What are the treatment options for arthritis?

Because there are so many types of arthritis, each type of arthritis has different symptoms and treatments. The good news is that many things work to help control arthritis. Care for arthritis often involves more than one type of treatment. Treatment may vary over time and may be different depending on the kind of arthritis. Consult your doctor to discuss the best treatment options for you.

Medication: Many drugs, both prescriptions and over-the-counter medications, are used to treat arthritis. Common medications are aspirin-free pain relievers, anti-inflammatory drugs, corticosteroids, disease modifiers, and sleep medications.

Exercise: Regular exercise is important to keep the body moving and flexible. It helps to lessen pain, increase movement, reduce fatigue, and helps you look and feel better.

Heat or Cold: Use of heat or cold over joints may provide short- term relief from pain and stiffness.

Pacing Activities: Pacing helps protect your joints by alternating periods of activity with periods of rest so that your joints don't tire from the stress of repeated tasks.

Joint Protection: Joints can be protected by learning to use them in ways that avoid excess stress. One way of doing this is to avoid using sore and weak joints. Unless larger joints are sore, for example, it is best to use them when carrying heavy items. The second method is walking with assistive devices like a cane. Lastly, weight control helps ease pain by reducing stress on your joints.

Self-Help Skills: You can learn ways to better manage how arthritis affects you emotionally by talking about your feelings with family members and friends, doing mental exercises, and by joining your local arthritis support group.Surgery: Most people will not need surgery, but in severe cases surgery may be effective in eliminating pain when other treatment methods have failed.

Easing the Pain of Arthritis

For people with arthritis, pain management is more complex than just taking aspirin. Arthritis is a chronic disease that can cause significant pain and discomfort. It requires a careful approach to pain management, including a combined effort involving you and your doctor.

The following provides a general overview of medications and other approaches to pain management. It will help you gain additional insight into pain management, but remember, it is very important that you discuss this subject with your doctor to determine what specific pain management course is right for you.

Here are a few basic considerations about the use of pain medications:

1. Not every drug is right for every patient.

2. Most drugs have some type of side effect.

3. A combination of drugs may be appropriate either by themselves or in conjuction with other drugs for some conditions if recommended by your doctor.

4. There's a great deal of information - and misinformation - available about medications. One helpful source is your pharmacist. The package insert and other labeling provided by the drug manufacturer is another. No matter where you start, it's important to talk with your doctor about using, changing, or discontinuing medications.

What are the analgesics prescribed for?

The primary purpose of an analgesic is to relieve pain. Some patients use aspirin, an analgesic that also reduces joint inflammation. The most commonly used analgesic, acetaminophen, is relatively effective and has few side effects. Acetaminophen does not contain aspirin, however, so it doesn't relieve joint inflammation. For this reason, acetaminophen is less likely to be used with rheumatoid arthritis and other types of arthritis that cause inflammation, and more likely to be used to treat osteoarthritis and fibromyalgia.

The main side effect of analgesics is a slight risk of dependency that can occur if the drugs are used for long periods of time.

What can you tell me about NSAIDs?

Nonsteroidal anti-inflammatory drugs (NSAIDS) are the most frequently used medications for arthritis. They are often used to treat osteoarthritis, rheumatoid arthritis, gout, juvenile arthritis, and bursitis. Some are available by prescription only, while others (such as aspirin, ibuprofen, and naproxen) can be purchased over the counter.

NSAIDs help reduce redness and swelling and relieve pain. The type of NSAID that your doctor recommends for you will depend on several factors:

1. The type of arthritis you have

2. The degree of pain and inflammation

3. How your body reacts to the NSAID

4. Other medications you are taking
   
   As with all medications, there are side effects that can occur with NSAIDs. The most common side effects include constipation and stomach irritation (ranging from indigestion and heartburn to development of stomach ulcers if symptoms are left untreated). For this reason, your doctor will monitor you carefully, and you should report any symptoms immediately.
   
   

When would a doctor prescribe corticosteroids?

Corticosteroids are similar to the hormone, cortisol, which occurs naturally in the body. Corticosteroids reduce painful inflammation in joints, but because of potentially serious side effects, they are rarely used as a first choice for long-term treatment.

Corticosteroids are almost never used to treat osteoarthritis, and when they are prescribed for rheumatoid arthritis, it is generally to relieve severe symptoms while waiting for another drug, such as an NSAID, to reach an effective level. If they are used for a longer period of time, they are generally used in lower doses.

Are there any medications that can help people with fibromyalgia?

Fibromyalgia is often mistaken for chronic fatigue syndrome because the patients never feel fully rested. Fibromyalgia, affecting deep muscle tissues and their attachments to bone, is extremely painful. A number of drugs that are not generally used to treat other types of arthritis may be prescribed for fibromyalgia, including antidepressants and antianxiety drugs.

Taken in smaller doses than for depression, these drugs can give patients the type of deep sleep they need, which contributes to pain relief and increased energy. Muscle relaxants can also promote sleep and ease painful muscles. Possible side effects vary depending on which type of medication is taken. You should discuss with your doctor the side effects of the drug prescribed for you.

Do I have to take drugs to relieve arthritis pain?

Arthritis patients have found that they may benefit from a number of other pain management techniques that do not involve medication. The most popular are:

1. Sleep

2. Exercise

3. Stress Management

4. Massage Therapy

5. Relaxation Therapy

6. Biofeedback

7. Hot/Cold Treatment

The Arthritis Foundation (www.arthritis.org) and American Academy of Orthopaedic Surgeons (www.aaos.org) web sites contain many articles and patient education information that you may find helpful as well.