Arthritis
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Arthritis
Overview
Arthritis is the swelling and tenderness of one or more joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. The most common types of arthritis are osteoarthritis and rheumatoid arthritis.
Osteoarthritis causes cartilage — the hard, slippery tissue that covers the ends of bones where they form a joint — to break down. Rheumatoid arthritis is a disease in which the immune system attacks the joints, beginning with the lining of joints.
Uric acid crystals, which form when there’s too much uric acid in your blood, can cause gout. Infections or underlying disease, such as psoriasis or lupus, can cause other types of arthritis.
Treatments vary depending on the type of arthritis. The main goals of arthritis treatments are to reduce symptoms and improve quality of life.
Diagnosis
During the physical exam, doctors check your joints for swelling, redness and warmth. They’ll also want to see how well you can move your joints.
Laboratory Tests
The analysis of different types of body fluids can help pinpoint the type of arthritis you may have. Fluids commonly analyzed include blood, urine and joint fluid. To obtain a sample of joint fluid, doctors cleanse and numb the area before inserting a needle in the joint space to withdraw some fluid.
Imaging
These types of tests can detect problems within the joint that may be causing your symptoms. Examples include:
- X-rays. Using low levels of radiation to visualize bone, X-rays can show cartilage loss, bone damage and bone spurs. X-rays may not reveal early arthritic damage, but they are often used to track progression of the disease.
- Computerized tomography (CT). CT scanners take X-rays from many different angles and combine the information to create cross-sectional views of internal structures. CTs can visualize both bone and the surrounding soft tissues.
- Magnetic resonance imaging (MRI). Combining radio waves with a strong magnetic field, MRIs can produce more-detailed cross-sectional images of soft tissues such as cartilage, tendons and ligaments.
- Ultrasound. This technology uses high-frequency sound waves to image soft tissues, cartilage and fluid-containing structures near the joints (bursae). Ultrasound is also used to guide needle placement for removing joint fluid or injecting medications into the joint.
Treatment
Arthritis treatment focuses on relieving symptoms and improving joint function. You may need to try several different treatments, or combinations of treatments, before you determine what works best for you.
Medications
The medications used to treat arthritis vary depending on the type of arthritis. Commonly used arthritis medications include:
- NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation. Examples include ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve). Stronger NSAIDs can cause stomach irritation and may increase your risk of heart attack or stroke. NSAIDs are also available as creams or gels, which can be rubbed on joints.
- Counterirritants. Some varieties of creams and ointments contain menthol or capsaicin, the ingredient that makes hot peppers spicy. Rubbing these preparations on the skin over your aching joint may interfere with the transmission of pain signals from the joint itself.
- Steroids. Corticosteroid medications, such as prednisone, reduce inflammation and pain and slow joint damage. Corticosteroids may be given as a pill or as an injection into the painful joint. Side effects may include thinning of bones, weight gain and diabetes.
- Disease-modifying antirheumatic drugs (DMARDs). These drugs can slow the progression of rheumatoid arthritis and save the joints and other tissues from permanent damage. In addition to conventional DMARDs, there are also biologic agents and targeted synthetic DMARDs. Side effects vary but most DMARDs increase your risk of infections.
Therapy
Physical therapy can be helpful for some types of arthritis. Exercises can improve range of motion and strengthen the muscles surrounding joints. In some cases, splints or braces may be warranted.