Arthritis
In this condition factsheet:
Diagnosing Arthritis
To diagnose arthritis, your doctor will take a thorough history and conduct a physical examination to determine which joints are affected and what other organs or tissues might be involved, and to rule out other possible diseases.
The joints may not show any abnormalities or may show tenderness, swelling, redness or heat, or limited range of motion.
Because there is no specific test to diagnose arthritis, almost all kinds of arthritis are based on the clinical diagnosis of the doctor. Doctors make a firm diagnosis based on the cumulative pattern of the person's own medical history, family history, environment, physical exam, tests, and course of condition over time.
X-rays may show nothing or may show characteristic changes of OA, RA, and other types of arthritis. MRI and ultrasound may show more information than an X-ray. Sometimes, it is necessary to withdraw a fluid sample from a swollen joint to examine it under the microscope and to send the sample to the lab for analysis of white blood cells and other factors.
Treating and Preventing Arthritis
Unfortunately, there's no cure for most forms of arthritis. The goal of treatment is to reduce symptoms of pain and inflammation with the help of exercise programs, physiotherapy, and medications.
There are things everyone can do today to prevent the possibility of OA later in life. The most important change you can make is to maintain a healthy weight to limit stress on the joints. Gaining an extra 10 to 20 pounds in early adulthood often increases wear and tear on the shock-absorbing cartilage in joints and can lead to serious joint damage in the long run. Avoiding repetitive movements over long periods of time can help, but if repetitive motions are part of a job or leisure activities, proper training is important. Daily stretching exercises may help with this.
If someone has a traumatic injury to a joint, they need medical care and rehabilitation to avoid further damage. Talk to a doctor about the proper use of ice, rest, heating pads, hot water bottles, and hot baths for treating any injury.
Exercise programs to maintain muscle tone are useful for managing OA and other kinds of arthritis. These may include special exercises prescribed by your physician. A physical therapist can help you do exercises that strengthen muscles and improve range of motion. Swimming may be helpful since it causes very little strain on the joints. Walking is an excellent form of therapy for arthritis in the knees, but only to the point that it does not cause pain. In some cases, joint pain due to OA is often relieved with heat and rest. Cold packs are good short-term pain relievers, but they can temporarily increase stiffness.
Medications for OA include a wide range of pain relievers and anti-inflammatory medications. Acetaminophen* is generally a good choice for long-term use, but it's important to not exceed the recommended amount (i.e., no more than 4,000 mg per day) . Even though it is sold over the counter, it can cause serious liver damage if used incorrectly. If acetaminophen is not effective or if inflammation is present, non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen may be recommended. Topical pain relievers, like diclofenac, or capsaicin, are also available to help with localized OA pain.
Acetaminophen and some forms of NSAIDs are available without a prescription, but always check with a doctor or pharmacist before taking any of these medications. They can also have serious side effects and drug interactions if used incorrectly.
Prescription narcotic pain relievers (such as various codeine derivatives) can help people who experience acute periods of pain, but they also can be harmful if not used correctly and may be habit-forming. Constipation is a common side effect of these medications if they are used regularly and you may need to treat this side effect.
If other options have failed, local injections of corticosteroid medication into the affected joints are another treatment option. These injections should not be used too often and should not be given to certain people, such as people with infection or blood problems. For severe cases, surgery such as a hip or knee replacement may be needed.
Therapy for RA and other inflammatory types of arthritis includes specially tailored exercises, and medications like celecoxib and other NSAIDs.
The group of medications called disease-modifying antirheumatic drugs (DMARDs) such as hydroxychloroquine and methotrexate can be helpful for RA, but they require time (weeks to months) before they start working. DMARDs can help to prevent joint destruction. Another group of medications called biologics (e.g., abatacept, adalimumab, anakinra, etanercept, infliximab, rituximab, and others) can also help improve RA symptoms and slow down joint destruction. Certain synthetic DMARDs called targeted synthetic DMARDs (e.g., tofacitinib, baricitinib, and upadacitinib) can improve RA symptoms by blocking specific signals in the inflammatory pathway.
Corticosteroids (e.g., prednisone, methylprednisolone) may also be used sparingly to control inflammation. By themselves, corticosteroids will not prevent joint deterioration. They are often combined with other medications to treat RA (e.g., a biologic is often combined with a DMARD). Relieving stress on joints is important to avoid further damage. Canes, walkers, splints, or crutches are sometimes needed to reduce the amount of body weight placed on certain joints.
NSAIDs are also used to treat the acute symptoms of gout, but low-dose ASA should be avoided as it affects the way the kidneys handle uric acid. Colchicine or corticosteroids may also be used to treat acute gout. Regular use of colchicine may reduce frequency of attacks. In some cases, people are prescribed other medications (e.g., allopurinol or febuxostat) to help prevent acute gout attacks.
All of these medications have serious side effects and should be carefully considered and monitored by your doctor. Make sure you understand all the risks and benefits of taking these medications before you start them. Rheumatologists are doctors that specialise in the diagnosis, treatment, and management of RA (and all other kinds of arthritis).
Living and coping with arthritis, as with any chronic disease, can be difficult. It may affect daily activities slightly, or it can be more severe and extremely debilitating. Some people may benefit from counselling or support groups to deal with the challenges of living with arthritis. There are many resources available – it's important to take advantage of them. The Arthritis Society provides valuable resources.
All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Arthritis
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