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November 13th, 2018
Woman with Plantar Fasciitis with Shoe Off

In this blog and the corresponding videos, we will talk about the two most common type of arthritis (osteoarthritis and rheumatoid arthritis).

Osteoarthritis is by far the most common form of arthritis. When you think of OA think DEGENERATIVE PROCESS, involving wear and tear of the cartilage that caps and protects the bones in your joints. As the cartilage wears down over time, the bones lose their lining, the nerve endings become exposed causing pain and decreased joint mobility over time.

Rheumatoid arthritis, on the other hand, is an AUTOIMMUNE DISORDER.

What does this mean?

It means that the body attacks itself. The body recognizes the lining of the joints as foreign and the immune system begins to attack it. This causes fluid and inflammation of the joint, subsequently breaking down the cartilage which is the protective lining of the joints.

RA is systemic and does not discriminate. As a result, multiple joints and bilateral sides can be effected. OA usually affects a single side and single joint.

Here is a picture of an RA knee, it has an inflammatory component. Fluid builds up in the joint, and you get erosions of the surrounding bone and wearing away of the cartilage.

So in both cases get cartilage damage, but the process is different. One is wear and tear (Osteoarthritis), the other is inflammation (Rheumatoid Arthritis).

OSTEOARTHRITIS Treatment

The best way to prevent osteoarthritis, or in better words, stop its progression, is to maintain a healthy weight by staying active and exercising on a regular basis. This includes strengthening your muscles with weight training to help lower the stress on your joints.

Next comes the treatment of the symptoms with medication (usually short term)

Acetaminophen (Tylenol)

NSAIDS (ibuprofen) — although too much can have GI and cardiovascular side effects, I don’t advocate the use of opioids due to its side effects and risk for dependency. Based on my experience there are much better and more effective ways to manage your arthritis.

Targeted injections are a very popular form of treatment with great results. This includes cortisone injections, hyaluronic acid injections, stem cell therapy and platelet rich plasma therapy.

In our clinic, we use ultrasound for precision guided injections and have excellent lasting results for mild, moderate and even moderate to severe OA.

Joint injections due not usually yield good results in severe OA, such as “bone on bone” arthritis. The best option at this stage is usually joint replacement surgery.

The goal is to manage your osteoarthritis early, because early treatment can help slow progression and prevent surgery.

RHEUMATOID ARTHRITIS Treatment

As we mentioned, RA is autoimmune inflammatory process.

The primary goal is to reduce the degree of inflammation and prevent joint damage.

The primary treatment for rheumatoid arthritis is medication. There are really few categories of medication commonly used to treat rheumatoid arthritis, including:

NSAIDS: just like osteoarthritis (Ibuprofen)

CORTICOSTEROIDS: Oral Prednisone

These two meds are for the short-term pain relief and have many unwanted side effects in the long run.

The next category are the DMARDS (Disease modifying Anti-rheumatic drugs)

They fall in 2 subcategories: Non-biologics & Biologics

Non-biologics: These medications help stop the immune system from attacking healthy tissue. Methotrexate, cyclophosphamide are two well-known medications in this class. Usually this is the first line of treatment. If the response is not good or if the patient has side effects, then the biologics may be used.

Biologics: These are the newest drugs that target and help block immune cells that cause this inflammation. Enbrel, Humira are two well-known medications in this class. These agents usually have a quicker onset of action and can be a very good choice when other treatments have not helped.

Along with medications, local steroid joint injections help relieve pain for rheumatoid arthritis as they have a strong anti-inflammatory effect. We do not have much data on PRP. Also, PRP induces a healing inflammatory response, and this may actually add to the inflammatory component of RA and worsen the condition. Also, hyaluronic acid is also not used since it helps lubricate the joint and do not address the underlying inflammatory component associated with RA.

Like osteoarthritis, the last-resort treatment for rheumatoid arthritis is surgery. This includes arthrodesis (fusion of the joint), and arthroplasty (joint replacement).

Posted on behalf of Advanced Healing Institute

22972 El Toro Road
Lake Forest, CA, 92630

Phone: (949) 239-3206

Our Patient Reviews

Advanced Healing Institute

5 / 5.0

Based on 38 reviews

Rich G.

Dr. Reza is a genius. My knee has been bothering me for YEARS since I tore my meniscus playing football. Achy, bothersome, with occasionally a limp. I went in to to get PRP (Platelet Rich Plasma) and it was everything I thought it would be and then some. The whole procedure took less than an hour, very little to no pain and in less than 24 hours my knee felt brand new. If you are looking for a quality Doctor who offers PRP -- go here! The rates are very on point. He is literally THOUSANDS of dollars less than some other clinics and believe me he does such an amazing job, he could charge 10x's and it would still be worth it. Don't sit there suffering, get up and get help. I am actually thinking of getting my other knee done and its not really necessary. Lol.. 10 STARS...

E Y.

Dr Reza is FANTASTIC. Staff is friendly and very accommodating. I was in such pain. He diagnosed the issue (Bursitis) and clearly understood everything about it from A-Z. So efficient and understanding, not to mention making the procedure painless. I barely slept a hour the night before, saw Dr. Reza at 5pm and was feeling a million times better by 7pm. It's been 36 hours and I went from practically a frozen shoulder in pulsating pain to gaining back 70% of my movement range and most importantly "NO PAIN". just stiffness which is the normal symptoms as kindly explained to me by Dr. Reza. Everything is as promised, I am fully confident that I will be back to 100% range of motion within 3 days. I'm still gonna take it easy and slowly stretch my shoulder back to full strength. Without his service, I would probably be feeling like I was hit by a truck laying in bed miserable. Thank you very much Dr. Reza for helping my aging old bones. Cheers!

Geri C.

I can’t say enough about how intelligent Dr. Reza Dehdari is! I came to him to read my MRI for my ankle and he found a tear that multiple Doctors missed!!!! Simply incredible and I trust him throughly. Thank you so much!

Marina S.

Had the PRP procedure and I have to say no pain at all, going on 6 weeks, if you decide to have the PRP listen to Dr. Dehdari's instructions thoroughly and do the physical therapy, it works and I am so pleased and it's getting better and better as days go on, Dr. Reza Dehdari is the best and very emphatic in explaining all your questions soothing away your doubts, and he checks up on you to make sure all is well, after the PRP procedure. Very trustworthy PRP procedure and his assistant Sandy is also the sweetest caring person you will ever meet. I'm a satisfied customer and patient.

Micheal W.

wczoraj Dr. Reza Dehdari you are an amazing person. Thank you for going the extra mile on my shoulder after three Doctors told me I needed surgery. You took your time and explained everything about what to expect and to be patient while I heal. And that’s exactly what I did was heal, I can’t thank you enough for what you did for me.

Helena L.

Within the last 6 months I've suffered two minor injuries on the same knee which have restricted my mobility and caused me a lot of pain. I've seen an orthopedic dr.,, a pain management dr., and a sports medicine dr., all of which simply told me either surgery or learn to live with the pain! I've heard about PRP as an alternative with a high percentage of success. Thus, I made an appointment to see Dr. Dehdari, and was pleasantly surprised by his high level of knowledge, professionalism and thoroughness. Dr. Dehdari reviewed my MRI (previously ordered by the Orthopedist) explained the extent of my injuries, took X-Rays and an ultrasound to carefully determined if I was a good candidate for PRP. I can only say that I wish more doctors will give you the time, attention and care that Dr. Dehdari provides. Thank you Dr Dehdari, thank you for such high work ethics and patient care. Many thanks to his staff as they are as attentive and caring as Dr. Dehdari. It has been only 24 hrs since I received my PRP treatment and my pain levels have drastically gone down! I highly recommend Dr. Dehdari.

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