More than 40 million Americans are affected by arthritis. If left untreated, arthritis can become a chronic condition with symptoms of severe pain and swelling that seriously disrupts everyday life. Learning how to live with arthritis can be extremely difficult, but by making healthy lifestyle changes and incorporating different treatments, you can manage the symptoms and improve your quality of life.
Treatments for arthritis will depend on your individual health needs, severity of pain and other symptoms associated with the arthritis.
Healthy lifestyle changes, such as adequate sleep, regular exercise, and a low-fat, high-fiber diet are often the first steps in managing arthritis symptoms. Low-impact exercise has been proven to do the following:
- improve joint mobility
- relieve stiffness
- reduce pain and fatigue
- strengthen muscles and bones
"Staying in motion actually helps to keep pain away," says Moshe Lewis, MD, MPH. Exercise, such as brisk walking, is critical in treating pain and stiffness associated with arthritis and is vital in extending the life of your joints.
Eating a healthy diet can help you lose weight, which can help to reduce inflammation and stress placed on the joints by excess weight.
Applying cold and heat to inflamed joints can be effective. Ice helps to restrict blood vessels, which reduces fluid in the tissue and decreases swelling and pain in the affected area. Wrap ice in a towel and apply to the aching area for 20 minutes a few times a day.
You can use heat treatments much the same way. Use a hot water bottle or heating pad and apply it directly to the swelling. Heat opens the blood vessels and increases circulation, bringing nutrients and proteins essential to repairing the compromised tissue.
Learn more about treating pain with cold and heat.
Over the counter medications are effective in relieving minor aches, pains, and swelling associated with arthritis. The most common types of over-the-counter pain-relievers are acetaminophen, such as Tylenol, and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen.
Topical creams that work to relieve pain associated with arthritis and muscle aches are also widely available. These may contain active ingredients such as menthol (Ben Gay, Stopain) or capsaicin (Capzasin, Zostrix), which is made from hot peppers.
If symptoms persist or worsen, your doctor may want to prescribe a stronger medication.
These injections, which contain a corticosteroid, reduce swelling and relieve inflammation and pain in arthritic joints.
Prescription Nonsteroidal Anti-inflammatory Drugs
Prescription NSAIDs work to reduce swelling and pain. This class of drugs includes:
- celecoxib (Celebrex)
- piroxicam (Feldene),
- nambumetone (Relafen)
- prescription-strength ibuprofen and naproxen
Tramadol (Ultram) is a prescription analgesic. For some, tramadol may cause fewer side effects than NSAIDs.
Strong painkillers can provide relief from severe pain. These include:
- meperidine (Demerol)
- oxycodone (OxyContin)
While these medications will reduce the pain symptoms of arthritis, they will not modify the course of the disease.
Disease Modifying Drugs
A class of medications known as disease modifying anti-rheumatic drugs (DMARDs) is often prescribed when there is evidence on an x-ray that rheumatoid arthritis is present. Examples of these medications include:
- azathioprine (Imuran)
- biologics (Actemra, Cimzia, Enbrel, Humira, Kineret, Orencia, Remicade, Rituxan, Simponi) cyclophosphamide (Cytoxan)
- cyclosporine (Neoral)
- hydroxychloroquine (Plaquenil)
- methotrexate (Rheumatrex, Trexall)
TNF-alpha inhibitors like etanercept can also modify the course of the disease. Each of these medications has its own sets of side effects that need to be discussed with your physician.
Trigger Point Injections
Injections of a local anesthetic that can also include a steroid can be used to relieve pain in areas of muscle that contain "trigger points." Trigger points occur when muscles bind together and don't relax. Injections can be used to treat muscle pain in the arms, legs, and back and often provide relief for several weeks or months at a time. .
Physical therapy can be effective in improving muscle strength, increasing the range of motion of joints, and reducing pain. Consult a physical therapist for an exercise regime tailored to your personal arthritis needs. Splints, shoe inserts, and/or braces may help provide support to weakened joints, take pressure off of your injured bones, and reduce overall pain.
Severe cases of arthritis may require surgery to replace or repair damaged joints. Types of surgery used to treat arthritis include:
- joint replacement
- bone realignment
- bone fusion
- arthroscopic surgery
Many types of complementary therapy can be added to the overall treatment plan for arthritis. The efficacy of these treatments vary among individual patients. Consult your primary care physician before starting any new treatment to see if it's safe for you.
Many relaxation techniques, such as meditation, massage, and yoga help to reduce stress, inflammation, and decrease muscle tension.
Acupuncture and acupressure are used to relieve pain by inserting small needles into the skin at key points, which prompts the body to release endorphins and blocks the message of pain from being delivered to the brain.
Biofeedback is another technique often used in pain management therapy. It works by measuring information about muscle tension, heart rate, brain activity, and skin temperature. The feedback is used to enhance an individual's awareness to physical changes associated with physical and psychological stress or pain.
Transcutaneous Electrical Nerve Stimulation (TENS)
TENS uses a small electric current that is applied to specific nerves, which interrupts pain signals and releases endorphins.
Herbs & Supplements
There are many herbal supplements that have anti-inflammatory properties and are recommended for arthritis treatment. Dr. Moshe Lewis recommends fighting arthritic pain with capsaicin, the natural chemical that gives chili peppers their heat. Turmeric is another healthy spice that has been used to reduce inflammation for hundreds of years. Moshe suggests taking 500mg of turmeric capsules three times per day.
Other natural remedies include:
- vitamin C
- fish oil
- avocade soybean unsaponifiable
There is little clinical evidence that nutritional supplements have a consistent impact on pain in arthritis, but some people find them helpful. In general, they are not harmful, and some—such as fish oil and vitamin C—provide other health benefits unrelated to arthritis. However, it is important to exercise caution when taking supplements because the contents are not verified by the FDA. You should always consult your doctor before taking any supplement to make sure it is a safe addition to your treatment plan.