Medications:



Nonsteroidal anti-inflammatory drugs (NSAlDs): These are a class of drugs including aspirin and ibuprofen that are used to reduce pain and inflammation and may be used for both short-term and long-term relief in people with osteoarthritis and rheumatoid arthritis.
Disease-modifying anti-rheumatic drugs (DMARDS): These are drugs used to treat people with rheumatoid arthritis who have not responded to NSAlDs. Some of these include methotrexate, hydroxychloroquine, penicillamine and gold injections. These drugs are thought to influence and correct abnormalities of the immune system responsible for a disease like rheumatoid arthritis. Treatment with these medications requires careful monitoring by the physician to avoid side effects.


Corticosteroids:

These are hormones that are very effective in treating arthritis. Corticosteroids can be taken by mouth or given by injection. Prednisotone is the corticosteroid most often given by mouth to reduce the inflammation of rheumatoid arthritis. In both rheumatoid arthritis and osteoarthritis, the doctor also may inject a corticosteroid into the affected joint to stop pain. Because frequent injections may cause damage to the cartilage they should only be done once or twice a year.


Weight reduction:

Excess pounds put extra stress on weight-bearing joints such as the knees or hips. Studies have shown that overweight women who lost an average of 11 pounds substantially reduced the development of osteoarthritis in their knees. In addition, if osteoarthritis has already affected one knee, weight reduction will reduce the chance of it occurring in the other knee.


Exercise:

Swimming, walking, low-impact aerobic exercise and range-of- motion exercises may reduce joint pain and stiffness. In addition, stretching exercises are helpful. A physical therapist can help plan an exercise program that will give you the most benefit.

"° Surgery:

In select patients with arthritis, surgery may be necessary. The surgeon may perform an operation to remove the synovium (synovectomy) realign the joint (osteotomy), or in advanced cases replace the damaged joint with an artificial one. Total joint replacement has provided not only dramatic relief from pain but also improvement in motion for many people with arthritis.


How Can You Cope with Arthritis Pain?


The long-term goal of pain management is to help you cope with a chronic, often disabling disease. You may be caught in acycle of pain, depression and stress. To break out of this cycle, you need to be an active participant with the doctor and other health care professionals in managing your pain. This may include physical therapy, cognitive-behavioral therapy, occupational therapy, biofeedback, relaxation techniques (for example, deep breathing and meditation), and family counseling therapy.

Another technique is to substitute distraction for pain. Focus your attention on things that you enjoy. Imagine a peaceful setting and wonderful physical sensations. Thinking about something that is enjoyable can help you relax and become less stressed. Find something that will make you laugh, a cartoon, a funny movie, or even a new joke. Try to put some joy back into your life. Even a small change in your mental image may break the pain cycle and provide relief.


What Research is Being Conducted on Arthritis Pain?


Recent NIAMS studies show that levels of several neuropeptides (compounds produced by cells of the nervous system), such as substance P, are increased in arthritic joints. Substance P is involved in the transmission of pain signals via the nervous system. At the University of Missouri, researchers are studying effects of substance P in the spines of animals with chronic arthritis. Findings from this study may be used to develop specific drugs for chronic pain such as that associated with arthritis.

Researchers are also studying the human knee and analyzing how injury in one joint may affect other joints. In addition, they are analysing the effect of pain and analgesics on gait (walking) and comparing pain and gait before and after surgical treatment of knee osteoarthritis.