Arthritis Management (Rheumatoid Arthritis, Osteoarthritis)
Rheumatoid arthritis is a chronic inflammatory disease in which the lining of the joints become inflamed, causing pain, swelling, and stiffness. It is as an ‘autoimmune disease’ because it occurs when our immune system, which normally fights against infection, starts destroying healthy joints. Severe rheumatoid arthritis can be very painful and even deform or change a joint. It also affects a person's ability to perform routine activities.
The exact cause for rheumatoid arthritis is unknown and there is no definitive cure. However, with better understanding of the disease helps in better management of disease by relieve the pain and other symptoms, and retarding the progression of the disease. Early diagnosis and treatment is important to minimise the damage to joints.
Management of Rheumatoid Arthritis
Several treatment modalities are available for the management of rheumatoid arthritis and they include medications, physiotherapy, occupational therapy, and surgery.
- Medications: There are different types of medications which include disease-modifying anti-rheumatic drugs (DMARDs)-methotrexate; pain medications such as non steroidal anti-inflammatory drugs (NSAIDs)-aspirin, ibuprofen, and COX-2 inhibitors. The DMARDs reduce the body’s immune response against the joints whereas the NSAIDs reduce swelling and pain
- Physiotherapy: Physical therapy exercises should be done regularly to increase the strength of muscles and flexibility of joints. Transcutaneous Electrical Nerve Stimulation (TENS) is a type of electrotherapy that is given to provide pain relief
- Occupational Therapy: Occupational therapy helps to perform daily activities at home and at work independently through the use of equipments. It also helps you to adapt to your condition using the relaxation and stress-management techniques
- Surgery: Surgical treatment is considered if you have severe rheumatoid arthritis and your symptoms do not get better with the conservative treatments. The benefits of surgery are pain relief and improvement in joint function
Osteoarthritis, also called degenerative joint disease is the most common form of arthritis. It occurs most often in older people. This disease affects the tissue covering the ends of bones in a joint (cartilage).In a person with osteoarthritis, the cartilage becomes damaged and worn out causing pain, swelling, stiffness and restricted movement in the affected joint. This condition most commonly affects the joints in hips, knees, hands, and spine. Rarely, the disease may affect the shoulders, wrists and feet.
Management of Osteoarthritis
There are several treatments and lifestyle modifications that can help you ease your pain and symptoms.
- Medications: Pain-relieving medications such as NSAIDs, COX-2 inhibitors and opioids may be prescribed. Topical medications such as ointments can be applied over the skin where there is pain. If the pain is very severe, corticosteroid injection can be given directly into the affected joint to ease the pain
- Other Treatments: Your physiotherapist will teach you exercises to keep joints flexible and improve muscle strength. Heat/cold therapy which involves applying heat or cold packs to the joints provides temporary pain relief. Lifestyle modifications can be done to control weight and avoid extra stress on the weight-bearing joints
- Surgery: Joint replacement surgery is considered as an option when the pain is so severe that it affects your ability to carry out normal activities