Conservative Approach

Among the steps recommended for conservative prescribing:

  • Think beyond drugs. Would other interventions help? Would a medication simply mask symptoms without treating the problem? Can a condition be prevented instead of treated? Would waiting to see if the symptoms self-resolve be wise?
  • Practice more strategic prescribing. Do you have a solid understanding of medication choices? Is there a valid reason to switch to a new drug? Is it the right drug for your patient? Can you avoid using multiple medications?
  • Maintain heightened vigilance regarding adverse effects. Do you check with patients about potential drug reactions? Do you teach them the warning signs? Are the drugs you're choosing prone to withdrawal symptoms or relapse?
  • Approach new drugs and new indications cautiously and skeptically. Where do you get your information about new treatments? Can you wait until a new drug has had a longer track record? Does the drug actually help resolve the core problem? Is it actually indicated for this problem? Does it deliver what it promises? Do studies tell the whole story on a drug?
  • Work with patients for a more deliberative shared agenda. Can you persuade patients not to demand drugs they have seen or heard advertised? Is a patient's noncompliance with therapy the source of the problem? Has the patient already tried this drug without success? Can you encourage healthy skepticism in your patients?
  • Consider longer-term, broader effects. Would a different therapy be less likely to cause future harm? Can you find a way to make the prescribing system better?

What is the treatment? All patients should try conservative treatment options before considering surgery.  Anti-inflammatories such as Aleve, Meloxicam or Celebrex work very well for arthritis if taken properly.  I usually tell my patients to take anti-inflammatories everyday for 2 weeks and then stop taking them for awhile and see how they do with their symptoms.  Often if your body reaches a therapeutic level over 2 weeks the medication will stay in your system and continue to work for you for a longer period.  

Topical medications are beneficial for many patients and can be bought over the counter or available by prescription. 

Corticosteroid injections work very quickly to reduce pain and decrease inflammation and should last 3-6 months ideally. 

Viscosupplement injections are another option for arthritic knees, this medication is a thick viscous fluid we put in your knee to help your knee to move better.  This medicine takes 4-6 weeks to gain maximum effect but ideally should last 6 months.  

Physical therapy and exercise when done correctly are ideal for arthritis patients because it keeps your weight down and your joints flexible. 

Vitamin supplementation with Calcium and Vitamin help to keep joints healthy and strong.  Other alternatives for certain arthritis include: braces, heat therapy gloves or knee wraps.

To find out more about Summer's conservative approach, call today.

First Publiched by the Archives of Internal Medicine
(928) 854-7666

...or fill in the contact form on our Contact Us page: