Drugs *
Depending on the type of arthritis, and how severe or progressed it is, there is a wide range of drugs used to treat arthritis. Some are designed to relieve pain, some reduce the inflammation and others control the underlying disease.
Your doctor may prescribe one, or a combination of drugs from any of the following types:
- painkillers (analgesics)
- non-steroidal anti-inflammatory drugs (NSAIDs)
- steroids
- disease-modifying anti-rheumatic drugs (DMARDs)
- biologics, including anti-TNFs
Painkillers
Getting relief from arthritic pain is paramount and the drugs used range from Paracetamol, Aspirin and Ibuprofen to stronger, prescription only drugs like Codeine. The anti-inflamatory effect of some of these drugs is also beneficial.
Non-steroidal Anti-inflammatory Drugs (NSAIDs)
NSAIDs help reduce inflamation and the pain associated with arthritis by suppressing the body’s production of Prostaglandins – which are a family of chemicals which promote inflamation and the sensation of pain as part of the body’s defence mechanism. In reducing the production of prostaglandins, NSAIDs help reduce the inflamation and pain within arthritic joints. However, other functions of prostaglandins include protecting the stomach lining from acid and helping the blood clotting effects of platelets. So potential side effects include stomach problems, like ulcers, and excess bleeding.
Steroids (corticosteroids)
Steriods are a much more powerful anti-inflammatory and, again, work by suppressing the body’s production of inflamatory chemicals. Steroids can be taken orally, injected into the bloodstream or injected directly into an arthritic joint. When injected into a joint the benefits are almost instant (in terms of reducing inflamation and pain) BUT, ironically, steroids are known to actually damage cartilage! So whilst the relief can be instant, steroids actually cause more long term damage. For this reason, you are normally only allowed up to three treatments… in your lifetime!
Disease-modifying Anti-rheumatic Drugs (DMARDs)
These are normally used in the treatment of rheumatoid arthritis and other forms of arthritis which are caused more by an overactive immune response, than by wear and tear. The action of DMARDs is to damp down the body’s immune system and so slow the progression of the these forms of arthritis.
Anti-TNFs
These are a newer generation of DMARDs and have shown to improve symptoms more quickly. They help to block the action of another chemical, produced by the body, called “tumour necrosis factor” (TNF). This chemical is believed to play an important role in promoting the inflammation and tissue damage in some kinds of inflammatory arthritis.
Surgery
As yet, there is no real cure for arthritis. All of the above treatments are designed to reduce the symptoms (the pain and the inflamation) and, hopefully, slow down the progression of arthritis. Sadly, most forms of arthritis do get worse as time goes by… there is a certain balancing act here – trying to suppress the symptoms enough, and for long enough, so that quality of life is preserved. As there are such a wide range of treatments available, most people with arthritis may never need surgery but for those who’s joints are so bad that other forms of treatment are becoming less and less effective, then surgery may be suggested.
Full joint replacement (knee, hip, ankle, shoulder, elbow, wrist and finger) is now fairly commonplace but there are other surgical procedures which you may be offered. These include: removing damaged/torn cartilage, joint resurfacing, removing bony spurs, removing the inflamed lining of a joint cavity or fusing a joint to make it more stable and therefore less painful.
This type of surgery is often looked at as a last resort but these are seen as fairly “routine” operations and the success rates are very high. A full hip relacement, for example, although a major operation, is expected to last about 20-30 years.
* Side Effects
ANY and EVERY drug has side effects – to a greater or lesser degree – and not all drugs are suitable for all patients or conditions. Before embarking on any course of drug treatment it is vital that you discuss all aspects of the treatment with your doctor or specialist and that you carefully consider the pros and cons of each treatment offered.