The REAL Guide to Arthritis

What is Arthritis

Arthritis ('arth' meaning joint, 'itis' meaning inflammation) isn't a one-note story or even a few variations on a single theme; it actually consists of more than 100 different conditions.These can be anything from relatively mild forms of tendonitis (as in 'tennis elbow') and bursitis to crippling systemic forms, such as rheumatoid arthritis.

There are pain syndromes like fibromyalgia and arthritis-related disorders, such as systemic lupus erythematosus, that involve every part of the body.

There are forms of the disease, such as gout, which almost nobody connects with arthritis, and there are other conditions - like osteoarthritis, the misnamed 'wear and tear' arthritis - that a good many people think is the only form of the disease.

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About Arthritis

The word arthritis literally means joint inflammation, but it’s used to refer to a group of more than 100 rheumatic diseases that can cause pain, stiffness, and swelling in the joints.

These diseases might affect not just the joints, but also other parts of the body, including supporting structures such as muscles, bones, tendons, and ligaments, as well as some internal organs.

Two of the most common forms of arthritis cause many of us a great deal of pain: osteoarthritis and rheumatoid arthritis.

How is Arthritis diagnosed?

Diagnosing can be difficult because some symptoms are common to many different diseases. Your health care provider will first do a complete physical exam, looking for any swelling, redness, warmth, deformity, ease of movement, and tenderness in your joints.

Your heart, lungs, eyes, ears, throat and other parts of your body may be examined as well. This is because some types of arthritis can affect your organs.

Lab tests may also be ordered and samples of blood, urine or synovial (joint) fluid may be taken. Your doctor may have you also see a rheumatologist, a doctor who specializes in arthritis.

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The main symptoms of Arthritis

The main symptoms of all forms of arthritis are stiffness, pain, and restricted movements of the joints. Swelling, warmth and redness of the skin over the joint may also occur.

Osteoarthritis begins slowly with pain and stiffness in joints when they are moved, and restricted movement of the joints affected. For some, slight stiffness is all they will experience, but others go on to have grating joints, knobbly bone growths (especially on the hands), and joints that go out of alignment. The pain and loss of movement tends to get worse as the day goes on, as the joints are used more.

Rheumatoid arthritis also begins gradually, with a swollen and painful joint, and may be accompanied by a general feeling of being unwell, such as tiredness. It can progress to pain, swelling and stiffness in the joints, and lack of mobility. It can also spread to other organs such as the eyes, lungs and skin. It is usually worse in the morning, but often improves during the day as the joints are flexed and used.

Arthritis Treatment

Prevailing myths inaccurately portray arthritis as an inevitable part of aging that must be endured. On the contrary, some forms of arthritis, such as osteoarthritis, can be prevented with weight control and precautions to avoid certain occupational and sports injuries.

Similarly, the pain and disability accompanying all types of arthritis can be minimized through early diagnosis and appropriate management, including weight control, physical activity, self-management, physical and occupational therapy and joint replacement surgery.

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What are the treatments and drugs to treat arthritis?

The goals of arthritis treatment are simple:
• Relief arthritis pain
• Minimize joint stiffness
• Reduce inflammation
• Preserve muscle and joint function
• Maintain a normal lifestyle
• Minimize side effects of arthritis medication.

A basic common sense approach achieves these goals for a majority of patients. Although this approach is not an arthritis cure, it helps patients maintain their quality of life. This arthritis treatment approach consists of
• adequate rest
• anti-inflammatory therapy
• physical therapy to maintain joint function
• drug therapy to slow the progression of the disease (in some patients).

One of the most important aspects of arthritis relief is the control of inflammation and pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) help control these symptoms. There are several types of these arthritis medicines. Some of these medicines are safer to use than others.

NSAIDs include salicylates, traditional NSAIDs and COX-2 inhibitors. Aspirin is a salicylate. Traditional NSAIDs are medicines like over-the-counter Motrin, Advil, and other ibuprofen containing brands and Aleve and other naproxen/naproxen sodium containing brands. Other drugs in this NSAID class include ketoprofen, flurbiprofen, oraprozin, nabumetone, tolmetin, indomethacin, sulindac, piroxicam, diclofenac, diflunisal, and etodolac. Aspirin and NSAIDs can cause GI upset, bleeding and ulcers in some patients.

COX-2 inhibitors are newer agents which bind only to COX-2 receptors. COX-2 inhibitors are less likely to cause GI symptoms than traditional NSAIDs. However, COX-2 inhibitors may not be safe choices for all patients. Recently, Vioxx, a popular COX-2 inhibitor was removed from the market due to increased risks of stroke and heart attack with long term use. Another COX-2 inhibitor, Bextra, may cause similar side effects. Celebrex, a third COX-2 inhibitor, may be a safer alternative.

It is important to remember that these drugs do not modify the progression of the disease, but simply help with pain and inflammation, which can significantly improve the patient's quality of life.

Other types of arthritis medication are the disease-modifying antirheumatic drugs (DMARDs) such as hydroxychloroquine, gold, penicillamine, and the immunosuppressive agents methotrexate, and azathioprine. These drugs can help slow the progress of the disease. Because these drugs have severe side effects for some patients, it is important that the patient be followed closely by their physician.

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