There are over 100 types of arthritis, which means there is no one treatment approach to managing the condition. The treatment approach will depend on the underlying mechanism causing arthritis.

Osteoarthritis

Osteoarthritis (OA) is the most common form of arthritis because most people will experience it at some point in their life, especially as they age. With OA, the cartilage between the joints decreases, increasing friction between the bones on either side of the cartilage. Due to the friction, other problems may arise, such as bone spurs (osteophytes). In addition to the pain and inflammation associated with OA, there may be catching or locking of the joint as the disease progresses. When arthritis only bothers you occasionally, taking OTC anti-inflammatory pain medicines may be all that is necessary to reduce pain and stay mobile. As the disease progresses, it may be necessary to have steroid injections. Injections of hyaluronic acid can be used to help cushion the joint. In the most severe instances, joint replacements might be the only option to reduce pain and resume use of the affected joint.

Inflammatory Arthritis

Inflammatory arthritis (IA) is a special class of arthritis caused by the immune system attacking joints. Arthritis may be the primary problem, such as in the case of rheumatoid arthritis or ankylosing spondylitis, or it may be one component of widespread damage caused by the immune system, such as arthritis in lupus. Treatments used in OA may be used in many types of IA, but it is also important to reduce the activity of the immune system to slow or stop joint damage. For many forms of IA, the first-line treatment will be disease-modifying anti-rheumatics (DMARDs). Biologics are often used when DMARDs are not effective and may be used in conjunction with DMARDs. Both classes of medicines target specific types of immune cells that are hyperactive and cause damage. Oral steroids may be used periodically to help suppress a major flare-up of the disease and achieve a quick reduction in symptoms.

Gout

Gout, or gouty arthritis, comes on suddenly and generally affects a small joint, such as the base of the great toe, but most joints are susceptible to attacks. People who experience gout, may have a few attacks with full remission between attacks. Less commonly, chronic gout can occur. Gout is caused by excess uric acid that creates crystals in the joint. The initial treatment approach for gout is similar to other types of arthritis. Anti-inflammatory medications are used for pain, whereas oral steroids can quickly reduce the attack. For people with chronic gout, it may be necessary to take medications that reduce uric acid levels. People who are prone to either acute or chronic gout can benefit from dietary changes. Purine breaks down into uric acid, so it may be necessary to limit or avoid high-purine foods. Animal proteins, especially beef, and alcohol are major sources of purine.

Regardless of the underlying reason for arthritis, it is important to treat the condition in a timely manner. Effective treatment can minimize or slow joint damage that can lead to disability or the need for a joint replacement.