Definition

Arthritis is an inflammation of the joints, surrounding tendons, ligaments and cartilage. It can affect virtually every joint of the body from the feet, to the knees, back, shoulders, and fingers. The term Arthritis describes a variety of arthritic conditions, with the three most common forms being Osteoarthritis, Rheumatoid Arthritis and Gout.  

Description

Symptoms will vary depending on the type of Arthritis, and include slight pain, stiffness and swelling of the joints, through to extreme disability and joint deformity. 

For more information refer to the topics on specific types of Arthritis. The three types of arthritis include:

Osteoarthritis

Osteoarthritis is a degenerative joint disease and is the most common form of Arthritis. This joint degeneration results in pain, deformity and a reduced range of motion. There is generally no inflammation.  

Rheumatoid Arthritis

Rheumatoid Arthritis is a chronic inflammatory type of Arthritis in which joints are equally red, swollen and tender on both sides of the body. Rheumatoid Arthritis is an autoimmune disease and typically affects the hands, feet, wrists, ankles and knees. This type of Arthritis may cause destruction and disfiguration of the affected joints.   

Gout

Gout is an arthritic condition of the body connected with an excess of uric acid in the blood. It causes the joints to become red, swollen and painful. The most common area on the body for Gout to occur is the joint of the big toe. Gout is not a single disease but is a syndrome resulting from high levels of uric acid in the blood.  

Treatment options

The treatment of Arthritis depends on the type of Arthritis. There are various causative factors associated with Arthritis which need to be identified. For detailed information and treatment refer to the topic on the specific type of Arthritis.  

Diet hints

The diet generally should be rich in fish oil e.g., salmon, tuna, mackerel and mullet. Fish oils may help to regulate the inflammatory process.

It is recommended to include vitamin C rich foods in the diet e.g., apples, pears, berries, pawpaw and green vegetables. Vitamin C plays a role in the formation and maintenance of connective tissue and collagen, which provides stability and strength to joints.

Foods rich in silicon may be beneficial for people with Arthritis. These include wholegrain cereals, nuts and apple. 

Weight control is important. This will help minimise the load on inflamed joints. 

Certain food groups such as the “nightshade” vegetables (potato, tomato, eggplant, chilli and capsicum) and salicylate-rich foods (see examples in the Hives and Hyperactivity Diet topic) may aggravate Arthritis.

Avoid acid forming foods such as red meat and sugar.

People with Gout should avoid foods high in purines. These include liver, kidney, heart, brains, pate, sardines, herrings, anchovies, mackerel, yeast and yeast products, beer, asparagus and yeast products.

Vitamins/minerals/herbs

Nutritional supplements are only to be used if the dietary vitamin intake is inadequate.

Glucosamine and Mucopolysaccharides can be taken to aid connective tissue support. 

Devil’s claw, feverfew, celery and white willow bark have been traditionally used to relieve pain and inflammation associated with Arthritis.

Bromelain, an anti-inflammatory enzyme derived from pineapple, may provide symptomatic relief.

Vitamin C with bioflavonoids are believed to have a positive effect on cartilage degeneration.

Omega-3 fatty acids are thought to be anti-inflammatory.

Zinc is believed to support the immune system and help reduce inflammation.

Organisations & support groups

See the Arthritis Foundation of Australia topic on the Healthpoint.  

Pharmacist’s advice

Ask your Pharmacist for advice.

Your Pharmacist can assist with some anti-inflammatory pain relief tablets. It is important to ask your Pharmacist to recommend the most suitable pain reliever for the type of Arthritis.

Remember to exercise according to the advice of your Doctor or Physiotherapist. A range of special exercises, such as daily stretching, might be suggested to help improve circulation and flexibility. 

Avoid activities which place a heavy amount of stress on the joints.

Some relief for Arthritis may be obtained from applying heat if the joints are stiff or a cold pack if the joints are warm and swollen. Massage, relaxation, exercise, liniments and joint wraps may also help to relieve the symptoms of the disease. Some creams may give relief. Ask your Pharmacist for advice. 

Some nutritional supplements may be considered if the diet is inadequate. See individual topics.

Your Pharmacist may suggest a suitable pain relief medication. Non-steroidal anti-inflammatory drugs or NSAIDsmay also be suggested. Take these only after advice from your Pharmacist as there are possible side effects.

Rheumatoid arthritis

Definition

Rheumatoid arthritis is a condition that causes pain, swelling and inflammation in the joints.  

Description

Rheumatoid arthritis is an autoimmune disease. This means that the immune system, which usually fights infection, attacks the lining of the joints, causing them to become inflamed. Over time these joints may become permanently damaged and stop working properly.

 

The symptoms of Rheumatoid Arthritis tend to develop gradually. The small joints, such as in the fingers and toes are often affected first. It can then spread to other joints e.g in the shoulders, elbows, hips and jaw. The condition tends to affect several joints at the same time, usually on both sides of the body e.g it often affects both knees or both hands.  

Signs and symptoms

Symptoms are often more painful in the morning and begin to ease as the day progresses. The most common symptoms of Rheumatoid Arthritis include:

Swelling, pain and heat in the joints

Stiffness in the joints, especially in the morning

Persistent fatigue

Sleeping difficulties because of the pain

Weak muscles

Joints on both sides of the body are usually affected.

Loss of appetite.

Generally feeling unwell.

Skin nodules – one in four people with Rheumatoid Arthritis develop painless lumps under the skin over the elbows and forearms, known as rheumatoid nodules.

Anaemia – eight out of ten people with rheumatoid arthritis are anaemic.

Flare ups

The symptoms of Rheumatoid Arthritis often tend to come and go and ‘flare ups’ can occur. This means that from time to time, the condition will worsen and the symptoms will be more intense and severe. Although Rheumatoid Arthritis can be frustrating, particularly during a flare-up, most people are able to carry on as normal, with some lifestyle adjustments.  

Treatment options

As with all medical conditions it is advisable to consult your Doctor for an accurate diagnosis and treatment. There is no cure for Rheumatoid arthritis but there are many medicines and therapies that can greatly improve your symptoms. If your GP suspects you have Rheumatoid arthritis, you will be referred to a specialist rheumatologist. This is so the diagnosis can be confirmed and the most appropriate treatment started as soon as possible.

 

Medication

Many different medicines are used to treat rheumatoid arthritis. Some aim to relieve symptoms and others help to slow the progression of the condition. Some of the different medicines that you may be prescribed are outlined below. 

Analgesics – more commonly known as painkillers e.g paracetamol, codeine etc. 

Non-steroidal anti-inflammatory drugs (NSAIDs) – help to relieve pain and stiffness while also reducing inflammation. Some of the most commonly used include ibuprofen and aspirin.

Disease-modifying anti-rheumatic drugs (DMARDs) – are a type of medicine that help to ease symptoms and slow down the progression of the disease. Early treatment with DMARDs leads to a better outcome for the patient.

Corticosteroids – are a type of medicine that help to reduce pain, stiffness and swelling. These are usually used when NSAIDs fail to provide relief. They are commonly prescribed on a short term basis, often during a flare-up. The long-term use of corticosteroids can have serious side effects.

Surgery

Surgery may be required if your Rheumatoid arthritis is particularly severe. The most commonly replaced joints are hips and knees. Osteotomy is another type of surgery that helps to realign joints. You may also need surgery on your hands, to repair damaged tendons

 

Lifestyle

Staying active is very important as exercise helps to maintain mobility and prevent the muscles around joints from becoming weak. Swimming is an ideal type of exercise as the water supports your weight, taking pressure away from your joints.

 

A physiotherapist will be able to devise an appropriate exercise plan for you. An occupational therapist can also advise you on ways to adapt your lifestyle to give you more independence, confidence and control.  

Diet hints

General dietary recommendations for a person with arthritis include:

Eat a well-balanced diet. 

Avoid fad diets or fasting. 

Increase dietary calcium to reduce the risk of osteoporosis in later life. 

Drink plenty of non-alcoholic fluids. 

Keep your weight within the normal range, by reducing the amount of dietary fats you consume.

Fish oils that contain omega-3 fatty acids have been found to help reduce the inflammation associated with some forms of arthritis, such as rheumatoid arthritis. Foods rich in omega-3 fatty acids include: 

Oily fish (such as salmon and sardines) 

Linseeds and linseed (flaxseed) oil 

Canola (rapeseed) oil 

Walnuts

Vitamins/minerals/herbs

See the topic Rheumatoid Arthritis – Supplements.  

Organisations & support groups

See the Arthritis Foundation of Australia topic on the Healthpoint.

Pharmacist’s advice

Ask your Pharmacist for advice.

Ask your Pharmacist about anti-inflammatory pain relief medication. It is important to ask your Pharmacist to recommend the most suitable pain reliever.

Remember to exercise according to the advice of your Doctor or Physiotherapist. 

Avoid activities that place a heavy amount of stress on the joints.

Some relief for Rheumatoid Arthritis may be obtained from applying heat if the joints are inflamed. Massage, relaxation, exercise, liniments and joint wraps may also help to relieve the symptoms of the disease. Some creams may give some relief. Ask your Pharmacist for advice. 

Some nutritional supplements may be considered if the diet is inadequate e.g glucosamine sulphate, chondroitin and fish oil