Your Health

Arthritis

Osteoarthritis and Rheumatoid Arthritis

Arthritis is a disease in which there is inflammation of a joint or joints, which usually causes pain and stiffness. There are more than 100 forms of arthritis. The most common types are osteoarthritis and rheumatoid arthritis.

What is osteoarthritis?

While osteoarthritis (OA) is a common condition in older age, 60% of Canadians with OA are under the age of 65. OA is caused by the thinning and erosion of joint cartilage,
a soft, smooth tissue that forms a cushion between two bones in a joint. Cartilage prevents friction during movement and serves as a shock absorber.

What are the symptoms of osteoarthritis?

Pain is usually the most important symptom in OA. In general, pain occurs when the joint is used and is relieved by rest. Other symptoms may include swelling, stiffness, and tenderness in affected joints. You are most likely to develop OA in joints in your fingers (but not your knuckles), hips, knees, neck, and back.

What are the risk factors for osteoarthritis?

OA affects about 8 out of 10 people over age 75. You are more at risk of developing OA if you:

  • have other family members who have it
  • have had fractures or joint-related traumas earlier in life
  • have performed repetitive use of certain joints (either through work or leisure activities)
  • are overweight

How is osteoarthritis diagnosed?

Your doctor will talk with you about your symptoms, examine your joints, and may take x-rays to confirm an OA diagnosis.

How can I prevent osteoarthritis?

One of the best ways to prevent OA is to exercise regularly. This will help strengthen your muscles and protect your joints. Before starting regular exercise, talk to your doctor and fill out an exercise safety questionnaire (PAR-Q), available from most fitness centres or your local Peoples Drug Mart. Reduce your risk of joint injuries by taking precautions (for example, warm up, stretch, and wear protective equipment and appropriate footwear), particularly if you play more intense sports. If you are overweight, losing as few as ten pounds may help prevent OA of the knees.

How can I treat osteoarthritis?

Unfortunately, there is no treatment that can cure OA. However, numerous measures such as lifestyle modifications, medications, therapies, or surgery can relieve the symptoms of OA and help you live better with this condition.

Lifestyle modifications

Consider the following lifestyle modifications to help manage your OA:

  • Plan your day so you are busiest when your joints feel strongest. Don’t overdo it — try to divide your day into shorter periods of activity.
  • Exercise regularly (for example, swim, cycle, or walk briskly) to help reduce pain and keep the muscles around your joints strong. Exercises that strengthen the thigh muscles will help reduce symptoms in your knees.
  • Lose weight to reduce strain on joints such as knee and hip joints — even ten pounds can make a difference.
  • Stop smoking.
  • Use assistive devices such as shopping carts and canes.
  • Take hot baths and use heat packs to help relax your muscles.
  • Apply cold gel packs to help reduce joint pain and stiffness.

Medications

Acetaminophen is effective for relieving mild to moderate pain and, for many people, it is enough to limit the symptoms of OA.

If acetaminophen doesn’t provide adequate relief, the use of anti-inflammatory medications (NSAIDs) should be considered. There are many NSAIDs. While some of them are over-the-counter medications (for example, ASA, and ibuprofen), others are prescription drugs (for example, naproxen, diclofenac). Coxibs (for example, celecoxib, valdecoxib, and rofecoxib) are a new type of NSAID and are proven to reduce joint pain and inflammation.

Glucosamine sulphate is a supplement that may relieve OA symptoms, particularly in the knees.

Talk with your doctor or Peoples pharmacist before using medications or supplements regularly — they may have adverse effects for some people if used for long periods.

In cases of severe pain, a doctor can inject corticosteroid medication directly into a joint. However, corticosteroid injections should not be used too frequently (no more than two to three times per year) because high doses can damage the joint.

Note: Pain medications are most effective when used in conjunction with lifestyle modifications.

Therapies or surgery

If you have debilitating OA, physiotherapy may help improve your strength and mobility and reduce your pain. If you have severe pain that cannot be treated, you may need surgically implanted artificial knee or hip joints. Your doctor will let you know if an operation is right for you.

What is rheumatoid arthritis?

Rheumatoid arthritis (RA) is a form of arthritis in which the immune system attacks the interior lining of a joint, causing it to swell and become irritated or inflamed.

What are the symptoms?

RA typically affects at least three joints, causing pain, swelling, tenderness, heat, or redness. The joints that are usually affected are the hands or the feet and, in general, joints are affected in a symmetrical way (on both sides of the body). RA often causes morning stiffness that lasts longer than 30 minutes. It may also cause systemic symptoms such as fever, weight loss, and fatigue.

What are the risk factors for rheumatoid arthritis?

RA affects about 1 in 100 people, occurring three times as often in women as in men. You are more at risk of RA if you have a family history of the disease.

How is rheumatoid arthritis diagnosed?

Your doctor will talk with you about your symptoms, examine your joints, order blood tests, and may take x-rays to confirm an RA diagnosis.

How can I prevent rheumatoid arthritis?

Researchers have not found a way yet to prevent rheumatoid arthritis.

How is rheumatoid arthritis treated?

The sooner you determine that you have RA, the sooner you will be able to control your symptoms and, if appropriate, find medication that will help slow the progression of the disease.

Medications

NSAIDs are medicines that reduce inflammation and relieve pain. Some are available over- the- counter (for example, ASA, or ibuprofen), while others require a prescription (for example, naproxen, diclofenac). Coxibs are a new type of prescription NSAID. These are three Coxibs proven to reduce joint pain and inflammation: celecoxib, valdecoxib and rofecoxib. In rheumatoid arthritis, NSAIDs need to be taken regularly and at full dose.

Disease-modifying anti-rheumatic Drugs (DMARDs) are medications used for slowing the progression of RA. Some examples of DMARDs are methotrexate, and gold compounds. They are sometimes prescribed in addition to an NSAID, but it takes several months before they begin to make a difference.

Corticosteroids are used to treat severe inflammation and pain in RA.

Talk with your doctor or Peoples pharmacist when using these medications — they are often beneficial but can occasionally have adverse side effects. Remember that any sudden changes in medication may cause your symptoms to flare up and make it difficult to get them under control again. Talk with your doctor first if you feel you need to stop taking your arthritis medication.

Surgery

Rarely, a doctor will recommend surgery to repair or replace damaged joints.

Where can I find out more about arthritis?

For more information about your medications or other health issues:

  • talk to your Peoples pharmacist
  • read People First, a health magazine of practical information available free from your neighbourhood Peoples Drug Mart or Peoples Pharmacy

Other resources

The Arthritis Society (B.C. & Yukon Office)
1 800 321-1433
www.arthritis.ca/bc

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