How Is Arthritis Treated?

Arthritis is inflammation of the joints, which are places where two bones meet. There are more than 100 types of arthritis, and they typically cause joint pain and stiffness.

While there is no cure for arthritis, you can take steps to manage the condition. The specific treatment options depend on the type of arthritis you have. Still, treatment goals are generally the same for all types of arthritis: To improve symptoms, increase quality of life, and slow or stop disease progression. 

Treatment by Arthritis Type

More common types of arthritis include osteoarthritis, rheumatoid arthritis, psoriatic arthritis, and gout. Treatment options are available for each of these arthritis types, including medications, physical therapy (PT), and surgery. 

It’s common for your healthcare provider to use a combination of treatments to help manage your arthritis. Only in the most severe cases is surgery usually considered.

You’ll work with your healthcare team to determine the most appropriate treatment plan for your condition. Your healthcare provider will consider your complete medical history when making treatment recommendations. Your treatment options will also be based on the type and location of your arthritis.

Treatments for Osteoarthritis

Osteoarthritis (OA) is the most common type of arthritis. It usually affects the hands, knees, and hips and causes symptoms like mild to severe pain and swelling in the affected joints.

Lifestyle habits like physical activity and weight management can help you manage your OA. 

Medical intervention may also be necessary. This can include PT to strengthen the joint’s surrounding muscles, the use of supportive devices like canes or crutches, and medication.

Over-the-counter (OTC) and prescription medications can help treat OA. The following medications can reduce pain and swelling, improve joint function, and prevent the affected joint from permanent damage:

• Anti-inflammatory medications: Non-steroidal anti-inflammatory drugs (NSAIDs) such as Advil or Motrin (ibuprofen), Aleve (naproxen), and Celebrex (celecoxib) are used to help reduce pain and swelling. These oral medications (taken by mouth) are considered first-line treatments for osteoarthritis. Ibuprofen and naproxen are available OTC and by prescription, while celecoxib is only available by prescription.
• Corticosteroid injection: Zilretta (triamcinolone) is an injection used to help relieve swelling around the affected joints. Your rheumatologist (a doctor who specializes in conditions of the joints) may suggest this option if NSAIDs aren’t helping with your symptoms. The injection can only be given in your provider’s office.
• Hyaluronic acid injection: Durolane (hyaluronic acid) is also an injection given by your rheumatologist. It’s administered when NSAIDs or corticosteroids don’t help your symptoms or if you can’t take those medications.
• Platelet-rich plasma (PRP): Some research suggests this treatment method might help with knee osteoarthritis. Platelets are fragments in blood that help in the blood-clotting process. They also contain proteins that can aid in injury healing. With PRP, platelets are separated from the blood and injected into the injured area.

Anti-inflammatory medications and corticosteroid injections provide short-term relief of osteoarthritis symptoms. People using these treatments may notice the effects for up to 12 weeks. 

Like any medication, side effects are possible with OA medications. You may experience an upset stomach, stomach ulcers, and gastrointestinal (GI) bleeding while taking NSAIDs. People using corticosteroid or hyaluronic acid injections may experience pain, bruising, or itching at the site of the injection.

Surgery is another potential treatment option for OA. It is usually considered after the rheumatologist or orthopedic surgeon has determined your joint is severely damaged. Surgical treatment can help improve the function and movement of the damaged joint. 

Surgical options include osteotomy (realignment of the bone around the damaged joint) and arthroplasty (replacement of damaged joint with artificial joint).

Treatments for Rheumatoid Arthritis

Rheumatoid arthritis (RA) is the most common type of autoimmune arthritis and usually affects the wrists, hands, and feet. Symptoms include pain, redness, and swelling of the affected joints. Treatment goals for RA include managing the condition until you reach remission, when you have few or no signs and symptoms.

It’s recommended that early RA be treated with disease-modifying antirheumatic drugs (DMARDs). These medications help slow or stop RA from progressing and can also control joint swelling. DMARDs prevent joint damage by blocking the body from attacking its own cells (autoimmune activity). Otrexup (methotrexate), Arava (leflunomide), Humira (adalimumab), Enbrel (entanercept), Orencia (abatacept) are examples of DMARDs. 

However, DMARDs may not work as quickly as NSAIDs or corticosteroids. NSAIDs help relieve joint pain and swelling. Corticosteroids such as Deltasone (prednisone) are prescribed oral medications that help decrease inflammation around the joint. Neither helps stop or slow the progression of joint damage; they only improve symptoms of pain and swelling. Therefore, it’s common for healthcare providers to combine your DMARD therapy with NSAIDs and corticosteroids. 

You may start to notice the effects of your DMARD after several weeks of starting the medication. If DMARDs don’t work, biologics might be the next option. They’re a type of DMARD that prevent symptoms and reduce joint damage progression. The drugs do this by blocking the parts of the immune system that cause RA symptoms.  

A major concern with DMARDs such as adalimumab, etanercept, and abatacept is the increased risk of serious infections. People with liver disease should avoid taking methotrexate and leflunomide. Your rheumatologist may evaluate your medical history before starting you on certain DMARDs.

If you take NSAIDs with your DMARDs and experience GI side effects, your healthcare provider may suggest taking celecoxib as it has fewer GI side effects. People taking corticosteroids may experience increased weight, water retention (edema), muscle weakness, high blood sugar, and decreased bone mass.

Surgical options for people with rheumatoid arthritis include synovectomy (removal of damaged tissue in the synovial joint), fusion (combination of two smaller bones to make one more functional bone), and arthroplasty (replacement of damaged joint with artificial joint).

Physical therapy, exercise, and weight management can also help treat RA.

Treatment for Psoriatic Arthritis

Psoriatic arthritis (PsA) is another common type of arthritis. Similar to rheumatoid arthritis, PsA is an autoimmune inflammatory condition. PsA occurs most often in people with psoriasis (an autoimmune inflammatory skin condition). People with PsA may have a dermatologist (a doctor specializing in conditions of the skin) on their healthcare team to help treat the skin portion of their condition.

If your PsA is mild, treatment may include f anti-inflammatory medications like OTC NSAIDs (such as ibuprofen) and prescription corticosteroid injections to help with joint pain and swelling.

If your PsA is more severe, you may need DMARDs and biologics to manage symptoms and prevent further damage.

Exercise programs, occupational therapy (OT), and physical therapy (PT) may also be recommended to help you learn to move more effectively in daily life.

Rarely, surgery may be needed to fix or replace damaged joints.

Treatment for Gout

Gout is a type of arthritis caused by an excess buildup of uric acid crystals (natural waste product) in and around the joint. This painful inflammatory condition often occurs in the big toe and more often affects men. People with gout also experience periods of severe pain called flares that usually last one or two weeks.

Treatment options for gout include the following medications used to reduce pain and swelling, prevent flares, and decrease excess uric acid in the body:

• Anti-inflammatory medications: Advil/Motrin (ibuprofen) and Aleve (naproxen) are considered first-line therapy to help relieve gout pain and swelling. These NSAIDs can also be used during severe flares. The medications are available OTC or with a prescription. Corticosteroids are a type of anti-inflammatory drug that can be used too.
• Colchicine: Sold under brand names like Colcrys and Gloperba, colchicine is a prescription medication that can help with gout pain. 
• Urate-lowering therapies: These medications are used to help manage the level of uric acid in your body and help prevent painful flares. Examples include Zyloprim (allopurinol), Benemid (probenecid), and Uloric (febuxostat).

Besides medication, you can also implement some self-care treatment strategies for gout, such as getting physically active and limiting purine-rich foods that may trigger gout flares.

Prognosis and Life Expectancy

While there’s no cure for arthritis, treatment can help increase the likelihood of living an active life. Advancements in treatment have significantly improved the course of the disease.

How greatly arthritis affects you may depend on factors like the number of joints involved and disease severity. People who are older, have obesity, or have multiple affected joints are more likely to have a quicker disease progression.

Early diagnosis and medication can help prevent permanent joint damage and physical limitations. 

Living With and Managing Arthritis

When you have arthritis, it’s important to partner with your healthcare team to help manage your symptoms. Make sure you keep your scheduled appointments. Talk with your rheumatologist when your symptoms don’t improve while taking your medications. Doing these things helps prevent further damage to your joints and the need for surgical treatment.

Understanding your overall treatment plan and learning how your condition affects your joints is helpful when living with arthritis.

Taking your medications as instructed will help decrease your symptoms, slow down disease progression, and help you achieve longer periods of no disease activity (remission). Eating a balanced diet, getting rest, increasing your physical activity, practicing mind-body exercises, and finding ways to decrease stress can also help improve your quality of life.