It’s common to have occasional pain in the muscles or joints, but arthritis symptoms may cause permanent joint damage if treatment is delayed. Fortunately, you can start a search to learn about the diagnosis process and treatment options available.
Arthritis is one of the costliest medical conditions to treat. In fact, its most common form osteoarthritis — affecting more than 30 million Americans — is the second most costly health condition treated at U.S. hospitals.
When to See a Doctor
Early intervention tends to improve outcomes for those with arthritis. This makes seeing a doctor imperative, especially if you are experiencing any of the following:
- Gradual joint pain and stiffness;
- Joint pain, swelling, or redness that does not resolve;
- Sudden joint pain presenting and accompanied by fever and/or weight loss, and;
- Visible joint deformities or loss of range of motion in one or more joints.
You should not ignore joint pain. Depending on the type of arthritis, the joint damage may be irreversible, even with appropriate treatment.
Diagnosis
Many types of arthritis are diagnosed with only a thorough medical history and physical examination and looking for signs.
Your primary doctor will likely ask you the following questions:
- When did you notice the start of your joint symptoms?
- What specific joints are painful to you?
- Does activity relieve the pain or make it worse?
- Do you have a relative with an autoimmune disorder or another arthritis-related disease?
If needed — especially if your primary doctor suspects that you may have a more serious form of arthritis — you will be referred to a specialist called a rheumatologist.
Common diagnostic laboratory blood tests, such as a complete blood count and specific types of antibodies, may be ordered by your primary doctor or a rheumatologist. Additionally, analysis of different types of body fluids — most commonly blood, urine, and joint — can lead to a definitive diagnosis as to the type of arthritis. If fluid surrounds or is indeed within a joint, your doctor may choose to obtain a sample of your joint fluid by aspiration.
Doctors commonly have access to a variety of imaging studies to help with the diagnosis of arthritis. These include:
- X-rays: May reveal loss of cartilage, bone spurs, or bone damage. Plus, it may be used to track the progression of some forms of arthritis.
- Ultrasound: Uses sound waves to acquire images of soft tissues, cartilage, and bursae. It can help guide needle placement for joint aspirations and injections.
- Computed Tomography Scan: Can visualize cross-sectional images of both bone and the adjacent soft tissues.
- Magnetic Resonance Imaging: Produces highly detailed cross-sectional images of soft tissues such as cartilage, tendons, and ligaments.
Complications
As OA and RA are the most common forms of arthritis, this section will concentrate on the possible complications of these two disorders.
Osteoarthritis
For many individuals, OA can lead to chronic pain that can be exhausting and decrease the quality of life. There are also links to anxiety and depression. Furthermore, knee OA is a leading cause of disability among adults.
Other possible complications of OA may include:
- Chondrolysis;
- Death of bone;
- Stress fractures;
- Joint infections, and;
- Loss of joint stability due to deterioration or rupture of the adjacent tendons and ligaments.
Rheumatoid Arthritis
RA is an autoimmune form of arthritis and possible complications may include:
- Carpal tunnel syndrome;
- Pulmonary fibrosis;
- Pericarditis;
- Sjögren’s syndrome;
- Vasculitis;
- Joint damage;
- Cardiovascular disease, and;
- Cervical myelopathy.
Severe Arthritis
Additionally, severe arthritis can make it difficult for you to do your typical activities of daily living. This includes:
- Personal hygiene;
- Ability to properly use the bathroom;
- Dressing;
- Feeding, and;
- Ability to walk independently.
In some cases of severe arthritis, joint deformities may develop.
Treatments
Arthritis has the potential to progress in an individual after its diagnosis. As a result, the treatment of arthritis has three overarching goals
- Control pain;
- Prevent or minimize joint damage, and;
- Improve or maintain quality of life.
Depending on the type, the treatment of arthritis may involve multiple modalities, including medications, physical therapy (PT), occupational therapy (OT), alternative treatments, and surgery.
Medications
For the treatment of pain and inflammation associated with arthritis, you may use a variety of medications including the following.
NSAIDs: NSAIDs combat both inflammation and pain. Examples are Aspirin, ibuprofen (Advil and Motrin), naproxen (Aleve), indomethacin (Indocin), piroxicam (Feldene), and meloxicam (Mobic). Oral NSAIDs may cause stomach irritation and ulcers, along with increase your risk of heart attack or stroke.
Painkillers: Painkillers only address pain. Examples include acetaminophen (Tylenol) and prescription opioids such as tramadol (Ultram), oxycodone (Percocet and OxyContin), and hydrocodone (Vicodin, Lortab). Chronic use of opioids may result in physical dependence/addiction.
Corticosteroids: Corticosteroids are potent inhibitors of inflammation and the immune system. These are the two driving forces behind most forms of arthritis. Examples include prednisone (Deltasone) and cortisone (Cortef).
Counterirritants: Counterirritants come in the form of topical creams or ointments containing menthol or capsaicin. They may ease your achy joints as these compounds disrupt the transmission of pain signals within the body.
DMARDs: DMARDs can slow or prevent your immune system from mistakenly attacking your joints. As such, they are often used to treat RA. Examples are methotrexate (Trexall) and hydroxychloroquine (Plaquenil).
Biologics: Biologics are another class of drugs used to treat RA. Adalimumab (Humira), infliximab (Remicade), and etanercept (Enbrel) are examples of biologics.
Therapy
PT and OT can be helpful for dealing with arthritis. A PT program can strengthen the muscles surrounding your joints and improve the range of motion in your joints. On the other hand, OT can help you adapt to the pain or disability of arthritis that is negatively affecting your job or educational routine.
Plus, a PT or OT specialist can recommend splints, braces, and/or assistive devices to make life a little easier.
Alternative Treatments
As of late, there has been a resurgence in the interest of alternative treatments or natural remedies for arthritis. These include:
- Acupuncture;
- The supplements glucosamine and chondroitin;
- Massage, and;
- Mind-body techniques, such as tai chi, yoga, and meditation.
It should be kept in mind that there is insufficient scientific evidence to support the use of many of these alternative treatments.
Surgery
Surgery is typically a last resort in the treatment of arthritis. It may consist of one of the following:
- Joint Fusion: This procedure fuses one or more joints in areas such as the back, neck, fingers, wrist, or ankle to provide pain relief and stability with loss of flexibility/mobility.
- Joint Repair: This procedure typically entails smoothing or realigning a joint to provide pain relief and improve function.
- Joint Replacement: This procedure involves the replacement of a worn-out natural joint with an artificial one; the hip and knee are the most commonly replaced joints.