How much do you know about arthritis?

Posted 3/21/23

Arthritis simply means inflammation of a joint.

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How much do you know about arthritis?


There are two basic types of arthritis, osteoarthritis and inflammatory arthritis.  Arthritis simply means inflammation of a joint.

The most common form is osteoarthritis, usually caused by age and wear and tear, although injury and genetics can cause it as well.  It usually affects the hands, knees, hips and feet. Osteoarthritis can affect the finger joints.  Damage to the cartilage is to blame.  The cartilage cushions the joint.

Treatment of osteoarthritis includes exercise (especially walking), Tylenol (acetaminophen) and NSAIDS like Advil (ibuprofen), Aleve (naproxen) and Mobic (meloxicam).  NSAIDS can be very effective but can cause stomach ulcers (that can bleed) and kidney damage.  All NSAIDS increase one’s risk of having a heart attack, Aleve (naproxen) has a lower risk than the other NSAIDS.  Sometimes a joint injection can give relief, sometimes surgery is needed.  Topical medications are available as well such as Voltaren (diclofenac) gel, which is now over the counter.

Inflammatory arthritis means actual joint damage.  The most common types are rheumatoid arthritis, lupus, psoriatic arthritis, gout and pseudogout.  Blood tests needed include a sed rate, CRP, RA, ANA and anti-CCP and sometimes a uric acid level.  X rays can be very helpful in establishing the diagnosis.  Taking DHEA 100mg daily helps prevent and treat many cases of inflammatory arthritis.  DHEA is your anti-aging hormone that tends to be low in patients with inflammatory arthritis - its available without a prescription.   

In rheumatoid arthritis (RA) the body’s immune system thinks the joints are a germ that it needs to kill.  The hands, wrists and feet are usually involved.  Experts want to change the name to rheumatoid disease because the whole body can be affected.  Treatment is with methotrexate and Plaquenil (hydroxychloroquine).  If these aren’t effective steroids or a biological like Humira may be necessary.  Biologics cost thousands of dollars.  Those taking Plaquenil (hydroxychloroquine) need an eye exam at a minimum every 6 months.  NSAIDS can be used for pain, but they do very little to the underlying disease.  Labs need to be checked every 3 months. The goal is to save as much joint as possible.

Lupus is a disease where the body thinks its own DNA is a germ and attacks the whole body.  Individuals with lupus can get a “butterfly rash” on the face.  Its treated the same as rheumatoid arthritis

Psoriatic arthritis has similarities to RA, although it usually affects different joints.  Its seen in patients with psoriasis.  Its also treated the same as RA, although NSAIDS are more likely to be effective compared to those with lupus or RA.

Gout is caused by too much uric acid in the joints.  It most commonly hits at the big toe and ankle, but any joint can be affected.  An acute phase can be treated with steroids and/or NSAIDS.  Prevention with Allopurinol or probenecid is often the wise choice.

Pseudogout is caused by deposition of calcium pyrophosphate in a joint.  Its treated with NSAIDS or steroids.  There are no preventive measures to prevent pseudogout.  Those with pseudogout should be tested for hemochromatosis and hyperparathyroidism.

Family Medical Practice