Learn about the many ways to pursue arthritis treatment.
Arthritis treatment varies widely and depends on both the type of arthritis and the patient's symptoms. Mild cases of osteoarthritis can often be manage with conservative treatments like over-the-counter (OTC) anti-inflammatory drugs and rest, while serious cases of rheumatoid arthritis (RA) may require surgery and treatment with prescription medications. The two main classes of medication used to treat arthritis are nonsteroidal anti-inflammatory drugs (NSAIDs) and disease-modifying anti-rheumatic drugs (DMARDs). Regardless of the specific symptoms, the goal of arthritis treatment is to slow the progression of the disease, prevent permanent damage to the joints and help the patient lead as normal a life as possible.
NSAIDs include OTC medications like aspirin, naproxen (Aleve) and ibuprofen, known under the trade names Motrin and Advil. These drugs are good for treating mild to moderate symptoms of arthritis because they alleviate pain and reduce swelling and inflammation around the joints. Other pain-killers like acetaminophen (Tylenol) may be used to manage arthritis pain, but they do not treat inflammation as well as NSAIDs, so they are not used as often. Depending on the severity of the patient's symptoms, the doctor may prescribe stronger versions of NSAIDs than those sold in stores. Although side effects for these drugs are usually mild, long-term treatment at high doses increases the risk of heart problems, gastric ulcers, kidney damage and stomach bleeding may occur, according to the Mayo Clinic.
DMARDs are an important part of treatment for severe forms of arthritis. Of these drugs, methotrexate (Rheumatrex) is the most commonly used to treat RA . Researchers are not entirely sure how DMARDs work, but doctors have successfully used them to slow the progress of arthritis and prevent permanent damage to the joints and tissues it can cause. Patients often take DMARDs in combination with NSAIDs, corticosteroids or immunosuppressants to obtain stronger relief from their symptoms than they would by only taking DMARDs alone. The results of many recent studies support this practice; for example, the Arthritis Foundation reports that methotrexate is most effective when used simultaneously with other drugs like rituximab (Rituxan), adalimumab (Humira) and leflunomide (Arava).
Other types of medication used to treat arthritis are immunosuppressants, TNF-alpha inhibitors and certain drugs that treat specific areas or chemicals in the body. Immunosuppressants like leflunomide prevent joint damage and inflammation by calming the immune system and keeping it from attacking the body's own cells and tissues. TNF-alpha inhibitors take a narrower approach to arthritis treatment by targeting a single cell protein (cytokine) known to cause inflammation, swelling and stiffness. Not only do these drugs control the symptoms of RA and other systemic types of arthritis, some research suggests they may also slow the disease's progression.
Anakinra (Kineret) and abatacept (Orencia) are two other arthritis medications that doctors often recommend to patients who have not been helped by DMARDs or TNF-alpha inhibitors. Anakinra is a self-administered injection that interrupts one of the chemical processes that cause inflammation. Abatacept inactivates the body's T cells, a type of white blood cells produced by the thymus gland that performs a variety of functions in the immune system.
Patients with osteoarthritis in the knee may be treated with visco-supplementation, a procedure during which they receive injections of special compounds that improve the cushioning in the joint. Sold under the brand names Hyalgan and Synvisc, these compounds are made from rooster combs and supplement the knee's natural cushioning and lubrication, improving the patient's mobility and comfort. Although visco-supplementation has not been approved for use in joints other than the knees, it can provide patients relief from their symptoms for several months .
Joint replacement, synovectomy and other surgical procedures allow doctors to slow and repair joint damage caused by arthritis. During joint replacement surgery, or arthroplasty, the doctor removes the affected piece of bone from the joint and replaces it with a prosthesis, or artificial part. This procedure is commonly used to treat patients with severely damaged knees or hips who are naturally unable to walk or lead independent, productive lives. In addition to hip and knee joints, finger, shoulder, elbow and ankle joints may also be replaced.
The other main surgical treatment for arthritis is the synovectomy. During this procedure, the doctor removes the inflamed joint lining from the joint, which provides (sometimes only temporary) relief from the early symptoms of RA. Despite its effect on arthritis symptoms, however, the synovectomy does not slow the progression of the disease.
As long as they have reasonably healthy joints, patients may be able to improve some of their arthritis symptoms with regular exercise . Gentle activities like walking, biking or swimming strengthen the muscles and connective tissues surrounding the joints, which can make them more stable. When combined with a healthy diet, exercise can be a safe way for overweight or obese patients with arthritis to lose weight and lessen the pressure placed on weight-bearing joints like the ankles, hips and knees. The Centers for Disease Control and Prevention estimates that two-thirds of adults with doctor-diagnosed arthritis are either overweight or obese, so these and other minor lifestyle changes can be important parts of both treating and preventing the disease.
Pain management classes or private therapy sessions can help patients struggling with chronic forms of arthritis to cope with long-lasting pain and discomfort. Arthritis doctors, pain doctors, psychiatrists, psychologists and medical social workers may all be able to provide therapy and support to patients with chronic pain, although patients should be cautious when choosing a therapist. To get the best treatment possible, the National Pain Foundation recommends patients start by looking for therapists who are either board certified in pain medicine or who have access to a pain specialist for consultation and advice. If patients have trouble finding an expert in the field, an arthritis doctor should be able to recommend or refer them to a certified pain specialist.