helping their patients stay healthy and prevent illness, but are also able to diagnose and treat both acute and chronic illnesses. Just a few of the many illnesses an internist would treat include hypertension, diabetes, high cholesterol, kidney disease, asthma, heart disease, arthritis, bronchitis, ear infections, back pain and the common cold. The list is exhaustive but basically includes any illness than can affect adults.

Internists are particularly skilled in reviewing the symptoms of patients with complex problems, performing physical exams, ordering diagnostic tests, and using this information to identify both common and rare illnesses. They are basically the detectives and problem-solvers of adult medicine; and they are also experts in treating extremely ill adults.  This is why internists are found in a variety of roles and settings. You may have an internist as your primary care provider, treating you in an office or clinic. However, some internists, known as hospitalists, care for acutely ill patients in the hospital. And some do both. Because of their specialized education and training, internists are exceptionally suited for treating patients with multiple medical problems, understanding how these illnesses, their medications, and their treatments interact, and adjusting the plan of care to best suit the individual patient’s needs.

The Primary Care Provider

A primary care provider (PCP) is basically the provider that you’ve always known as “your family medicine provider.” They are responsible for the ongoing health and wellbeing of their patients, by promoting healthy behavior, helping you prevent illness, and quickly diagnosing and treating any new or potential health problems. He or she is the family medicine provider who knows you the best and who you can turn to for any health concerns. The primary care provider is usually your first contact with the health care system, and they are skilled in providing a comprehensive assessment of health care needs, as well as continuous monitoring of chronic illnesses and treatment of new problems. They will also know when a referral to another specialist is warranted.

The central person in primary care is the patient, and the primary care family medicine provider will focus on you as a whole individual. They work hard to maintain a trusting relationship with their patients and will partner with you to come up with the best plan for your good health. This plan will usually include age-appropriate health maintenance, routine monitoring, immunizations, counseling, patient education, and treatment of acute and chronic illnesses. To realize the real benefit of having a primary care provider, you should look at them as your focal point of all your health care needs. By turning to your primary care provider first, you will make sure that the family medicine provider treating you knows and understands you; and you will avoid unnecessary tests or trips to specialists.

The role of primary care provider is performed by more than one type of provider, and each provides care to the population that they have specialized in. Internists are experts in the care of adults, or those 18 years and older. Geriatricians, on the other hand, are internists that have additional training for the medical needs of adults 65 and older. Family Practice providers are qualified to provide primary care for patients of all ages, from newborns to the elderly, while pediatricians see patients from infancy through adolescence. Specialists in obstetrics and gynecology (OB/GYN) can provide primary care for women, including reproductive health and family planning. While we often think of primary care practices as those in outpatient offices and clinic, in reality, primary care can be performed in a number of settings. This includes long-term care settings such as nursing homes, home care, day-care and even in the hospital. Whichever the setting, the primary care provider carefully tailors the healthcare plan to meet the individual needs of each patient, with the goal of helping their patients achieve their highest level of health.

When your family medicine provider knows and understands you, and is carefully monitoring your health needs, the results are bound to be of benefit to you. With the focus on prevention and early action when an illness arises, the primary care provider can often help patients avoid severe illness, the need for specialists and hospitalizations. Experts agree that primary care increases everyone’s access to healthcare and improves the quality of health care. On a more personal level, patients and providers are given the opportunity to form trusting and lasting relationships.

We would be happy to answer any questions you may have about internal medicine or primary care. At Advanced Medical, PA, we pride ourselves in providing quality health care in both internal medicine and primary care. To learn more about us and the services we offer, or to schedule a visit, call us at (561) 434-1935 to request an appointment, or request one online.