Arthritis is a group of diseases that cause joint pain, swelling, stiffness and reduced mobility. Although there's no cure for these diseases, you can manage your symptoms with a variety of treatments. This guide outlines your treatment options and explains how they can help you manage your symptoms.
Before prescribing medications or recommending physical therapy, your doctor may recommend lifestyle changes to reduce stress on your joints. Lifestyle changes don’t work for everyone, but they may reduce arthritis pain, slow down the progression of your arthritis and help you maintain your mobility.
Without regular exercise, the muscles and tendons around your joints become weak, causing inflammation that can worsen joint pain, stiffness and swelling. If your doctor thinks it’s safe for you to exercise, you can prevent arthritis from worsening by engaging in aerobic exercises and performing range-of-motion exercises designed to increase your flexibility.
Aerobic exercise increases your heart rate and engages the large muscle groups in your body, making it ideal for slowing the progression of arthritis. If you’re starting an exercise program for the first time, walking is one of the easiest things you can do to strengthen your muscles.
Start out slowly, walking short distances and maintaining a comfortable pace. Once you build up some endurance, you can increase your distance or walk faster. Don't worry if you can't walk long distances at first; according to the Centers for Disease Control and Prevention, taking three 10-minute walks offers the same aerobic benefits as taking one 30-minute walk.
Range-of-motion exercises are most effective when you focus on your sorest, stiffest joints. The aim of these exercises is to reduce stiffness and increase flexibility, both of which help relieve arthritis symptoms. If your doctor okays it, try these range-of-motion exercises to keep your joints as healthy as possible:
- Forward arm reach: Extend your arms in front of you with your palms facing each other. Raise your arms as high as possible and then lower them slowly. If you have difficulty raising both arms, try raising one arm and using the other arm for support.
- Head turns: Start out with your head facing forward. Then turn your head toward your left shoulder and hold for three seconds. Return to the starting position and repeat the head turn on the other side.
- Knee lift: Sit straight up in a chair, lift your left knee about four inches and hold for three seconds. Repeat the exercise using your right knee.
If you're overweight or obese, losing even a few pounds can help ease pain and reduce the pressure on your joints.
The Arthritis Foundation reports that losing just 10 pounds takes 40 pounds of pressure off your knees, which can help reduce inflammation, slow the breakdown of the cartilage that protects your joints from friction and reduce your risk of gout, a painful form of arthritis that develops when uric acid crystallizes in the joints. If you have rheumatoid arthritis or psoriatic arthritis, losing weight can also help improve your chances of remission.
Over-the-counter medications are available without a prescription from a doctor or another medical professional. Although you don't need a prescription to buy them, you should check with your doctor to make sure it's safe to use over-the-counter products, especially if you have kidney disease, heart disease or another chronic health condition.
Acetaminophen changes the way your body senses pain, relieving the discomfort caused by osteoarthritis. Potential side effects include nausea, loss of appetite, abdominal pain, rash, clay-colored stools and darker urine.
It's important not to take too much acetaminophen, as taking more than the recommended amount can cause liver damage. You can reduce your risk of liver damage by following the directions on the package and refraining from taking more than one acetaminophen-containing product at a time.
Nonsteroidal Anti-inflammatory Drugs
Nonsteroidal anti-inflammatory drugs treat arthritis by reducing inflammation, swelling and pain in the joints. When used for short amounts of time, NSAIDs are safe for most consumers; however, they increase the risk of gastrointestinal bleeding when used long-term. NSAIDs may also increase the risk of heart attack, stroke, abnormal heart rhythms and heart failure.
You can minimize the risk of these complications by using the lowest dose possible for the shortest amount of time possible. If you have a history of heart attack or stroke, or if you currently have a heart condition, don't take NSAIDs without checking with your doctor.
Like other medications, NSAIDs cause side effects in some users. The most common side effects include constipation, abdominal pain, diarrhea, heartburn, vomiting, nausea, dizziness and gas. In addition to GI bleeding and heart complications, NSAIDs may also cause some serious side effects, including the following:
- Kidney failure and other kidney problems
- High blood pressure (hypertension)
- Asthma attacks
- Liver failure and other liver problems
- Life-threatening skin reactions
Supplements aren't a replacement for treatment by a licensed medical professional, but several over-the-counter supplements have been proven effective in treating the symptoms of arthritis.
Fish oil contains omega-3 fatty acids, substances involved in the development of the human nervous system. Many people take fish oil because it helps reduce the risk of coronary artery disease, but this supplement can also help with swelling, pain and inflammation caused by arthritis.
According to a study published in the Mediterranean Journal of Rheumatology, the omega-3 fatty acids found in fish oil help to control disease activity, reducing the number of tender, swollen joints.
Although fish oil is generally safe for most people, talk to your doctor if you have a disorder that interferes with normal blood clotting. Fish oil can interfere with medications used to treat these disorders, making them less effective and putting you at risk of serious complications. Potential side effects of fish oil include the following:
- Bad breath
- Unpleasant-smelling sweat
Turmeric, a plant native to Southeast Asia, is typically used as a spice in curries and other dishes. When used to treat arthritis, it appears that turmeric improves joint mobility and reduces pain and stiffness. What makes turmeric so appealing is that it's been used for centuries as a food ingredient, eliminating the need to wonder if it's safe. High doses may cause diarrhea or nausea, but long-term studies have not revealed any toxic effects of turmeric use.
Gamma Linolenic Acid
Gamma linolenic acid is a fatty acid that comes from plant seeds and is found in hemp seeds, barley, oats and spirulina. When GLA breaks down, it produces a substance that prevents inflammation and helps regulate the immune system, making it effective for treating inflammatory conditions.
In one study, six months of GLA use resulted in "significantly significant" reductions in disease activity in a group of people with rheumatoid arthritis. Potential side effects of GLA include gas, belching, loose stools and diarrhea. GLA can also interfere with normal blood clotting, so check with your doctor before adding it to your diet or taking a supplement.
Researchers have had some promising results in using SAMe to treat the pain caused by arthritis. In one study, researchers compared SAMe with a prescription arthritis medication to see if the SAMe could be used to control arthritis symptoms. They concluded that SAMe is as effective as some prescription medications at controlling arthritis pain, provided you give it time to build up in your system. Potential side effects include digestive problems, dizziness, insomnia and sweating.
Topical medications work faster than oral medications, so you may want to try a cream or a spray for quick relief of arthritis symptoms. Because topical medications are absorbed through the skin, they're especially effective when applied to the knees and hands, as these joints are close to the skin's surface. Topical treatments may contain capsaicin, anesthetics, counterirritants or diclofenac free acid, all of which work in different ways.
Capsaicin relieves pain by reducing the amount of a substance used to transmit pain signals from the nerves to the brain. One of the most common side effects of capsaicin is warmth and burning at the application site. You may also experience coughing, throat irritation, watery eyes or sneezing if you inhale the residue from the cream.
After applying capsaicin, wash your hands thoroughly unless you're using the cream to treat arthritis in your hands or fingers. Avoid touching your face, mouth and eyes to prevent transfer of the capsaicin residue.
Anesthetics numb the sore area, relieving pain and giving you a break from your arthritis symptoms. Many topical anesthetics contain lidocaine, a substance that blocks nerve signals in the skin and mucous membranes.
One of the most common side effects of topical anesthetics is burning or stinging at the application site. If you decide to use a topical anesthetic to relieve arthritis pain, follow the directions on the package and avoid applying the medication more often than recommended. Overuse can lead to fast heart rate, increased blood pressure, abnormal heart rhythms, seizures or respiratory depression.
Menthol, camphor and methyl salicylate are all counterirritants, substances that produce hot or cold sensations that change the way you feel pain. These substances are especially effective in the early phase of the pain response, so try to apply one as soon as you start to feel arthritis pain. One of the most common side effects of counterirritants is skin irritation at the application site.
Diclofenac Free Acid
Diclofenac free acid is the active ingredient in Voltaren gel, a topical NSAID that relieves pain and other arthritis symptoms. The medication comes with a dosing card to help ensure you use the correct amount each time you apply it. If you use diclofenac gel, avoid applying lotion, cosmetics and other topical products to the affected area. Potential side effects include constipation, gas, abdominal pain, dizziness, acne and dryness, redness, irritation, numbness or scaling at the application site.
During a physical therapy session, your therapist will guide you through a series of exercises designed to strengthen the muscles around the affected joint, prevent stiffness and reduce pain.
If you have arthritis in your knee, for example, your therapist may have you perform exercises that target your quadriceps and hamstrings. Some physical therapy facilities offer additional treatments, such as transcutaneous electrical nerve stimulation (TENS) or ultrasound therapy, to improve your symptoms.
At your first session, you'll meet with the physical therapist to review your medical history and discuss your symptoms in detail. The therapist will use this information to develop a custom treatment plan based on your current activity level, the severity of your symptoms and other important factors.
Many insurance plans cover physical therapy, but the level of coverage depends on your provider and the terms of your plan. You may need to pay a deductible before the insurance company covers any of the costs, or you may have to pay a copay for each physical therapy session.
If over-the-counter products don't relieve your symptoms, talk to your doctor about whether a prescription medication can help. Your out-of-pocket costs depend on the terms of your insurance plan.
Many plans cover prescription medications for arthritis, but you may need to pay a copay or deductible. Check your insurance company's drug formulary – a list of drugs covered by a health plan – to find out if the drug is covered and, if so, how much you can expect to pay.
Nonsteroidal Anti-inflammatory Drugs
Some NSAIDs are only available by prescription, including celecoxib, which doesn't interfere as much with the protective effects of the COX-1 enzyme on the stomach lining. This may reduce the risk of GI bleeding and other gastrointestinal side effects. Potential side effects of celecoxib include sore throat, cold symptoms, gas, dizziness, constipation and changes in the way food tastes.
Corticosteroids are highly effective for reducing inflammation, which can help you manage the pain, stiffness and swelling caused by arthritis. If you have rheumatoid arthritis, an autoimmune disorder, a corticosteroid can also suppress your overactive immune system and prevent it from attacking your joints. Prednisone, dexamethasone, cortisone, prednisolone and methylprednisolone are all examples of corticosteroids.
The most common side effects of corticosteroids include weight gain, mood swings, acne, easy bruising, hair thinning or excessive hair growth, blurred vision, mild muscle weakness in the limbs and a rounder face. Long-term use of corticosteroids can also cause high blood sugar, high blood pressure, stomach ulcers, stretch marks or stomach irritation.
Disease-Modifying Antirheumatic Drugs
Disease-modifying antirheumatic drugs block inflammation, preventing further damage to your joints. Remicade, Humira, Enbrel, Orencia and Rituxan are just a few examples of the DMARDs available for treating rheumatoid arthritis. Once you start taking a DMARD, it may take several months for it to build up in your bloodstream and start relieving your pain. You also need to be aware that using a DMARD makes you more susceptible to infections. Potential side effects of DMARDs are as follows:
- Upset stomach
- Mouth ulcers
- Mild hair loss
- Vision problems
- Low blood cell counts
- Elevated liver enzymes
Hyaluronic acid injections are used to treat osteoarthritis that hasn't responded to over-the-counter medications, prescription drugs or other treatments. Also known as viscosupplementation, hyaluronic acid injections relieve arthritis symptoms by lubricating the joints, which reduces friction and helps the joints work properly. You should not have one of these injections if you have a joint infection, skin infection or any other problem at the injection site. If you have a condition called joint effusion, you should wait until the condition resolves before trying hyaluronic acid injections.
To treat arthritis effectively, you'll need to have weekly injections for about three or four weeks. Your doctor will also monitor your progress to make sure it's safe for you to continue receiving the injections. The most common effects of viscosupplementation include joint pain, muscle pain, muscle stiffness and difficulty moving the joint. Hyaluronic acid injections may also cause redness or swelling of the joints.
Synovectomy, bone fusion and total joint replacement are some of the surgical options for treating arthritis when medications, physical therapy and lifestyle changes aren't enough to control pain, swelling and stiffness.
Your insurance plan should cover surgery, but it's important to review the plan documents or contact your insurance company directly to be sure. You may need to obtain prior authorization for the procedure or meet other requirements before your insurance company agrees to cover the surgery.
Synovectomy, a procedure used to treat rheumatoid arthritis, involves the removal of inflamed synovium. The synovium is a membrane that produces the fluid that lubricates your joints and protects them from friction.
Your doctor may recommend this procedure if you still have significant pain after six to 12 months of taking prescription medications for your rheumatoid arthritis. The main risks of synovectomy are bleeding within the joint and an increased risk of infection. You may also lose some range of motion in the affected joint.
Synovectomy doesn't cure arthritis, but it can provide temporary relief from pain, swelling and stiffness. The length of the recovery period depends on the size of the incision and the location of the joint.
You can expect to start physical therapy within a day or two of the procedure to prevent the joint from stiffening up and causing more pain as you recover. You'll also need medication to prevent a recurrence of inflammation in the joint.
Joint fusion, also known as arthrodesis, is a procedure in which a surgeon fuses two or more bones in the joint. Once the bones are fused, you'll lose a little range of motion, but the joint becomes more stable. As a result, arthrodesis is used to relieve joint pain and other symptoms of arthritis.
In some cases, the surgeon needs to use a bone graft during the procedure. If this applies to your case, your surgeon may harvest the tissue from another part of your body or use donor tissue or a synthetic graft.
Arthrodesis is typically performed on people with significant pain that hasn't responded to other arthritis treatments. Because fusing the bones limits mobility in the affected area, the procedure is usually done only after all other treatment options have been exhausted.
Risks of joint fusion include infection, continuing pain at the surgical site and failure of the fusion. Recovery from arthrodesis takes up to 12 months depending on which bones were fused, your general health and other factors. The procedure doesn't cure arthritis, but it relieves pain and may increase function in the affected joint.
Total Joint Replacement
During a total joint replacement procedure, the surgeon removes damaged joint material and replaces it with a prosthesis made from ceramic, plastic or metal. Your doctor may recommend this procedure if significant arthritis pain persists even after you've tried other treatments.
Like all surgical procedures, total joint replacement does have some risks, including blood clots, nerve damage and infection at the surgical site. In some cases, the patient also experiences problems with the prosthesis, such as dislocation, which prevents the prosthesis from acting like a natural joint.
The length of the recovery period depends on several factors, including which joint was replaced and how committed you are to participating in physical therapy and exercising the new joint.
After the procedure, you can expect some pain as your body gets used to the prosthesis. The pain should resolve within a few months, but let your doctor know if it persists. Your doctor will have you do physical therapy to strengthen the muscles around the joint and ensure that the prosthesis is as stable as possible.
Total joint replacement can improve your quality of life and make it easier to do your daily activities.
- American Academy of Orthopaedic Surgeons
- American Heart Association Fitness
- American Physical Therapy Association
- Arthritis Foundation
- Arthritis National Research Foundation
- DailyMed - U.S. National Library of Medicine
- Gout Education Society
- National Center for Complementary and Integrative Health
- National Weight Control Registry
- Rheumatoid Arthritis Foundation
- American Academy of Orthopaedic Surgeons: After Your Joint Replacement Surgery
- American Occupational Therapy Association: Managing Arthritis
- Arthritis Foundation: 36 Tips for an Arthritis-Friendly Diet
- Arthritis Foundation: Arthritis by the Numbers
- Arthritis in America
- Strength Training for Older Adults
- Palomar Health: Joint Replacement Surgery Patient Guide
- University of Texas: No-Equipment Home Workouts
- U.S. Department of Health: Physical Activity Guidelines for Americans
- Versus Arthritis: Diet and Arthritis