Arthritis

The Rheumatology Program at UT Southwestern Medical Center delivers advanced, evidence-based care to people with arthritis. Our program is widely recognized as one of the nation’s leading clinical and research centers for rheumatic diseases, including rheumatoid arthritis.

Advanced Care for Different Types of Arthritis

Arthritis, which literally means inflammation of a joint (where two or more bones meet), actually refers to more than 100 different diseases and is one category of rheumatic disease. Rheumatic diseases typically cause pain, stiffness, and swelling in the joints and other supporting body structures, such as muscles, tendons, ligaments, and bones.

Common types of arthritis include:

• Osteoarthritis, the most commonly diagnosed form of arthritis, occurs when the cartilage that covers bones can be worn away. This can happen as a normal consequence of aging, as well as in areas of prior trauma.
• Psoriatic arthritis commonly affects patients with psoriasis, a chronic disease of the skin and nails.
• Rheumatoid arthritis – in which the autoimmune system attacks the bones and joints – can affect anyone, at any age and of any race.

Rheumatic diseases can also affect other areas of the body, including internal organs. Some rheumatic diseases involve connective tissues, while others are caused by an autoimmune disorder, which means the body's immune system attacks its own healthy cells and tissues.

Evaluation

Diagnosing arthritis is often difficult because many symptoms are similar among the different types of arthritis. Our Rheumatology Program is dedicated to providing the correct diagnosis and to prescribing therapies needed to slow or halt the progression of all types of arthritis.

To make an accurate diagnosis, our physicians might need to review the patient’s medical history, perform a physical examination, and obtain laboratory tests, X-rays, and other imaging tests. 

When reviewing the medical history, the physician might ask the following questions:

• Where is the pain?
• How long have you had the pain?
• When does the pain occur, and how long does it last?
• What were you doing when you first noticed the pain?
• How intense is the pain?
• What tends to relieve the pain?
• Have you had any illnesses or injuries that might explain the pain?
• Is there a family history of arthritis or other rheumatic diseases?
• What medication(s) are you currently taking?

Treatment Options

Because there is no cure for arthritis, the goal of treatment is often to limit pain and inflammation while ensuring optimal joint function. AT UT Southwestern Medical Center, our physicians develop treatment plans that are tailored to the type of arthritis, as well as the severity of the condition.

Treatment plans

For osteoarthritis

• Medications: Provide short-term relief for pain and inflammation. These might include pain relievers such as acetaminophen, aspirin, ibuprofen, or other nonsteroidal anti-inflammatory medications.
• Pain relief: Can be obtained temporarily by using moist heat (warm bath or shower) or dry heat (heating pad) on the joint. Pain might also be temporarily relieved with the use of a small TENS device that directs mild, electrical pulses to nerve endings beneath the skin in the painful joint area. TENS blocks pain messages to the brain and modifies pain perception.
• Splint or brace: Can help a joint rest and protect it from further injury.
• Canes, crutches, and walkers: Can help to keep stress off certain joints and to improve balance while reachers and grabbers help people extend their reach and reduce straining. Dressing aids help people get dressed more easily.
• Joint injections: Corticosteroid joint injections and hyaluronic acid joint injections can provide relief. 

For inflammatory arthritis

Several types of medications can be used to reduce pain and symptoms of inflammatory arthritis, including nonsteroidal anti-inflammatory medications such as aspirin, ibuprofen, and disease-modifying antirheumatic medications.

Examples of disease-modifying antirheumatic medications include methotrexate, hydroxychloroquine, penicillamine, and gold injections. Corticosteroids might also be used to treat rheumatic diseases.

For psoriatic arthritis

• Medications: Prescription or over-the-counter nonsteroidal anti-inflammatory drugs may temporarily relieve pain and reduce swelling. In more serious cases, disease-modifying antirheumatic drugs, such as methotrexate, may be recommended. These drugs suppress the immune system to reduce inflammation.
• Biologics: If medication proves ineffective, we may recommend biologics, also known as biosimilars or biologic response modifiers, which ease inflammation by targeting different parts of the immune system. These treatments may be administered through injection or infusion.
• Joint injections: Corticosteroid joint injections and hyaluronic acid joint injections can reduce inflammation and relieve pain. Biologics may also be administered by injection.

Other treatment options

• Exercises such as swimming, walking, low-impact aerobics, and range-of-motion maneuvers might help reduce joint pain and stiffness. Stretching exercises can also help keep the joints flexible.
• Pacing yourself (alternating periods of activity with periods of rest) can also help protect your joints and minimize symptoms of arthritis.
• Surgical options might include arthroscopy, fusion, or joint replacement.
• Weight reduction can help because extra weight puts more stress on the hips, knees, and other weight-bearing joints.

Surgery

If your affected joint shows evidence of torn cartilage or loose fragments of bone or cartilage, surgery might be required. Our orthopaedic surgeons are highly trained and experienced in the latest minimally invasive arthroscopic and open-surgery research and techniques.   

In the minimally invasive outpatient procedure, a small incision is made and a tiny camera is inserted into the surgical site to guide surgeons through the procedure. Small surgical instruments are then inserted through the incision to repair any tears or remove any loose fragments.

Even if a patient has had a previous surgery elsewhere for arthritis that was not as successful as hoped, our orthopaedic surgeons are highly skilled in revision surgery to fix the issue.

Quick Links

• American College of Rheumatology
• Arthritis Foundation
• Lupus Foundation of America, Inc.
• National Psoriasis Foundation
• Spondylitis Association of America