Arthritis

Causes of arthritis

What causes osteoarthritis?

Osteoarthritis starts when the cartilage that covers the ends of your bones stops renewing, causing damage to the joint resulting in pain and impairing mobility. The cartilage may stop renewing because of overuse after an injury, or because of severe damage from gout or RA. The reason why the cartilage stops renewing is not well understood. Older people, women and obese people are more at risk from osteoarthritis.

What causes rheumatoid arthritis (RA)?

The autoimmune condition RA is not perfectly understood yet. An autoimmune condition occurs when the body’s immune system, which usually does the important job of fighting off infections, starts attacking the body’s own healthy tissues. In the case of rheumatoid arthritis, the immune system targets the tissue around joints. The tissue that covers the joints gets inflamed and starts to cause damage to other nearby tissues, including bones, cartilage, tendons and ligaments.

Over time, the joint’s shape and alignment changes, affecting mobility and causing further pain.

RA is more common in women than in men. Smoking can increase your risk of RA, and it may also be inherited.

What causes gout?

Gout is caused by crystals of uric acid forming about a joint causing sudden, severe pain. An attack may be triggered by:

• over-consumption of alcohol or fats
• dehydration
• injury
• fever
• some medications such as diuretics and ACE inhibitors

Gout is more common in older men and in people who are overweight, have high cholesterol, high blood pressure, trouble with their kidneys, osteoarthritis or diabetes.

What are the symptoms of arthritis ?

The physical symptoms of arthritis can include:

• pain in a joint
• stiffness in a joint
• restricted movement
• heat or reddening of the skin over a joint
• weakness and wasting of muscles

How is arthritis diagnosed?

Arthritis is diagnosed by a GP. They will examine your joints and ask you about your symptoms.

If they suspect you have rheumatoid arthritis, they will refer you to a rheumatologist, as this long-term condition is best treated and managed with the help of a specialist.

Osteoarthritis and gout are usually simpler to diagnose.

Sometimes the doctor will recommend blood tests and scans to confirm an arthritis diagnosis, or to monitor your condition. You may also be assessed to see the impact of arthritis on how you carry out everyday activities like self-care, walking and eating.

What should I do if I think I have arthritis ?

If you think you might have arthritis , rheumatoid arthritis or gout speak with a healthcare professional. You will need support to manage this condition, and without a prescription you will not be able to obtain the meds that will slow the progression of your arthritis.

Arthritis is a complex condition that can affect many aspects of your life. By getting medical advice about your joint pain and inflammation, you will be able to get the best treatment for your condition. A doctor can identify the cause of your arthritic symptoms and prescribe medication to help with the pain and inflammation, as well as support you in making lifestyle changes that will maximize your wellbeing. A medical diagnosis will also help you to access any social care services you may need.

What treatments are there for arthritis ?

Arthritis cannot be cured, but the symptoms can be relieved, and the progression of arthritis can be slowed by minimizing joint inflammation to reduce joint damage. Your GP and arthritis doctor may recommend medication, lifestyle changes, surgery and physiotherapy.

It may take some trial and error to get a regime of meds and therapy that helps your arthritis. So, keep in touch with your GP, and be honest about your symptoms, mobility and your pain levels. If the side-effects from one treatment are hard to bear, there may be another your doctor can try, or there may be a way of reducing the side-effects, so don’t be afraid to ask if something doesn’t seem right in your arthritis care regime. Some types of arthritis get worse over time, and regular check-ups will allow you and your doctor to adjust your arthritis care regime as needed.

Treatments for osteoarthritis

Drugs and medications used for osteoarthritis

Part of your treatment regime for osteoarthritis will be pain relief or analgesics. There are various analgesics used to control the pain of arthritis. These include:

• acetaminophen
• ASA
• NSAIDs cream and tablets
• capsaicin cream

Acetaminophen and NSAIDs like ibuprofen and capsaicin cream are available over the counter in pharmacies. But you may have a prescription if you need a specific formulation. NSAIDs can make your stomach more sensitive to its own acids, and so your GP may also prescribe a proton pump inhibitor (PPI) med to counteract this.

For more severe arthritic pain, your GP may prescribe an opioid like codeine. As opioids cause constipation, you may have a prescription for a laxative, too.

Another treatment for arthritis is steroid injections. This is usually recommended if other treatments haven’t worked. You will have to go to a health centre to get a steroid injection, but it will ease the pain for weeks or months.

Assistive devices for osteoarthritis

You may need assistive devices such as walking sticks or special footwear. Your physiotherapist can help with these. There are also devices that can help with dressing or turning on taps, which may be recommended by an occupational therapist.

Surgery for osteoarthritis

There are various surgeries available to relieve osteoarthritis, including joint replacement, joint fusing or osteotomy.

Treatments for rheumatoid arthritis

There is no cure of rheumatoid arthritis (RA) so treatment focuses on relieving pain through analgesics, reducing inflammation and slowing joint damage. The aim is to keep the patient active and to reduce disability.

These are some of the drugs and medications used to treat RA:

Disease-modifying anti-rheumatic drugs (DMARDs)

DMARDs ease RA symptoms and slow its progression by stopping chemicals released by your immune system from attacking joints. Some commonly prescribed DMARDs are:

• methotrexate
• leflunomide
• hydroxychloroquine
• sulfasalazine

Side-effects of rheumatoid arthritis drugs

Some DMARDs can affect your blood, liver and lungs, so your doctor will monitor you. It takes a while to see results from a DMARD regime, and there may be some side-effects, including:

• nausea
• sore mouth
• headache
• hair loss
• reduced appetite
• diarrhea

It’s really important to keep taking your RA meds, even if you don’t see any benefit. If the side-effects are troubling you, speak with your doctor or pharmacist. It’s common to try several DMARDs before you find the right one for you. You’ll need to take this medication long-term to treat rheumatoid arthritis. The Arthritis Society has some guides to help you make informed decisions about DMARDs.

Biological treatments for rheumatoid arthritis

Examples of biological treatments for RA include adalimumab, etanercept and infliximab. These are injected and they work on chemicals in your body that activate your immune system. You may have a reaction at the injection site, and sometimes biological RA treatments cause old infections to arise again.

JAK inhibitors

JAK inhibitors are given to adults who can’t tolerate DMARDs or biological RA treatments.

Painkillers for rheumatoid arthritis

Pain relief or analgesics play an important role in maintaining the wellbeing of RA patients. There are various analgesics used to control the pain of rheumatoid arthritis. These include:

• acetaminophen
• NSAIDs cream and tablets
• steroids

Treatments for gout

Your GP will recommend a non-steroidal anti-inflammatory (NSAID) for example, ibuprofen, to treat the pain and swelling from gout. This should start to work after about 48 hours. Resting and raising the limb will help, as will cooling the affected joint with a 20-minute ice pack.

Your GP might test your blood for uric acid, particularly if you have recurrent gout attacks. These can be prevented with meds that lower uric acid. These need to be taken regularly.

How do I get medications for arthritis?

Some drugs used to treat arthritis are available over the counter. Examples of these include acetaminophen and some NSAIDs. But other arthritis meds are available only with a prescription. You will need to see a doctor about your arthritis . They will prescribe the right meds to help relieve pain and maintain your mobility. They may also advise on lifestyle changes that will slow the progression of your arthritis.

In Canada you can depend on NX Pharmacies for your arthritis drugs. We serve all areas of Canada and can fill your prescription of arthritis medication. We can help with renewals and refills. Our discretion is assured, and you can depend on us for authentic Health Canada-approved medications.

Even experienced, knowledgeable arthritis patients benefit from the support of a doctor or pharmacist in managing their regime. So, keep in touch with your healthcare team, and ask if the side-effects of your DMARDs or painkillers are troubling you, something has changed or if you think you need to stop taking your meds.

How to manage arthritis with lifestyle changes

Your GP may recommend some lifestyle changes to ensure your meds work as they should and to slow the progression of your arthritis. Ask for support if you need help with implementing any of these lifestyle changes.

Maintain a healthy weight if you have arthritis

Maintaining your weight to avoid obesity will reduce strain on your joints and keep you moving comfortably.

A healthy diet for arthritis

A healthy, balanced diet will help you to maintain a healthy weight that does not strain your joints so that you can stay mobile. There is not much evidence for a particular ‘arthritis diet’ but The Arthritis Society has some advice about good eating generally.

Balance exercise and rest to manage arthritis

Gentle exercise balanced with rest will help you keep your weight and your pain under control to maintain your mobility.

Rest will help inflamed joints, but it may also stiffen your joints. Find a balance of activity and rest that works for you. Stop an activity that causes pain, and increase your activity levels gradually. You can get advice from a physiotherapist about exercise if you need that.

Control your alcohol intake if you have gout

Higher alcohol intake is linked to gout attacks. Keep your intake to under 14 units a week, and try to have alcohol-free days each week.

Get regular health reviews to manage arthritis

Arthritis is a long-term condition, and you’ll be cared for by several different healthcare professionals, including a doctor, a physiotherapist, an occupational therapist and a pharmacist. With some drugs, notably those used to treat rheumatoid arthritis, you’ll need to have regular blood tests to make sure they are not harming other parts of your body.

Get your flu shot, particularly if you have RA

Getting any vaccinations that your doctor recommends will protect you from seasonal illnesses such as flu and pneumococcal viruses.

Use a tobacco cessation service to stop smoking

Smoking and tobacco use are linked to some kinds of arthritis, including gout and RA. A stop-smoking service can help you to quit if your doctor recommends it.

Learn skills to reduce the impact of arthritis

You can learn skills, such as pain management and exercise techniques that will help you to live better with arthritis. By taking control of your condition, you can reduce its impact on your mobility and improve your wellbeing.