Treatment:

The goal of treatment is to reduce pain, improve function, and prevent further joint damage. The underlying cause cannot usually be cured.

LIFESTYLE CHANGES

Lifestyle changes are the preferred treatment for osteoarthritis and other types of joint inflammation. Exercise can help relieve stiffness, reduce pain and fatigue, and improve muscle and bone strength. Your health care team can help you design an exercise program that is best for you.

Exercise programs may include:

• Low-impact aerobic activity (also called endurance exercise)
• Range of motion exercises for flexibility
• Strength training for muscle tone

Physical therapy may be recommended. This might include:

• Heat or ice
• Splints or orthotics to support joints and help improve their position; this is often needed for rheumatoid arthritis
• Water therapy
• Massage

Other recommendations:

• Get plenty of sleep. Sleeping 8 to 10 hours a night and taking naps during the day can help you recover from a flare-up more quickly and may even help prevent flare ups.
• Avoid staying in one position for too long.
• Avoid positions or movements that place extra stress on your sore joints.
• Change your home to make activities easier. For example, install grab bars in the shower, the tub, and near the toilet.
• Try stress-reducing activities, such as meditation, yoga, or tai chi.
• Eat a healthy diet full of fruits and vegetables, which contain important vitamins and minerals, especially vitamin E.
• Eat foods rich in omega-3 fatty acides, such as cold water fish (salmon, mackerel, and herring), flaxseed, rapeseed (canola) oil, soybeans, soybean oil, pumpkin seeds, and walnuts.
• Apply capsaicin cream over your painful joints. You may feel improvement after applying the cream for 3-7 days.
• Lose weight, if you are overweight. Weight loss can greatly improve joint pain in the legs and feet.

MEDICATIONS

Medications may be prescribed along with lifestyle changes. All medications have risks, some more than others. It is important that you are closely monitored by a doctor when taking arthritis medications.

Generally, over-the-counter medications are recommended first:

• Acetaminophen (Tylenol) is usually tried first. Take up to 4 grams a day (two arthritis-strength Tylenol every 8 hours). Do not take more than the recommended dose or take the drug along with a lot of alcohol. Doing so may damage your your liver.
• Aspirin, ibuprofen, or naproxen are nonsteroidal anti-inflammatory drugs (NSAIDs) that can relieve arthritis pain. However, they have many potential risks, especially if used for a long time. Potential side effects include heart attack, stroke, stomach ulcers, bleeding from the digestive tract, and kidney damage.

Prescription medicines include:

• Biologics are used for the treatment of autoimmune arthritis. They include etanercept (Enbrel), infliximab (Remicade), adalimumab (Humira), abatacept (Orencia), rituximab (Rituxan), golimumab (Simponi), certolizumab (Cimzia), and tocilizumab (Actemra). These drugs can improve the quality of life for many patients, but can have serious side effects.
• Corticosteroids ("steroids") help reduce inflammation. They may be injected into painful joints or given by mouth.
• Disease-modifying anti-rheumatic drugs (DMARDs) are used to treat autoimmune arthritis. They include methotrexate, gold salts, penicillamine, sulfasalazine, and hydroxychloroquine.
• Immunosuppressants such as azathioprine or cyclophosphamide are used to treat patients with rheumatoid arthritis when other medications have not worked.

It is very important to take your medications as directed by your doctor. If you are having difficulty doing so (for example, because of side effects), you should talk to your doctor. Also make sure your doctor knows about all the medicines you are taking, including vitamins and supplements bought without a prescription.

SURGERY AND OTHER TREATMENTS

In some cases, surgery may be done if other treatments have not worked. This may include:

• Arthroplasty to rebuild the joint
• Joint replacement, such as a total knee joint replacement

Expectations (prognosis):

A few arthritis-related disorders can be completely cured with proper treatment.

Most forms of arthritis however are long-term (chronic) conditions.

Complications:

Complications of arthritis include:

• Long-term (chronic) pain
• Disablity
• Difficulty performing daily activities

Calling your health care provider:

Call your doctor if:

• Your joint pain persists beyond 3 days.
• You have severe unexplained joint pain.
• The affected joint is significantly swollen.
• You have a hard time moving the joint.
• Your skin around the joint is red or hot to the touch.
• You have a fever or have lost weight unintentionally.