4 ways to cope with arthritis
“As soon as they tell you that you have a disease which is going to change your life, you start replaying all the moments in your life that have led you to this point. But what is truly important now, is not looking back with regret, but focusing on what you can do now to get better.”
Stella (48 years old, osteoarthritis)
Like Stella, you are probably in the process of accepting your diagnosis of some type of arthritis. Whilst this is a difficult time, it is important to recognize that the decisions you make from now on will define your future quality of life.
Arthritis is a disease where the joints become inflamed. It is also an autoimmune disease, which means that it is your own body that is causing such damage.
There are certain cases of arthritis caused by an infection that can be completely cured with antibiotics, but a cure has yet to be found for most types of arthritis, although there are a number of treatment options available [Arthritis Foundation. 2016].
For most types of arthritis, proper treatment and your commitment as a patient can reduce the symptoms that are causing your discomfort and disability (remission).
Treatments for combating arthritis
According to the Centers for the Control and Prevention of Diseases (CDC), although there is no cure for most types of arthritis, early diagnosis and proper management are extremely important, especially for inflammatory types of arthritis.
In general, the usual treatments for arthritis include rest, physical therapy, exercise, medication and, occasionally, surgery if there is significant damage to the joints. Below, we outline each one of these treatment options in detail, along with several other types of treatments that you may want to consider.
1. Specific medication for arthritis
Medication used to treat arthritis varies according to the type of arthritis. The purpose of using drugs is to relieve pain, inflammation, fever and common symptoms of arthritis. These are the most common types of medication used to treat arthritis:
Analgesics for pain
They block the enzymes that produce general pain, including joint pain. The most common type of analgesic is acetaminophen, which is available without a prescription. Other stronger types of analgesics include codeine, oxycodone or tramadol, which are only available with a prescription.
In very advanced cases, medication in the form of patches containing very strong ingredients, such as buprenorphine or fentanyl, can be used. Lidocaine patches are used in the early stages of this disease.
Some analgesics are prescribed to be taken only when pain occurs and others at regular intervals to prevent the feeling of pain before it occurs. You should talk to your doctor about the maximum and minimum frequency with which to take your medication in order to avoid overdosing.
NSAIDs (non-steroidal anti-inflammatory drugs)
This is a group of analgesics with anti-inflammatory characteristics, which means that they are focused on reducing inflammation. They are used to treat some types of chronic arthritis, such as rheumatoid arthritis, osteoarthritis and lupus.
NSAIDs can also reduce inflammation, fever, swelling, redness and other symptoms of arthritis. These drugs must be taken under strict supervision, since they can alter the liver and kidney functioning.
DMARDs (disease-modifying antirheumatic drugs)
DMARDs help preserve the joints by blocking inflammation. They act by slowing down (or even stopping) the onset of the disease, but they are not used for relieving pain like analgesics, so they are almost always used in combination with other medication.
They are called slow-acting drugs, meaning that it takes several months before their effects manifest themselves. Medications in this group include cyclosporine, cyclophosphamide, hydroxychloroquine, methotrexate, sulfasalazine, among others.
Corticosteroids
These drugs are used to treat inflammation in arthritis patients. They are so precise that they can also be used to treat a single affected joint. They can be given orally or via injection into the affected area (infiltration).
Due to their fast-acting nature and few side effects in the short-term, they are the primary medication option for managing pain. They are not recommended for long-term use, since they pose a risk of producing a disease called Cushing syndrome.
This group includes medications such as prednisone, dexamethasone and methylprednisolone, among others.
Biologic drugs and biopharmaceuticals
This type of medication is produced by means of genetic engineering, and they originate in human cells. These drugs are targeted at specific parts of the immune system that feed inflammatory arthritis.
If you would like to know more about this type of medication and how they work, check out our article on Conventional medicines for treating arthritis.
2. Surgery for joints
This is without a doubt a last resort for treating any type of arthritis. If other treatments have not worked and pain in the joints becomes unbearable, your doctor will most likely recommend surgery.
It is important to clarify that surgery is not the only solution for inflammatory and autoimmune diseases, it is just one way of reducing pain and improving mobility.
These are the most common surgeries used to repair joints that have been damaged by arthritis:
Arthroscopy
By inserting instruments and tiny cameras into small incisions, the surgeon is able to see how the joint is doing and repair the soft tissue (if it does not need to be replaced), principally in the knee, hip and shoulders.
Partial hip or knee replacement
These procedures are carried out when the part of the joint that is the most compromised has been identified and when its alteration could potentially change the structure of the rest of the joint.
In the knee, for example, one of the three compartments (medial, lateral and patellofemoral) is replaced with an implant to provide better stability to the rest of the structure. A similar procedure is carried out to restore a damaged hip joint, whereby the ball of the hip is replaced with a metal ball.
Osteotomy
This surgery uses a bone fragment to stabilize the joint affected by arthritis. In the knee, this procedure is used to displace some weight from the affected area to another part of the joint that is in better condition.
Synovectomy
The synovial tissue, which covers the joints, can become inflamed when pressure is placed on the cartilage. In this case, this type of surgery is used to take out the synovial tissue, as well as prevent future inflammation, reducing the risk of infection, but increasing the risk of joint damage.
This procedure is carried out using two different techniques:
- A large incision is made and the capsule is taken out directly from the knee
- An arthroscopy is carried out
Arthrodesis or joint fusion
The joint is fused either due to very intense pain, or a high level of instability within the joint. For this reason, it is an option that is used after having tried many other types of therapies.
The purpose of this surgery is to fuse the two bones that form the joint which is affected by arthritis. This is done to relieve pain or reduce deformity in the joints. It is usually carried out in the fingers, wrists and ankles.
This procedure prevents movement within the joint, so it is not possible to flex the joint completely afterwards, due to the presence of osteosynthesis elements (pins and plates used to fuse the joints).
Total joint replacement
When the joint has been severely affected by arthritis, it is likely that your doctor will consider a complete replacement of the joint with an implant (either metal, plastic or ceramic) that imitates the natural movement of the joint.
This surgery doesn’t just depend on how advanced the joint disease is. If there is a lot of damage to the bones, this surgery will not be possible since the implant must be attached to the bone. This is a determining factor to be evaluated by the doctor before any sort of intervention.
Nowadays, this procedure is carried out using minimally invasive techniques with small incisions, so as to cut through less muscle and facilitate scarring. Recovery time is also shorter compared to conventional joint replacement surgery.
Any surgery where implants or support pieces are inserted, requires subsequent monitoring, follow-ups, physical therapy and eventually, a new replacement. In addition, all surgeries imply a certain amount of risk, including nerve or tissue damage, failure to adapt to the changes from the surgery and infection, which, if left untreated, can lead to blood clots in the legs or lungs.
The success of this procedure depends on the patient’s recovery, on how soon they start physical therapy and whether they have followed prior recommendations (e.g. losing weight, avoiding aggressive movement of the joints, using supports to carry out activities).
Occupational and physical therapy for arthritis
Have you ever wondered how your daily movements, from tying your shoelaces, to making the bed or picking up an object from the floor, are affecting your joints? Many of these movements, when carried out incorrectly, may not be helping your joints if you suffer from arthritis.
Occupational therapy teaches you the proper way to carry out routine movements to avoid putting excess pressure on the joints. Preventing major damage to your joints is easier than you would think. Here are some examples of how to better perform simple movements and avoid causing yourself more pain:
| When | Avoid | How to do it? |
Standing up | Standing up in one movement, straining your back | – Turn your legs towards the edge of the bed and push yourself up from one side |
Showering | Twisting and getting into uncomfortable positions to reach your back | – Use some kind of sponge with a long handle to wash your body |
Getting dressed | Balancing on one leg to put on underwear, trousers or socks | – Get dressed sitting down and only stand to finish getting your clothes on – Use tools to help you, such as a shoe horn |
When eating | Using conventional cutlery or eating while holding a plate in one hand | – Use cutlery with rubber or modified handles – Put your plate on a flat surface |
At work | Holding tools in your hand for a long time (pencil, paintbrush, screwdriver, etc.) Typing on a computer for a long time without stopping Excessive use of electronic devices such as tablets and cell phones (with touchscreen keyboards) | – Let go of objects every 10 to 15 minutes, or when you feel like your arm is getting tired – Stretch and gently rotate your hands and thumbs for 10 seconds every hour |
When walking | Wearing tight shoes Carrying a handbag or shopping bag in your hands or away from your body | – Wear comfortable shoes – Carry any bags on your shoulders or on your back – If you have to carry a heavy load, bring it close to your body and rest some of the weight on your forearms |
ALWAYS | – Take breaks – Change positions between gentle and moderate activities – Pick up objects from the floor bybending your knees and slowly lowering your hips – Take your time with each movement |
In physical therapy, a health professional will advise you on the exercises you should be doing to strengthen the muscles that support the joints affected by arthritis, reduce stiffness and increase range of motion.
Depending on the type and stage of your arthritis, your doctor may advise you to carry out this type of therapy, which consists of sessions that are programmed for several times a week. Usually, these exercises can be carried out at home or at work.
As well as physical exercises, physical therapy also uses localized cold and heat to relieve pain and stiffness, electrodes to stimulate the muscle with electricity, or red lamps to help reduce inflammation and pain.
Complementary therapies for treating arthritis
As well as the medical treatments available for arthritis, which are part of a treatment plan that is supervised by your doctor. In addition, you also have the option to complement your treatment with more natural alternatives that are non-invasive and have fewer side effects.
It is very important that you talk to your doctor before starting any complementary treatments.
Acupuncture for joints
The National Center for Complementary and Integrative Health (NCCIH) considers acupuncture to be an acceptable alternative treatment for osteoarthritis, especially if it affects the knees.
Acupuncture is a form of ancient Chinese medicine that consists of inserting fine needles into specific points in the body.
Even the World Health Organization (WHO) recommends acupuncture for treating over 100 different diseases. If you opt for this complementary therapy, always ensure the practitioner is a certified professional.
This technique has been known to reduce pain and inflammation in the joint and, as a result, improve range of motion. It has yet to be scientifically proven whether acupuncture can reduce injuries or stop the onset of arthritis.
Neural Therapy
Consists of applying a local anesthetic (procaine or lidocaine) in similar points to those used in acupuncture, in order to reduce pain, stimulate the muscles and reduce inflammation.
It has not been found to have any effect on the reduction of rheumatoid factors or reactive inflammatory reactions.
Homeopathy
Studies have compared the use of homeopathic ibuprofen gel without finding any difference; piroxicam gel was also studied and compared to a gel containing Symphytum officinale, rhys toxicodendron and ledum toxicodendron and ledum palustre, which was found to reduce inflammation and pain.
Additionally, a positive effect from homeopathic medicine was found regarding state of mind, overcoming depressing events, greater acceptance of the disease and tolerance to frustration.
Cognitive therapy against pain
Through education, modification of behavior and relaxation techniques, it is possible to improve the pain produced by arthritis, which is cognitive therapy. This therapy helps patients overcome the physical limitations associated with arthritis with actions such as:
- Sessions to improve emotional and psychological wellbeing
- Routines to teach patients to control stress and relax their mind
- Advice for carrying out daily activities at a realistic pace
- Workshops to help patients overcome obstacles associated with their disease in a creative way
Meditation to lower stress
It is clear that the mind controls the body, learning to manage our impulses and emotions impacts the way we feel physically. Meditation and relaxation techniques can help reduce pain caused by arthritis.
According to the National Institute of Health (NIH), practicing mindful meditation can be very useful for people suffering from painful joints. By lowering stress levels, you can reduce inflammation, swelling and pain.
These techniques are especially important for arthritis related to emotional changes or crises like gout or lupus.
Natural supplements to help your joints
A healthy diet full of fresh produce and low in excess sugar and processed foods, is enough to nourish your body, but if you wish, you could also incorporate additional supplements into your diet, so long as you consult your doctor first.
Here are some supplements that can help those suffering from arthritis:
- Plant-based Omega-3 (flax, chia or nuts)
- Boswellia
- Bromelain
- Harpagophytum (devil´s claw)
- Gingko biloba
- Nettle
- Gamma-linolenic acid – GLA (Evening primrose, borage, hemp and blackcurrants)
CBD Oil
CBD impacts CB2 receptors belonging to the endocannabinoid system, this creates a positive effect on pain response and inflammation in the body, which are symptoms of arthritis. This was proven in a 2017 study, in rats, that showed the reduction of inflammatory arthritis in the early stages through the use of CBD.
Other preclinical trials carried out in rats also support this idea that the endocannabinoid system is involved in relieving pain associated with arthritis. The study concluded that the application of CBD to the affected area has a therapeutic effect for relieving the symptoms related to arthritis without any evident side effects.
In 2015, the selective activation of the cannabinoid 2 receptor (CB2R) was found to have therapeutic potential to eliminate synovitis (inflammation of the synovial membrane) and reduces the destruction of the joint by preventing the production of antibodies and inflammatory substances.
Analyzing the treatment options that exist for arthritis, there are two important conclusions: the first is that you should first talk to a certified doctor in order to formulate the ideal treatment for you according to your type of arthritis; and the second is that a combination of therapies can offer the greatest relief from joint pain caused by arthritis.
There are many ways to deal with this disease, but the most powerful component is your willingness to get better. Did you find this information useful? Share this article with your loved ones and help them get informed about the different treatments available for arthritis.
Sources
Understanding Your Joint Procedure Options [Arthritis foundation]
Does CBD Oil Really Help Treat Arthritis Pain? [Rheumatoid Arthritis Support Network]
Can CBD oil relieve arthritis pain? [Medical News Today]
Attenuation of early phase inflammation by cannabidiol prevents pain and nerve damage in rat osteoarthritis [Philpott HT,OʼBrien M, McDougall JJ. 2017 ]
Involvement of the endocannabinoid system in osteoarthritis pain [La Porta C1, Bura SA, Negrete R, Maldonado R. 2014]
Activation of cannabinoid receptor 2 attenuates synovitis and joint distruction in collagen-induced arthritis [Immunobiology. 2015]