Arthritis is a general term for more than 100 rheumatic diseases. In a CDC survey, more than 46 million Americans reported they had been diagnosed with arthritis or chronic joint symptoms. Arthritis can affect the joints, muscles, connective tissues, skin, and organs. The most obvious warning signs are pain, swelling, stiffness, or problems moving one or more joints.
Although there's no cure for arthritis, the symptoms can be treated effectively in many cases. Here are some proven treatments:
Daily exercise is an important part of arthritis treatment. It helps build and preserve muscle strength, protects joints from further stress, and keeps them flexible. An effective exercise program consists of three types of exercises:
Range-of-motion exercises keep muscles and joints flexible.
Aerobic exercises promote cardiovascular conditioning and overall fitness, and they help manage weight. The exercises should be low impact, such as walking, swimming, bicycling, or cross-country skiing. Experts recommend cross-training programs that involve these activities.
Strengthening exercises build supporting muscles so they can absorb stress on joints and keep them stable.
Talk to your doctor or physical therapist about the activities within each category that are right for you.
Excess weight can put stress on weight-bearing joints and increase wear and tear on the cartilage that cushions joints. Research has found a connection between obesity and osteoarthritis (OA) of the knee and hips. Because overweight people often are less active, they're susceptible to joint stiffening.
The goals of treatments are to control pain, improve function, and slow the progress of the disease. Many drugs are used to treat arthritis. These are the most common:
Analgesics. These drugs reduce pain, but not inflammation. Acetaminophen is an analgesic available without a prescription and is often combined with other analgesics. Prescription analgesics include opiates such as codeine and hydrocodone. Tramadol is a drug that is similar to opiates but has less potential for abuse and addiction.
Nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs relieve pain and inflammation by slowing down the body's production of prostaglandins. The most commonly used over-the-counter NSAIDs are aspirin, naproxen, and ibuprofen. Specific treatment will be determined by your doctor, based on your overall health and medical history. Other stronger NSAIDS may be available by prescription.
Disease modifying anti-rheumatic drugs. These drugs are used for rheumatoid arthritis and are given only under a health care provider's close supervision. Examples include leflunomide (Arava), hydroxychloroquine (Plaquenil), methotrexate, chlorambucil (Leukeran), and sulfasalazine (Azulfidine).
Biologic response modifier drugs (BRMs). BRMs are made from living sources, such as cell cultures, and they block the reaction of tumor necrosis factor, an immune system protein. BRMs are monoclonal antibodies that specifically target tumor necrosis factor, which is associated with rheumatoid arthritis and some other autoimmune diseases. These drugs are injected or given intravenously. Examples of these drugs are etanercept (Enbrel), infliximab (Remicade), adalimumab (Humira), and anakinra (Kineret).
Two medications specifically for OA of the knee are sodium hyaluronate substitutes. These drugs, which are injected into the joint, are fluids similar to a substance that normally lubricates and nourishes a joint. This involves a series of three to five injections.
Corticosteroids. These potent anti-inflammatory medications provide relief initially, but may produce troublesome side effects such as calcium loss from bone, weight gain, cataracts, and abnormalities in glucose regulation with long-term use. These are given only under a doctor's close supervision.
Research has shown that people with arthritis benefit from educational programs that teach them how to stay active and practice pain and stress management. They get up to 80 percent more relief from pain and joint tenderness than they can get from using medication alone.
Applying heat or cold can temporarily reduce arthritis pain. This treatment is especially helpful before and after exercise. Most people with arthritis respond more positively to cold packs than to heat, when active inflammation produces severe pain and joint swelling.
Physical therapists teach prescribed muscle-strengthening and range-of-motion exercises. They also teach ways to control pain without medication. Occupational therapists demonstrate how to use self-help devices and reduce strain on joints.
People with severe arthritis may need an orthopedic surgeon to perform joint replacement or joint resurfacing procedures.