Upcoming EventsMany newly diagnosed patients with arthritis come in with misconceptions about the condition, says Oliver Kurucz, MD, Chief of Rheumatology at Montefiore Nyack Hospital. For Arthritis Awareness Month in May, Dr. Kurucz discusses the most common questions he receives from patients.
Q: What is arthritis?
A: The word “arthritis” means joint inflammation. In fact, there are more than 100 kinds of arthritis and related diseases. Osteoarthritis is the most common form of arthritis. Symptoms include achy joints after physical work or exercise. Joint swelling and bony enlargement of the joints are other common signs. Osteoarthritis affects the weight-bearing joints at the base of the spine, hips, knees and the base of the thumb.
Rheumatoid arthritis is an autoimmune disease, meaning the body’s immune system mistakenly attacks the joints, causing swelling and pain in and around the joints. It most often affects the joints of the hands, feet, wrists, elbows, knees and ankles.
Q: Is arthritis more likely to develop as a person ages? Are women more likely to develop it?
A: It depends on the type of arthritis. About 80% of people over age 50 have some form of osteoarthritis, and it is equally common in men and women. Rheumatoid arthritis is most common in people between the ages of 30 and 50, and occurs more often in women.
Q: Can arthritis be treated through diet?
A: Eating a so-called “anti-inflammatory” diet, also known as a Mediterranean diet, can help reduce inflammation associated with both osteoarthritis and rheumatoid arthritis. This diet includes fish, nuts and seeds, fruits and vegetables, whole grains and beans. Other anti-inflammatory foods include avocado and dark chocolate. Some evidence also suggests the spices turmeric and ginger, as well as green tea and vitamin C, have anti-inflammatory effects.
Q: Will exercise make my arthritis worse?
A: No—exercise can improve your arthritis symptoms. Strengthening exercises help support muscles around affected joints, easing the burden on those joints and reducing pain. Low-impact aerobics help improve stamina and energy levels, while flexibility exercises help maintain and improve joint flexibility and reduce stiffness.
Q: Should I take glucosamine/chondroitin for my arthritis?
A: Glucosamine and chondroitin are popular supplements used to treat the pain and loss of function associated with osteoarthritis. Numerous studies have looked at the effectiveness of these supplements, and about half say they help, while the other half say they don’t. My recommendation to patients who ask about these supplements is to try them for three months and see if it helps. If you don’t notice a benefit in that time, it’s probably not worth your money.
Q: Are there any medications that can cure arthritis?
A: There are currently no treatments that can cure osteoarthritis. Treatment generally starts with diet, exercise, physical therapy and weight loss, and then moves to pain relievers if non-drug treatments are not effective. Other medications used to treat osteoarthritis include topical creams, rubs and sprays to relieve pain. Scientists are studying treatments called disease-modifying osteoarthritis drugs (DMOADs) designed to stop the progression of the disease, but none have yet been approved by the U.S. Food and Drug Administration.
Rheumatoid arthritis treatment includes nonsteroidal anti-inflammatory drug (NSAIDs) such as aspirin, ibuprofen, naproxen and naproxen sodium to relieve pain and inflammation, and disease-modifying antirheumatic drugs (DMARDs) or biologic agents to slow or stop the progression of the disease and damage to the joints. Some newly developed medications for plaque psoriasis can also reduce the signs and symptoms of psoriatic arthritis. Examples include apremilast (Otezla), ustekinumab (Stelara) and secukinumab (Cosentyx). Up to 30% of people with psoriasis develop psoriatic arthritis.
Q: Does my arthritis need to be treated by a rheumatologist, or can I be treated by my internist?
A: Many people with osteoarthritis can be successfully treated by their internist. If you have an inflammatory type of arthritis, such as rheumatoid arthritis or psoriatic arthritis, I would recommend treatment by a rheumatologist. DMARD medications used to treat these types of arthritis may have potential side effects that should be monitored closely by a specialist. While the most common side effect with DMARDs is stomach upset, some of these medications may also increase the risk of infection because they suppress your immune system.
The most important thing to understand about arthritis treatment is that there isn’t a one-size-fits-all approach. Not everyone responds the same way to medication. A key to successfully treating your arthritis is to work with a doctor who understands your individual needs, and matches you with the correct type of treatment to prevent further joint damage.
