What Are The Treatments For Different Types Of Arthritis?

Arthritis is an extremely common condition. In the UK, it’s estimated that around 10 million people suffer from some form of arthritis, but since many people don’t ever get diagnosed, the true number could be higher.


Arthritis

Arthritis is an extremely common condition. In the UK, it’s estimated that around 10 million people suffer from some form of arthritis, but since many people don’t ever get diagnosed, the true number could be higher.

Arthritis is a condition that is characterised by pain and inflammation in any of the joints found in the body. It can be experienced acutely, or as a chronic and persistent condition.

The severity with which people experience arthritis can also vary considerably, and again, it may get better or worse in different circumstances. Nevertheless, all arthritis has the potential to be very painful, debilitating, and negatively affect your quality of life.

Fortunately, there are some very effective treatments for arthritis that can make the condition easier to manage.

“Helping patients cope with pain is just one aspect of arthritis treatment,” explains Dr Colin Tench, Consultant Rheumatologist specialising in Lupus, Rheumatoid Arthritis, Gout, Osteoporosis and Orthopaedics at One Welbeck. “Our primary goal is to target the prevention of further joint damage to prolong the patient’s quality of life,” he continues.

We sat down with Dr Tench to talk all about arthritis — including the causes and different types of arthritis, as well as how to manage the condition.



What causes arthritis and what different types of arthritis are there?

It’s important to understand that exactly what causes arthritis depends on the type of arthritis that you have. There are more than 100 types of arthritis, although some are much more common than others.

Let’s take a look at some of the most commonly diagnosed varieties of arthritis and why they occur.

Osteoarthritis

Osteoarthritis is the single most common type of arthritis in the UK, affecting around 8.5 million people. It occurs due to degeneration and wear and tear in the joint. “Many people assume that their joint pain is just down to old age, but osteoarthritis can be treated, meaning patients don’t have to live with their symptoms,” explains Dr Tench.

Although it is more common in people over the age of 45, younger people can be affected, particularly if they are involved in sports which can accelerate wear and tear on their joints. The most commonly affected joints are the hands, knees, hips and spine.

In osteoarthritis, the smooth cartilage that lines the inside of joints starts to wear away, meaning that movement isn’t as smooth as before. Eventually, friction within the joint causes pain and stiffness, which are the two primary symptoms associated with arthritis.

Excess weight also places unnecessary pressure on the joints which can accelerate damage to the joint and make the symptoms of osteoarthritis worse.

Rheumatoid arthritis

Rheumatoid arthritis is a little different from osteoarthritis. It occurs when your body’s immune system attacks healthy cells inside your joints, causing inflammation and pain. Since it is an immune response, it often affects multiple joints at once with the hands, wrists and feet being most commonly affected.

It’s also most often seen in women. “Around 1% of the female population experience rheumatoid arthritis,” explains Dr Tench.

It usually occurs in peaks, with periods of acute disease followed by periods of remission. Some people with rheumatoid arthritis also experience other symptoms associated with their immune system attacking other healthy cells, such as fatigue and weight loss.

Although anyone can develop an autoimmune disease that is responsible for rheumatoid arthritis, you are at greater risk if you are a woman, if you smoke, and if you have a family history of the disease.

Psoriatic arthritis

Psoriatic arthritis is another autoimmune type of arthritis. However, this type specifically affects patients who have a common skin condition called psoriasis. Psoriasis is characterised by a build-up of dead skin cells that cause itchy, red, flaky patches to appear anywhere on the skin. It’s not contagious.

It’s estimated that as many as 40% of people with psoriasis develop psoriatic arthritis. And just like psoriasis, the severity of the condition can vary. Psoriatic arthritis can also get progressively worse to the point where it causes permanent damage to your joints.

Anyone with psoriasis can go on to develop psoriatic arthritis, which usually first starts to cause symptoms between 5 and 10 years after a psoriasis diagnosis.

Fibromyalgia

Fibromyalgia isn’t actually a form of joint disease, but as some of the symptoms it causes (such as chronic pain and fatigue) are similar to arthritis, some people with fibromyalgia may be recommended to see a rheumatologist — especially since it often co-occurs with other types of arthritis. The cause of fibromyalgia isn’t known, but fortunately, it can be effectively treated and managed.

Other signs of fibromyalgia include pain and stiffness all over the body, anxiety and depression, sleep problems, brain fog (issues with memory and concentration) and headaches.

While anyone can develop fibromyalgia, it is more often diagnosed in people who also have Lupus or rheumatoid arthritis.

Gout

Gout is arguably considered to be a particularly painful form of arthritis. It most often affects one joint at a time — usually the joint of the big toe. It is another type of arthritis that can flare up suddenly, lasting for days or weeks before treatment is successful, and it goes into remission.

Gout is caused by a condition called hyperuricemia, which is where there is too much uric acid in the body. This causes acid crystals to form in the joints which results in arthritis symptoms.

There are a variety of factors that can increase your risk of developing gout. These include:

  • Being male
  • Being obese
  • Using certain medications such as diuretics
  • Drinking alcohol (the more alcohol you consume, the greater your risk for gout)
  • Eating or drinking products high in fructose or purines
  • Having certain health conditions, including congestive heart failure, high blood pressure, diabetes and poor kidney function


Treatment for arthritis

There are a variety of different treatments for arthritis. Since every patient is unique, the type of treatment you will be recommended will be based on the type of arthritis you have, and its severity. “Bespoke treatment plans are the best way forward,” says Dr Tench. “We can be sure to suggest the most effective treatments based on each patient”. It’s also important to be aware that it’s not unusual for a patient to have different types of treatment during the course of their lifetime.

This is because sometimes treatments are carried out in conjunction with one another. Over time, you may find that a treatment that was previously effective in reducing your pain and maintaining or improving your mobility no longer works as well as it did.

Lifestyle changes

At OneWelbeck, we have a holistic approach towards the treatment of any disease. This means that we focus on the entire wellbeing of the patient. By improving your overall wellbeing, many diseases will also improve, and arthritis is no exception.

Some of the steps that your consultant may advise you to take to help reduce your symptoms include:

  • Eating a healthy, balanced diet that is rich in fruits and vegetables
  • Maintaining a healthy weight
  • Getting regular exercise, which can improve your strength and range of motion, reduce stiffness and releases feel-good endorphins
  • Consider supplements to help with mobility, such as glucosamine

Medications

Many people with arthritis are prescribed medications. These include pain medications and, where appropriate, those which help counteract the underlying cause of arthritis. Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the most effective medicines for arthritis as they help to counteract inflammation and swelling and relieve pain. However, consultants are reluctant to prescribe stronger pain relief.

“Pain relief can be helpful for some types of arthritis, but should only ever be a short term solution since over time, they can become less effective, meaning patients need to take increasingly higher doses to get the same effect,” explains Dr Tench.

The reason for this is that taking these medications simply masks the discomfort and could actually lead to you doing too much and causing more damage to the joint. For this reason, pain medications aren’t recommended as a long-term solution, but as safer to be taken intermittently.

There are also medications that can be prescribed specifically for rheumatoid and psoriatic arthritis. The most common work by blocking the effects of the chemicals that are released when your immune system attacks your joints, essentially switching off your body’s inflammatory response. They are often referred to as biologics or TNF inhibitors.

If you have gout, you’ll probably be treated with NSAIDs, although you may also be given medications to reduce the amount of uric acid in your blood. Meanwhile, fibromyalgia is usually treated with a combination of antidepressants and anti-seizure medications which can help to reduce pain.

Physiotherapy

Physiotherapy is recommended only for patients with certain types of arthritis, including mild to moderate osteoarthritis and rheumatoid arthritis.

The goal of physiotherapy is to prevent further joint damage, relieve pain and maintain joint function. While the knees are the most treated joint in physiotherapy, the hips, shoulders and elbows can also be targeted.

Therapeutic injections

For some patients, cortisone therapeutic injections may be recommended. Cortisone is a powerful anti-inflammatory that helps to reduce swelling and stiffness in the joint, improving patient mobility and making discomfort easier to manage.

Cortisone injections usually begin working within 24 hours, with the effects lasting anywhere from 6 weeks to 6 months before further treatment is needed.

Surgery

Surgery is nearly always a last resort for patients with arthritis and is usually only recommended when a joint has degenerated so much that it requires surgical intervention to repair it.

There are several different types of surgery which may be suitable depending on the individual needs of the patient. These include:

  • Joint resurfacing — This is where part of a hip or knee joint is removed and replaced with an artificial component
  • Osteotomy — This procedure involves removing bone or adding a wedge of bone to shift weight from an area damaged by arthritis to an undamaged area
  • Synovectomy — This surgery removes some or all of the inflamed lining of the joint
  • Total joint replacement — As its name suggests, this is where the damaged joint is replaced with an artificial implant

If you need surgery, your consultant rheumatologist will refer you to an orthopaedic surgeon for the next stage in your treatment journey.



Speak to a rheumatologist today

“There are many different reasons why you may be experiencing joint pain, so don’t just dismiss your discomfort,” advises Dr Tench. “There are many treatments for arthritis or other joint pain that can help”.

If you are suffering from joint pain, or if you are concerned about arthritis, an appointment with a OneWelbeck rheumatologist is the first step to restoring your quality of life.

Schedule your consultation today by contacting our knowledgeable and dedicated team. 

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Written by Dr Colin Tench

Dr Colin Tench is a Consultant Rheumatologist at OneWelbeck. He has over 25 years of experience in treating a wide variety of joint and muscle problems with specialist interests in Lupus, Rheumatoid arthritis, gout and osteoporosis. To book an appointment directly, please contact Dr Tench's practice manager, Nicola George, on 07859 902608 or office@colintench.co.uk.