English
Arthritis occurs when inflammation damages your joints. There are different types of arthritis and treatment can vary depending on the type.
HealthyWomen spoke with Tiffany Lin, MD, rheumatologist and senior professor in the Department of Medicine, Division of Rheumatology at the University of Wisconsin School of Medicine and Public Health, about how medications and lifestyle adjustments can be helpful in living well with arthritis.
What are the goals of arthritis treatments?
I care for patients with various types of arthritis and we often first try to identify the cause of the arthritis in order to initiate treatment appropriately.
The ultimate goal of treatment is to control pain and prevent disabling injuries from this condition.
Does treatment differ depending on the type of arthritis you have?
For arthritis, treatment depends on whether you have arthritis caused by an autoimmune disease (such as psoriatic arthritis and rheumatoid arthritis), gout, pseudogout (types of arthritis caused by crystals), or infections.
For example, in patients with psoriatic arthropathy, treatment includes long-term anti-inflammatory administration. The choice of medication depends on the severity of the symptoms and the risk of developing irreversible joint damage. For milder illnesses we tend to prefer oral medications, while for more severe illnesses we consider biopharmaceuticals and CJ inhibitors.
Read: Biopharmaceuticals, Biosimilars and Generics: What’s the Difference? >>
What types of treatments can be helpful for pain relief?
We use anti-inflammatories and start with the mildest treatments. For example, we might suggest the use of topical anti-inflammatory medications such as diclofenac gel.
We also recommend over-the-counter medications such as ibuprofen and naproxen, but remind our patients that like any other medication, they have side effects and should therefore be used under the guidance of a doctor.
What medications are most commonly used to slow or stop the progression of this condition?
The treatments examined aimed to act directly on the immune system and relieve inflammation in the body and therefore also in the joints. And by reducing inflammation in the joints, we prevent or slow down injuries.
Some of these drugs, such as hydroxychloroquine and methotrexate, have been available for a long time and are an excellent starting point for fighting inflammation. They may need to be monitored to make sure they are not causing problems to the liver, kidneys, or blood.
There is also a group of medicines called biopharmaceuticals, which are usually administered through injections given by the patient at home or through intravenous infusions.
Biopharmaceuticals have changed how aggressive these diseases can be for people who are at higher risk or who tend to be more severely affected by the disease. They have changed the quality of life of the patients, as they would otherwise have developed very serious joint diseases.
These medications also allow patients to live relatively normal lives. However, they are at higher risk of serious infections and we should also pay attention to complications such as an increased risk of non-melanoma skin cancer. But if a patient needs them and oral medications haven’t shown good results, they’re a really good option.
Can treatment reverse joint damage that has already occurred?
Most treatments aim to control inflammation, and there is no pill, injection, or infusion that can reverse this damage. However, in certain circumstances we may consider surgical procedures to heal the injuries or possibly replace the joint.
Surgery is an option we consider for advanced arthritis when the lesions have reached a point where many other types of interventions are no longer available to us.
What role do physiotherapy and exercise play in the therapy plan?
Even if injuries are not visible on x-rays or other types of imaging, important issues with pain, mobility and function can be addressed through treatments such as physical therapy and exercise.
Although these treatments do not actually do anything to change joint injuries, they can be very important in terms of relieving symptoms so that you do not have to resort to more aggressive treatments such as surgery.
What additional modifications or lifestyle changes might be helpful in treating joint weakness, stiffness, and pain?
Although we do not have specific guidelines for this, many rheumatologists believe that patients benefit from a diet rich in whole foods such as whole grains, vegetables, fruits, and legumes.
Minimizing inflammatory elements in the diet, such as red meat, can also be helpful in limiting inflammatory joint pain.
It can feel like arthritis is an invisible diagnosis. This can lead to depression and difficulty dealing with stress, as not everyone is aware of the difficulties patients face on a daily basis. Organizations like the Arthritis Foundation provide opportunities to connect with other people who understand what you’re going through.
Virtual groups can be useful for people who cannot meet in person. They’re not a replacement for your doctor when it comes to medical advice, but they can provide a much-needed sense of belonging.
Features
Arthritis Foundation: Socialization Groups
This resource was created with support from Merck and Takeda.
