Arthritis Treatment in Delhi, India

There are several types of Arthritis known to medical science, but here are some of the most common ones.

• Ankylosing spondylitis: It is an inflammatory disease that causes the vertebrae (bones in the spine) to fuse making the spine less flexible.
• Gout: It's one of the most complex forms of arthritis that often leads to sudden instances of pain, swelling, redness and tenderness in the joints.
• Osteoarthritis: Osteoarthritis is a common type of arthritis that occurs because of the wearing out of the protective cartilage that cushions the ends of the bones. It usually affects the hands, knees, hips and the spine.
• Psoriatic arthritis: It is usually diagnosed in people with a preexisting condition, psoriasis. While most people contract the disease years before being diagnosed with psoriatic arthritis, some individuals may develop psoriatic arthritis before they start showing signs of psoriasis.
• Reactive arthritis: It is a type of arthritis that usually affects the knees, ankles and feet. It is known as a reactive type as the symptoms are triggered because of infections in other parts of the body, such as genitals, urinary tract, and intestines.
• Rheumatoid arthritis: It is an autoimmune disorder that affects two or more joints. It is caused by the immune system attacking the body's own tissues.
• Childhood arthritis: It is also known as Juvenile Idiopathic Arthritis. As the name suggests, it is inflammation of joints in children, and it can permanently damage joints, making it difficult to walk.
• Fibromyalgia: Fibromyalgia is a disorder that causes musculoskeletal pain and is often accompanied by altered sleep, fatigue, and mood issues. It is generally triggered by physical or emotional stress.
• Lupus: Lupus is a condition in which a faulty immune response leads to damage to body cells, and it can affect joints, blood cells, skin, heart, lungs and brain.

The symptoms range from mild to severe and they vary based on the type of arthritis. The most common symptoms of arthritis include:

• Joint pain
• Joint swelling
• Redness of the skin around a joint
• Decreased range of motion
• Stiffness, especially in the morning
• Limited movement
• Warmth
• Tenderness
• Pain while moving

The cause of arthritis depends on its type. Following are some of the major causes of arthritis:

• Faulty immune response in which immune cells damage the body’s own cells.
• Metabolic disturbances such as an increase in uric acid.
• Obesity
• Repetitive movements
• History of injury

• Family history: Arthritis can run in families and be passed on from one generation to another.
• Age: With advancing age, the risk of arthritis increases.
• Your sex: Most arthritis affects women more than men, but some types of arthritis, such as gout, affect men more than women.
• Previous joint injury: A history of injury increases the risk of arthritis.
• Obesity: Obesity can affect weight-bearing joints and may be one of the more significant risk factors for arthritis.

Arthritis is diagnosed with the help of the following modalities: 

• Physical examination: The doctor checks for redness, swelling and warmth. 
• Laboratory examination: The following lab tests may be used to diagnose arthritis:

• Antinuclear antibody
• Complement tests
• Arthrocentesis
• Complete blood count
• C-reactive protein
• Creatinine
• Erythrocyte sedimentation rate
• Rheumatoid factor
• Urinalysis
• Uric acid test
• Haematocrit

• Imaging techniques

• X-Ray: It helps identify bone damage and deformities.
• Ultrasound: Ultrasound helps to assess ligament, tendon and synovial tissue.
• Magnetic Resonance Imaging (MRI): Magnetic Resonance Imaging (MRI) are better than X-Ray as they give a better picture of damage and deformities.
• Arthroscopy: Arthroscopy is a procedure used to see the inside of a joint using a small camera called an arthroscope. It requires a small incision to allow the insertion of a camera and helps detect bone diseases and tumours.

Arthritis is treated with medications and physiotherapy. But when conservative treatment does not provide relief, surgery may be advised.

Medications 

The following medications may be used to treat arthritis:

• NSAIDs: Certain over-the-counter pain-relieving medications can provide joint pain relief. Doctors may suggest stronger medications that are available only on prescription.
• Topical ointments: The doctor may advise the patient to apply ointments containing capsaicin or menthol for pain relief.
• Corticosteroids: Injection of corticosteroids may be given directly into the joint, and it is sometimes combined with local anaesthesia to provide pain relief.
• Disease-modifying antirheumatic drugs (DMARDs): It is given to treat the underlying cause of arthritis and provide pain relief. It is given to patients with autoimmune diseases such as rheumatoid arthritis.

Physical therapy

The doctor may refer the patient to a physiotherapist who will help the patient with strengthening exercises. The physiotherapist may also use ultrasound and TENS to provide pain relief.

Surgery

One of the following surgeries may be advised:

• Osteotomy: In the Osteotomy procedure, the damaged bone piece is removed, and joint surfaces are scraped and smoothened.
• Joint replacement: Joint replacement surgery involves the replacement of the joint with an artificial joint.
• Joint fusion: It is a treatment modality most commonly used for smaller joints such as the ankle and wrist. The doctor may use rods, wires, plates or pins to join the two bones and make a continuous joint.

Severe arthritis may lead to the joints gradually losing their alignment and shape. This, in turn, affects the hands or the arms making it difficult for those with arthritis to perform their day to day activities. It can also lead to problems with walking comfortably or sitting up straight. In some cases, arthritis may even lead to disability.

While there is no sure way to prevent arthritis, here are a few things that one must do to ensure healthy joints.

• By maintaining a healthy weight
• By controlling blood sugar level
• By exercising regularly
• By stretching regularly to keep joints limber
• By staying careful and avoiding injury
• By quitting smoking
• By ensuring a diet that's high in Omega-3

1. Does arthritis occur in old people only?

From children to young adults to the elderly, arthritis can occur in individuals of any age group. However, it is more common in those individuals who are 65 years and above.

2. What if arthritis is left untreated?

Arthritis, if left untreated, can lead to severe complications such as deformities of hands, wrists, ankles and feet. It is, therefore, recommended to ensure early diagnosis and treatment, as soon as one notices any symptoms

3. Can arthritis be fully cured?

No, arthritis cannot be cured completely. However prompt diagnosis and treatment does help keep the symptoms under control, allowing patients an improved quality of life.

4. Will I have to take medications for the rest of my life?

Yes, arthritis patients need to take medicines for the rest of their life. The good thing is that your doctor may reduce your dosage if your condition gets better with time.

5. Does arthritis run in the family?

Yes, some types of arthritis, such as rheumatoid arthritis, psoriatic arthritis, and lupus do tend to run in the families. One must get themselves tested regularly, if they have anyone in their family with any of these arthritis types.

6. Do arthritis medicines lead to side effects?

Yes, arthritis medications can cause side effects. Common ones include stomach issues with NSAIDs, weight gain or bone weakness with corticosteroids, and a higher risk of infection with DMARDs or biologics. It's important to discuss side effects with your doctor and report any unusual symptoms.

7. What foods can worsen arthritis?

Patients with gout (an arthritis type that develops due to excess uric acid in joints) must avoid food such as shellfish, red meat, and alcoholic beverages as they can worsen their condition. They should, instead, include foods like green leafy vegetables, fish, and dairy products in their diet to ensure strong bones, muscles, and joints.

Reviewed by Dr. L. Tomar, Principal Director and Unit Head Department of Orthopaedic and Joint Replacement, on 6 Dec 2024.