Cortisone appropriate for arthritis

DEAR DR. GOTT: I am a 54-year-old female with osteoarthritis in both hips. My general practitioner sent me to an out-of-state specialist who recommended cortisone injections. When I tried to have cortisone injections done by a local specialist, I was told that they would not help me because I don't have bursitis.

I am most uncomfortable when I stand still, sit or lie down for any length of time. Using a heating pad several times during the night helps alleviate the muscle cramping, though. I have more pain in my lower back/sacral area, knees and thigh muscles than in the hips themselves. Who is right? Would the cortisone injections really help?

DEAR READER: I must side with the out-of-state specialist. Cortisone injections are often beneficial as one of the initial steps toward relieving the pain of arthritis. A randomized placebo-controlled trial of glucocorticoid injections for osteoarthritis of the hip demonstrated benefits lasting up to three months. Over-the-counter medications such as acetaminophen, ibuprofen or naproxen, topical capsaicin or menthol ointments (especially those made with castor oil), and ice packs or heat may also provide relief. If these options fail to provide satisfactory results, consider physical therapy, low-impact exercise programs or enter a chronic-pain class to learn other ways to manage the pain. A final option for those with severe joint deformity, pain and dysfunction is surgery, such as joint realignment or replacement.

Seek out another local specialist or return to the out-of-state physician for further advice and treatment.

To provide related information, I am sending you a copy of my Health Report "Understanding Osteoarthritis." Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

DEAR DR. GOTT: Thank you for all your interesting questions and answers. I have questions about a condition I have never heard of - "spongiotic dermatitis eosinophils consistent with allergic contact dermatitis." What is it? And what can be done for it?

DEAR READER: Spongiotic dermatitis (SD) is primarily an allergic reaction that causes swelling rather than a rash. It can sometimes be associated with the formation of microvesicles, which are small fluid-filled sacs. Eosinophils are a component of the blood, often found in elevated numbers when an allergic reaction is present, and can generally be used to determine how severe the reaction is.

There are two types of SD. The first is acute SD, which implies that the allergic reaction is occurring at that point in time. The second is chronic SD, which is present for an extended period. This type can also lead to permanent thickening of the outermost layer of the epidermis.

The condition is an allergic reaction most likely due to a skin irritant. Plants, animals, chemicals and much more can cause allergic contact dermatitis. An individual with this diagnosis would probably benefit from the care of a dermatologist or allergist.

To provide related information, I am sending you a copy of my Health Report "Allergies." Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Dr. Peter Gott is a retired physician and the author of the book "Dr. Gott's No Flour, No Sugar Diet," available at most chain and independent bookstores, and the recently published "Dr. Gott's No Flour, No Sugar Cookbook." Copyright 2010, United Feature Syndicate Inc.