Treatment. Arthritis

Arthritis diagnosis

To diagnose arthritis, your physician will perform a physical examination, during which your joints will be checked for any signs of redness, warmth, or swelling. Your ability to move your joints will also be checked. Your doctor may also recommend some of the following tests, depending on what condition is suspected.

• LABORATORY STUDIES. Analyzing the various kinds of fluids of the body can help to determine the form of arthritis that may be present. These studies commonly include analysis of the urine, joint fluid, and blood. 
• IMAGING STUDIES. Imaging studies can help provide information about various types of arthritis by detecting problems within the joints. They can also help rule out other conditions as a cause of your symptoms. Imaging studies may include: 
  • X-rays
  • Computerized tomography
  • Magnetic resonance imaging 
  • Ultrasound
• ARTHROSCOPY. In some cases, a physician needs to see inside the joint to confirm an arthritis diagnosis. To do this, the physician uses a tiny tube inserted through an incision. The arthroscope is able to transmit images of the inside of the body to a video screen. 

Arthritis treatment

To help preserve joint mobility, physical therapy and/or occupational therapy may be recommended. What kind and how much therapy is recommended depends on many different factors. These include the type and severity of arthritis that is present and the general health of the patient.

Physical Therapy as Arthritis Treatment

People who have arthritis often avoid movement of the joints that are affected due to pain. Physical therapists help patients relieve joint stiffness due to immobility without causing further damage to the joints. Physical therapists can also help improve mobility by strengthening the muscles around the joints affected by arthritis. Patients also receive instruction on safe and more effective ways to change positions and are taught the correct use of assistive devices like a cane, crutches, or a walker if these are needed.

Occupational Therapy as Arthritis Treatment

Occupational therapists teach patients methods for reducing strain on the joints during typical daily tasks. They provide suggestions for modifying the home and place of work so that tasks do not inflict more joint damage or inflammation. They can also provide assistive devices that can make activities easier, such as dressing aids, bathing and grooming aids, or splints and braces.
Therapists sometimes use, as well as instruct patients in the use of heat or cold to provide relief from pain due to arthritis.

Medications for arthritis treatment

• NSAIDs: Nonsteroidal anti-inflammatory drugs. These are the most often prescribed arthritis medications. Some are available over-the-counter (OTC), and others require a physician’s prescription. All types work by blocking specific hormone-like chemicals called prostaglandins that trigger inflammation, pain, fever, and muscle spasms. However, individuals who have suffered a stroke or heart attack or who have peripheral vascular disease or heart disease should not take NSAIDs.
  • Traditional NSAIDs:  This is the largest group of NSAIDs. They have the potential to cause side effects, including stomach problems and gastrointestinal bleeding. Patients with arthritis should only take these medications in high doses with a doctor’s supervision. 
  • COX-2 inhibitors: These NSAIDs also are used to reduce the inflammation and pain of arthritis. They carry less risk for gastrointestinal and stomach side effects, but they do carry a risk of other side effects.  
  • Salicylates: These types of NSAIDs include aspirin. Patients should not use aspirin more than just occasionally without consulting their doctor due to the risk of side effects. Long-term use of aspirin in high doses may cause serious side effects like gastrointestinal bleeding and kidney problems. Unfortunately, large doses of aspirin are needed to control arthritis effectively. Some physicians prescribe nonacetylated salicylate, which has less risk of harmful side effects. 
• Glucocorticoids: These are steroids that have strong anti-inflammatory properties. They can effectively control the pain and inflammation of several types of arthritis, but they carry the risk of many serious side effects. 
• Hydroxychloroquine and chloroquine: These are anti-malaria drugs that are sometimes used as mild forms of inflammatory arthritis medications. 
• Minocycline: The use of this drug is not recommended by all physicians, but sometimes it is used as a treatment of rheumatoid arthritis. It is an antibiotic.
• Sulfasalazine: This is a form of sulfa. It is used to treat several forms of inflammatory arthritis. 
• Methotrexate: This medication is reserved for treating severe forms of inflammatory arthritis.
• Azathioprine: This drug is also used in serious types of inflammatory arthritis.
• Gout medications: Some doctors prescribe them as arthritis medications.
• Leflunomide: This drug is used in the treatment of psoriatic arthritis and rheumatoid arthritis. It is being used less as biologic therapy is becoming more popular. 
• Cyclosporine: This drug works by blocking the body’s immune response. It is known as an immunosuppressant drug and is often taken in combination with methotrexate. 

Arthritis Surgery

If non-surgical treatments are ineffective, physicians sometimes recommend surgery as an arthritis treatment. Procedures for arthritis may include:

• Joint replacement. In this procedure, the joint that is damaged is replaced by an artificial joint. Joints most often replaced are knees and hips. 
• Joint fusion. This arthritis surgery is most often performed on smaller joints, such as those in the spine, fingers, wrist, or ankle. Typically, the ends of bones are removed where they meet in a joint, and the ends are fused, sometimes using surgical instrumentation, until they form one solid piece of bone.