Arthritis refers to more than 100 different diseases that cause pain, swelling, and limited movement in joints and connective tissues throughout the body. It is usually chronic, meaning that it lasts a lifetime. Specific causes for most forms of arthritis are not yet known. How the disease progresses also varies depending on the form of arthritis. The two most prevalent forms of arthritis are:

Osteoarthritis
A degenerative joint disease in which the cartilage that covers and protects the end of the bones in the joint deteriorates, causing pain and loss of movement as bone begins to rub against the bone.

Rheumatoid Arthritis
A systemic disease that affects the entire body. It is characterized by the inflammation of membrane lining the joints, which causes pain, warmth, redness, and swelling. The chronic inflammation causes deterioration of the joint, pain, and limited movement.

Treating and Preventing Arthritis

The treatment options used by PM&R physicians to help manage arthritis may include a combination of the following:

Exercise
Proper exercises performed on a daily basis are an important part of arthritis treatment. They help build and preserve muscle strength, keep joints flexible, and help protect joints from further damage.

Done carefully and regularly, certain isometric (non-movement) exercises can help strengthen muscles around joints and reduce wear and tear. These exercises can be taught by the PM&R physician and should be supervised.

A PM&R physician can also recommend a stretching program that benefits muscles by maintaining flexibility and range of motion. Joints need to move to remain healthy and well lubricated. Lack of use is often why many arthritis patients experience joint stiffness when they wake up in the morning. Once mastered, stretching and flexibility exercises can be done at home.

Physical/Occupational Therapy
Physical and occupational therapies are designed to help people with arthritis make their lives easier. Physical therapy treatment includes muscle strengthening and range-of-motion exercises. It also teaches ways to control pain without medication. Occupational therapy focuses on obtaining maximum independence and minimizing reoccurrence through education and treatment techniques.

Medicines
Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce inflammation and relieve pain. For more severe arthritic symptoms, PM&R doctors may prescribe corticosteroids, but they should be taken for short periods of time only, since they have substantial side effects. A PM&R physician may inject steroids directly into an arthritic joint, but relief will vary from person to person.

Injections of visco-lubricants are sometimes used, because this new medication may lubricate and build up cartilage. A survey of joint studies in Arthritis and Rheumatism showed little evidence of efficacy. Furthermore, these treatments can be expensive.

Rest
Rest helps relieve the effects of too much activity. However, too much rest may lead to stiffness and poorly moving joints. The right balance has to be found for each person.

Fire and Ice
Depending on patient preference, heat or ice may bring temporary relief from arthritis pain. The ice or heat is typically applied 3-4 times a day for 10-15 minutes. Why one person feels better with heat and another with cold is not clear, but these treatments can bring relief and often some reduction of inflammation. Heat can be applied in many forms including warm baths or showers, electric pads, infrared lamps, and whirlpools. Cold therapy includes ice packs, frozen bags of peas or corn, or a wet towel that has been placed in the freezer.

Diet
Diet may influence certain forms of arthritis. A balanced diet and careful weight control can help people with arthritis manage the pain, inflammation, and loss of movement caused by arthritis.

Support
Systems Braces and neoprene sleeves can help support joints and lessen wear on cartilage. Crutches and canes can also be very helpful, but some patients, concerned about how they look, choose to not use them.

Prevention
Taking the following steps may help prevent or reduce the effects of arthritis:

Know the Warning Signs
If you have any of these signs in or around a joint for more than two weeks, see your doctor:

		Pain
		Stiffness
		Swelling (sometimes)
		Difficulty moving a joint

Seek Early Diagnosis and Treatment
Early diagnosis and treatment are important to help slow or prevent damage to joints that can occur during the first few years after arthritis is diagnosed. The longer the disease persists, the more the joints are damaged; therefore it is vital to receive treatment as soon as a diagnosis is made.

Maintain Appropriate Weight
Maintaining an appropriate weight can reduce the risks for developing osteoarthritis in the knees, and possibly in the hips and hands.

Protect Joints
Joint injuries caused by accidents, injuries, or overuse can increase the risk for osteoarthritis. Keeping the muscles around joints strong may reduce the risk of wear on that joint.

Exercise
Regular physical activity helps build and maintain healthy bones, muscles, and joints.