Arthritis

The most commonly diagnosed form of arthritis is osteoarthritis, caused by normal wear and tear of aging. However, rheumatoid arthritis – in which the autoimmune system attacks the bones and joints – can affect anyone, at any age, or of any race.

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 diseases. Rheumatic diseases may cause pain, stiffness, and swelling in the joints and other supporting body structures, such as muscles, tendons, ligaments, and bones.

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

Severe advanced osteoarthritis or rheumatoid arthritis can be debilitating, and in acute cases surgery may be necessary to help you regain normal function and return to an active lifestyle.

Symptoms

The following are the most common symptoms of arthritis and other rheumatic diseases:

• Chronic pain or tenderness in the joint(s)
• Fatigue
• Joint pain
• Joint stiffness that lasts for at least one hour in the early morning
• Limited movement in the affected joint(s)
• Swelling in the joint(s)
• Warmth and redness in the joint area

Evaluation

Diagnosing arthritis and other rheumatic diseases is often difficult, as many symptoms are similar among the different diseases. Our Rheumatology Program is dedicated to providing the diagnostic procedures and interventional therapies needed to slow or halt the progression of all types of rheumatic conditions.

Our multidisciplinary team approach is particularly important in managing the symptoms of arthritis because many symptoms are chronic and change in severity over time. To make an accurate diagnosis, our physicians may need to review your medical history, perform a physical examination, and obtain laboratory tests, X-rays, and other imaging tests. 

When reviewing your medical history, your physician may 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 may explain the pain?
• Is there a family history of arthritis or other rheumatic diseases?
• What medication(s) are you currently taking?

Treatment Options

Since 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 your type of arthritis, as well as the severity of the condition.

Treatment plans often involve both short-term and long-term relief approaches.

Short-term Relief

• Medications: Provide short-term relief for pain and inflammation. These may include pain relievers such as acetaminophen, aspirin, ibuprofen, or other nonsteroidal anti-inflammatory medications.
  
• Pain relief: May be obtained temporarily by using moist heat (warm bath or shower) or dry heat (heating pad) on the joint. Pain may 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.
  
• Light stroking and/or kneading of painful muscles: May increase blood flow and bring warmth to the muscle.
  
• Acupuncture: Performed by a licensed acupuncture therapist, is the use of thin needles that are inserted at specific points in the body. Acupuncture seems to stimulate the release of natural, pain-relieving chemicals produced by the brain or nervous system.
  
• 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.
  

Long-term Relief

There are several types of medications that may be used long-term to reduce pain and symptoms, 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, medications that contain hormones, can also be used to treat rheumatic diseases. They can be taken orally or as an injection.

Other options include:

• Exercises such as swimming, walking, low-impact aerobic exercise, and range-of-motion exercises may help reduce joint pain and stiffness. Stretching exercises may 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 may include arthroscopy, fusion, or joint replacement.
• Weight reduction, as extra weight puts more stress on the hips, knees, and other weight-bearing joints.

Surgery

If surgery is required, our orthopaedic surgeons are highly trained and experienced in the latest minimally invasive arthroscopic and open surgery research and techniques.

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

If your affected joint shows evidence of torn cartilage or loose fragments of bone or cartilage, your orthopaedic surgeon may suggest arthroscopic surgery, or arthroplasty. In this common 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.

In severe cases, particularly in younger patients with early arthritis or deformity of the bone or joint, open surgery, or osteotomy, may be necessary. This involves cutting and realigning bones to decrease pressure within the joint.

Quick Links

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