The treatment and research into arthritis is known as rheumatology. However, arthritis treamtents extend beyond rheumatology also. Striking the right balance of treatments to best control your arthritis isn't easy and often differs from person to person.
Arthritis medication is a fact of life for most people living with the condition. It is important that you feel in control of your medication and can discuss what works best for you with your doctor or healthcare team.
There are two main families of drugs used by people with arthritis, and your doctor may prescribe a combination from each. They are:
Drugs which control the symptoms of your disease. These are used to treat most types of arthritis, including osteoarthritis and rheumatoid arthritis, and they alleviate specific symptoms such as pain, swelling and stiffness. They include painkillers and non-steroidal anti-inflammatory drugs (NSAIDs)
Drugs which affect the disease itself. These drugs affect the progression of the disease through, for instance, suppressing the immune system (the body's own defence system). These drugs include disease modifying anti-rheumatic drugs (DMARDs), like methotrexate and corticosteroids (steroids). They can also control symptoms.
Download our Drugs and Complementary Therapies information booklet for more information on arthritis medication.
Many people with arthritis find that having surgery brings about a dramatic reduction in their pain, and an improvement in their mobility and quality of life. A wide range of types of surgery can help people with arthritis, from small procedures (such as operations to remove cysts or nodules), to major surgery (which includes total joint replacement).
Hip and knee replacements are very common procedures. In the past, most operations were performed on people over 60 but, as the quality of artificial hips and knees has improved, younger people are having these procedures. Younger people who have joint replacements are likely to need revision surgery later in life, so the decision to have surgery needs to take this into account.
Download our information booklet on Surgery and Arthritis for more information.
Important Notice: DePuy Orthopaedics recently announced a recall of two specific hip replacement implant products. While this was a worldwide recall, about 3,300 patients received these implants in Ireland, across 16 public and 14 private hospital sites nationwide since 2003. Click here for a full guide to the recall.
Physiotherapy plays an important role in treating arthritis by providing you with improved mobility, strength and flexibility. It is often used along with medication.
If you are referred to a physiotherapist, at your first appointment you will be given a full assessment of your joints, muscles, posture and how you walk and generally move around.
You will be asked about your pain and what problems you might have. Taking into consideration the general state of your health and arthritis, a treatment plan will be decided upon and agreed between you and your physiotherapist.
Treatment and general advice may include exercise, hydrotherapy, mobilisation techniques, relaxation techniques, pain relief, TENS, splinting, walking aids and advice on posture.
It is normal to have around six sessions with a physiotherapist.
Hydrotherapy allows people with arthritis to exercise the joints and muscles while being supported by warm water. The warm temperature of the water aids muscle relaxation and eases pain in the joints, making it easier to relax. Because the water supports your weight, the range of movement in your joints should also increase.With a water temperature usually set between 33-36 degrees Celsius (warmer than a standard swimming pool), hydrotherapy differs from swimming because it involves special exercises that you do in a warm-water pool.
Scientific studies have shown that hydrotherapy can improve strength and general fitness in people with various types of arthritis. The exercises can be tailored to your individual needs, so you can start slowly and gradually build up your strength and flexibility. The extra support that the water provides may make you feel like you can do more exercise than normal, so be careful not to overdo it. The exercise and the warmth of the water may make you feel tired after treatment, but this is quite normal. In general, hydrotherapy is one of the safest treatments for arthritis and back pain.
If you are experiencing difficulty with day-to-day tasks like washing, dressing, cooking and cleaning you may benefit from visiting an occupational therapist. They have a wealth of expertise on what equipment is available to assist you with a particular task. They may also be able to supply, on temporary loan, some of the more expensive items.
Adaptations may include:
- ergonomic cutlery
- kettle tippers
- bath rails
- stair lifts
Your GP or consultant can put you in touch with an occupational therapist. There may be one at your local hospital or they may visit you at home.
For a full listing of private occupational therapists in Ireland, please visit www.privateOT.ie
Podiatry, or chiropody, specializes in care of the foot and can make a big difference to mobility and walking ability in people with arthritis.
The feet and ankles provide us with the ability to do some of the most essential tasks in life, like walking and standing, but are also two of the most arthritis-affected areas.
If you visit a podiatrist - an appointment can be made through your GP or independently in some cases - they will closely examine the way you walk (gait analysis), to assess the range of motion, pressure on the foot, forces on the joints and the way you protect your painful foot. An x-ray and ultrasound scans may also be carried out to get a better idea of your condition. You may then be prescribed with orthotic insoles and shoes, which are designed with good support and ease of movement in mind.
As their name suggests, these types of therapies are designed to complement and work alongside conventional medicine and treatments - not replace them. They concentrate on treating the whole person. Even if your usual drug treatment is working well, you may be curious to know why many people living with arthritis are choosing to explore therapies like acupuncture, aromatherapy and reflexology, and want to know whether you could benefit too.
The wide choice of complementary therapies can be bewildering, but they all have a common goal: to treat the person, not the condition itself.
Like conventional medicine complementary therapies cannot offer a cure for arthritis. Unlike conventional medicine, there is very little scientific evidence to support their benefits. However, many people claim they can help alleviate symptoms such as pain and stiffness, as well as counteract some of the unwanted side effects of drugs.
■ Popular forms for people with arthritis include:
The roots of acupuncture lie in traditional Chinese medicine where it has been practised for thousands of years. It works on the theory that health is determined by the flow of internal energy (chi) through the body. By inserting fine needles at these special points, imbalances in the flow of energy can be corrected.
The Alexander technique concentrates on how we use our bodies in everyday life and teaches people new ways of using the body to improve balance, co-ordination and awareness. By learning to stand and move correctly, people can ease stresses on their body and alleviate conditions that are made worse by poor posture.
Chiropractic is one of the complementary therapies which has gained a lot of respect from the medical community. It aims to improve mobility and relieve pain by focusing on mechanical problems in the joints - especially the spine. Chiropractors use their hands to adjust the joints in the spine and other parts of the body where movement is restricted. While they cannot reverse the damage in joints affected by arthritis, chiropractors claim that this regular adjustment can keep joints healthier and more mobile, while also reducing pain and slowing down further damage.
We use massage instinctively to 'rub something better' or soothe and calm someone in distress. As a therapy it can loosen stiff muscles by using gentle, soothing and kneading movements, and improve the tone of slack muscles using firmer, faster movements. Massage can also increase the flow of blood and lymph through the body and ease tension. On a psychological level, a good massage leaves you feeling relaxed and cared for.
Reflexologists believe that stimulating the reflex points in the feet can help remove energy blocks, relieving stress and allowing the body to heal itself. The therapy is built on the principle that pressure applied to one part of the body can relieve pain in other parts. Practitioners apply a pressing movement using their finger or thumb.
Yoga is a way of promoting flexibility and strength in mind and body. It can improve posture, muscle tone and mobility. It can also help relaxation. Yoga positions have evolved over thousands of years as a way of stretching and readjusting the balance of the spine (the structural and nervous centre of the body). Asanas (positions) move the body in many different directions and this, together with special yoga breathing, stimulates muscles and joints, circulation, digestion and the nervous and endocrine systems.
For more information check out our Drugs and Complementary Therapies information booklet.
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