Arthritis treatment
INTERVIEW WITH WARREN RINGOLD, MD ON ARTHRITIS AND ARTHRITIS TREATMENT.
Dr. Ringold is the Chief of Family Medicine at a major metropolitan hospital in the State of Michigan. He was elected to this position by his colleagues. He also serves on many overseeing committees including the Medical Executive Committee, Quality Assurance Committee, Family Medicine Quality Committee, as well as other governing bodies.
He has had a private medical practice for nearly 30 years. He is a 1975 graduate of the prestigious University of Michigan Medical School. Today he is interviewed by Andrew Cook from California.
Mr. Cook: Dr. Ringold, do you see a lot of patients suffering from arthritis?
Dr. Ringold: Yes, Andrew, I see patients suffering with this difficult affliction on a daily basis. It can vary from annoying to completely debilitating depending on the patient.
Mr. Cook: How do you treat these patients?
Dr. Ringold: Prior to late in 2004, I always used prescription medication. However, when the popular medication called Vioxx was withdrawn from the market, I decided to take a strong look at my approach to arthritis treatment.
Mr. Cook: What changes have you made?
Dr. Ringold: Traditionally for the first 20+ years or so of my practice I would use medications from a class of drugs called NSAIDS. These drugs treated both the inflammatory source of the pain as well as the pain. They were known to be potentially harsh on the stomachs of some people so they were used with caution in people with history of ulcer or stomach irritation.
Mr. Cook: You said you used them for 20+ years, then what happened?
Dr. Ringold: A new class of drugs emerged called COX-II drugs. These drugs were presented to us as physicians as drugs that would greatly help arthritic patients without such a high risk of stomach difficulty. Most physicians began prescribing these in high volumes in order to avoid the difficult complication of gastrointestinal bleeding that came along with the NSAIDS.
Mr. Cook: Did the COX-II drugs work well?
Dr. Ringold: Yes, these drugs worked very well; however, in 2003 there began to be some talk that Vioxx might have some potentially bad side effects. These side effects had to do with the heart and heart failure.
Mr. Cook: Is that why Vioxx was recalled?
Dr. Ringold: Yes, the drug was recalled after it was shown that it increased the risk of heart attack or stroke when compared to other arthritis drugs.
Mr. Cook: Were there other drugs in this class that you could use?
Dr. Ringold: Yes, there are other drugs in this class; however, I have become afraid of all of the prescription drugs for arthritis as well as the over the counter anti inflammatory drugs. All of the drugs have been shown to be associated with an increased risk of heart attack or stroke.
Mr. Cook: What do you prescribe now?
Dr. Ringold: I try to recommend glucosamine or glucosamine plus chondroitin sulfate. These are natural supplements that have not been shown to be associated with these horrible side effects. I also recommend over the counter acetaminophen. This drug has not been shown to cause heart attack or stroke, and when used in combination with the supplements; fairly substantive pain can be controlled.
For more information on supplements to treat arthritis, please visit:
http://www.ringoldmd.com
Dr. Ringold is the Chief of Family Medicine at a major metropolitan hospital in the State of Michigan. He was elected to this position by his colleagues. He also serves on many overseeing committees including the Medical Executive Committee, Quality Assurance Committee, Family Medicine Quality Committee, as well as other governing bodies.
He has had a private medical practice for nearly 30 years. He is a 1975 graduate of the prestigious University of Michigan Medical School. Today he is interviewed by Andrew Cook from California.
Mr. Cook: Dr. Ringold, do you see a lot of patients suffering from arthritis?
Dr. Ringold: Yes, Andrew, I see patients suffering with this difficult affliction on a daily basis. It can vary from annoying to completely debilitating depending on the patient.
Mr. Cook: How do you treat these patients?
Dr. Ringold: Prior to late in 2004, I always used prescription medication. However, when the popular medication called Vioxx was withdrawn from the market, I decided to take a strong look at my approach to arthritis treatment.
Mr. Cook: What changes have you made?
Dr. Ringold: Traditionally for the first 20+ years or so of my practice I would use medications from a class of drugs called NSAIDS. These drugs treated both the inflammatory source of the pain as well as the pain. They were known to be potentially harsh on the stomachs of some people so they were used with caution in people with history of ulcer or stomach irritation.
Mr. Cook: You said you used them for 20+ years, then what happened?
Dr. Ringold: A new class of drugs emerged called COX-II drugs. These drugs were presented to us as physicians as drugs that would greatly help arthritic patients without such a high risk of stomach difficulty. Most physicians began prescribing these in high volumes in order to avoid the difficult complication of gastrointestinal bleeding that came along with the NSAIDS.
Mr. Cook: Did the COX-II drugs work well?
Dr. Ringold: Yes, these drugs worked very well; however, in 2003 there began to be some talk that Vioxx might have some potentially bad side effects. These side effects had to do with the heart and heart failure.
Mr. Cook: Is that why Vioxx was recalled?
Dr. Ringold: Yes, the drug was recalled after it was shown that it increased the risk of heart attack or stroke when compared to other arthritis drugs.
Mr. Cook: Were there other drugs in this class that you could use?
Dr. Ringold: Yes, there are other drugs in this class; however, I have become afraid of all of the prescription drugs for arthritis as well as the over the counter anti inflammatory drugs. All of the drugs have been shown to be associated with an increased risk of heart attack or stroke.
Mr. Cook: What do you prescribe now?
Dr. Ringold: I try to recommend glucosamine or glucosamine plus chondroitin sulfate. These are natural supplements that have not been shown to be associated with these horrible side effects. I also recommend over the counter acetaminophen. This drug has not been shown to cause heart attack or stroke, and when used in combination with the supplements; fairly substantive pain can be controlled.
For more information on supplements to treat arthritis, please visit:
http://www.ringoldmd.com
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