Health

How Is Arthritis Treated?

One of the most common questions I’m asked is, “How is arthritis treated?” Most people just think of arthritis as someone everyone has to deal with as they get older, so there’s no point in actually treating it. But as anyone with autoimmune arthritis knows, you really need to treat it in order to life you’re happy with. So in this post, I’m discussing how arthritis is treated at large. Not every treatment will work for every arthritis patient, especially because there are so many forms of arthritis. I’ve also included some lifestyle treatment that are worth trying. Again, not everything will work for everyone, but in my opinion, it is worth figuring out what works for you.

This is your regular reminder that I am not a medical professional and that all advice and information in this post is cited so you can go read what the actual professionals have to say. This is an informational post and you should talk to your doctor before making a treatment change!

Boston lifestyle blogger and rheumatoid arthritis patient Kate the (Almost) Great answers the question, "How is arthritis treated?" There are over 100 types of arthritis, and they're not all treated the same way!

How Is Arthritis Treated?

Different types of arthritis need different treatments – This might sound obvious but it’s important to note. There are over 100 different types of arthritis and they work in different ways, so your treatment could be different if you have one kind than if you have another. For example, osteoarthritis can be caused by joint injury or overuse, age, genetics and more (x). On the other hand, rheumatoid arthritis is caused by your immune system attacking healthy cells (x). So my rheumatoid arthritis treatment(s) of immunosuppressants probably won’t help someone who has osteoarthritis from playing sports for 20 years. Plus, even people who have the exact same type of arthritis will respond differently to different treatments. I won’t have any of that “My aunt’s neighbor with RA does [insert random treatment here] and she’s fine!” on my blog.

What’s the difference between osteoarthritis and rheumatoid arthritis?

Different doctors you might need to see – The doctor to start with is your primary care doctor, or GP. Not only can they point you a specialist if you need to see one, but most insurance companies will require a referral in order for you to see a specialist. The specialist you’ll need to see for autoimmune arthritis is a rheumatologist. The American College of Rheumatology defines rheumatologists as, “A rheumatologist is an internist or pediatrician who received further training in the diagnosis (detection) and treatment of musculoskeletal disease and systemic autoimmune conditions commonly referred to as rheumatic diseases. These diseases can affect the joints, muscles, and bones causing pain, swelling, stiffness, and deformity” (x). Orthopedic surgeons are doctors who specialize in one or a few joints and, if necessary, perform surgery. My knee surgeon has given me way more cortisone injections than he has operated on me!

Other doctors you might see for your arthritis include osteopathic doctor, pain specialist, acupuncturist, chiropractor, and many more. You might also want to see a therapist to help you unpack the many complicated feelings of living with chronic pain.

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Different Arthritis Treatments

Medications

NSAIDs – NSAIDS (or non-steroidal anti-inflammatory drugs) are some of the most common painkillers in the world. Aleve and Advil are NSAIDs, for example. WebMD says, “By blocking the Cox enzymes, NSAIDs stop your body from making as many prostaglandins. This means less swelling and less pain” (x). As their name suggests, they are used to reduce inflammation (aka swelling), which is a common symptom of arthritis. The problem is that it’s not great for your body to take NSAIDs every single day. A common side effect is that they “can cause ulcers and other problems in your esophagus, stomach, or small intestine” (x).

DMARDs – DMARDs (or disease-modifying anti-rheumatic drugs) are frequently the first medication taken when someone is diagnosed with autoimmune arthritis. As a whole, “DMARDs help preserve joints by blocking inflammation. Without DMARDs, inflammation would slowly destroy joint tissue over the years to the point where the joint would become misshapen and unusable” (x). How do these work? “Traditional DMARDs restrict your immune system broadly. Targeted DMARDs block precise pathways inside immune cells” (x). Again, with autoimmune arthritis, the immune system is the problem, so you need to shut it down to a certain extent.

Steroids – When we talk about steroids in the arthritis sense, we’re talking about corticosteroids and not the kind that athletes might take. These steroids “reduce inflammation because they are chemically similar to cortisol, one of your body’s natural anti-inflammatories” (x). Not only that, but they’re also immunosuppressants. (Are you sensing a theme with these medications?) Generally, steroids are prescribed for a flare, although some people like me are on low doses constantly. The goal for me specifically is to get off of them, but that requires a working overall treatment, so it will be a little bit longer before that happens. But I digress.

Biologics – The FDA says, “Biologics can be composed of sugars, proteins, or nucleic acids or complex combinations of these substances, or may be living entities such as cells and tissues. Biologics are isolated from a variety of natural sources – human, animal, or microorganism – and may be produced by biotechnology methods and other cutting-edge technologies” (x). So biologics for arthritis go after parts of the immune system, such as TNF, b-cells, and more. Some arthritis biologics include Humira, Enbrel, Rituxan, and more.

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Surgeries

Surgeries – It’s pretty obvious that this is going to vary wildly depending on the area of your body. The University of Washington has a great overview of what goes on in joints, which is necessary in order to understand where and why you might need surgery.

A joint is a place in the body where two bones come together. Ligaments are fibrous cords that attach bones to bones. Tendons are like ligaments except they connect muscles to bones. A bursa is a fluid-filled sac that acts as a cushion between muscles and bone or tendons. The tissue lining the joints is called the synovium. In conditions like rheumatoid arthritis, the synovium becomes inflamed. This inflammation releases chemicals that, over months or years, will thicken the synovium and damage the cartilage and bone of the affected joints. Inflammation of the synovium causes pain and swelling. The ends of the bones are covered with cartilage. In osteoarthritis, the cartilage becomes cracked and pitted and no longer allows smooth movement of the joint. When cartilage wears away in a weight-bearing joint such as the hip or knee, it can produce severe pain, deformity, and loss of mobility.

University of Washington

One type of surgery for arthritis is a synovectomy of the joint, in which case the diseased synovium is removed. This is commonly done in RA patients, as the synovium is a problem for them. However, UW says, “the synovium often grows back several years after surgery and the problem can happen again” (x). Other possible surgeries include osteotomy, resection, arthrodesis, arthroplasty, and more. Athroplasty can include a joint replacement.

Lifestyle Changes

The lifestyle changes I made for my rheumatoid arthritis

Foods – Unfortunately, there’s no one-size-fits-all list of foods that affect arthritis patients. If you have osteoarthritis, you might not respond negatively to food, but if you have an autoimmune version, you might. I personally can’t eat gluten, dairy, corn, soy, and egg; my RA reacts terribly to them. It is worth trying to find what foods you might respond to. Through my non-scientific discussions with other patients, gluten is the one that irritates most people. Healthline suggests arthritis patients should cut out fried and processed foods, sugars and refined carbs, dairy, alcohol and tobacco, salt and preservatives, and corn oil (x).

Please speak to your doctor before making any big changes!

Exercise – For many people, exercise improves their arthritis pain. This doesn’t happen for all patients (I feel worse after I exercise), but it does for many. The Mayo Clinic says that exercise “increases strength and flexibility, reduces joint pain, and helps combat fatigue” (x). They explain types of exercises to try, tips for protecting your joints, and more.

Physical Therapy – You might think PT is only for after you have a surgery or after an injury, but it doesn’t have to be! The Arthritis Foundation says, “Goals of physical therapy in arthritis include improving the mobility and restoring the use of affected joints, increasing strength to support the joints, and maintaining fitness and the ability to perform daily activities” (x).

Occupational Therapy – OT is slightly different from PT. as it focuses on helping you do everyday things slightly differently. The Arthritis Foundation says, “An occupational therapist is a specialist who helps people with arthritis maximize their ability to participate in activities safely and enhance their quality of life” (x).

What would your ideal arthritis treatment look like?

Like this post? Check out:

All arthritis posts, Arthritis Glossary: Frequently-Used Words, Chronically Ill Tips: What To Do When a Doctor Isn’t Listening to You, Caring for Rheumatoid Arthritis Patients, Why Is Rheumatoid Arthritis Hard To Diagnose?

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1 Comment

  • Reply Richard

    Hi. I have been reading your blog for what feels like a long time. I am also plagued with chronic illnesses that decrease my quality of life, including RA, like you. This is what drew me to your writing.

    It has been going on for a very long time, since the beginning, so I feel obligated now to alert you to it–for someone who considers herself an editor and writer, your posts are often terribly edited. The majority are ridden with grammatical errors or odd spelling mistakes. In one post, you asked your readers to refer you to clients who may need proofreading services–in that very post there were multiple errors, which does not bode well for your skills as an editor.

    I have considered bringing this issue up for a long time now. I have to do it now. I understand you live in pain and this hinders your ability to perform some tasks, from time to time. I do not mean to offend. But I hope this will alert you to the problems with your writing and help you to be more serious about your work as a blogger. Thanks for your work, I truly appreciate your patient advocacy and outreach. Best of luck in your life.

    September 1, 2019 at 1:12 am
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