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Muscle and joint pains

Treating joint pain

There are many different kinds of arthritis. Osteoarthritis, rheumatoid arthritis and gout are the most common.

 

Symptoms include inflammation, pain, stiffness and swelling. Rheumatologist Dr Andrew Bamji explains the treatment.

Osteoarthritis

Osteoarthritis is the most common form of arthritis and usually occurs in older people. It's sometimes thought to be caused by wear and tear, but that's not entirely true: both joint damage from an injury and the repair that occurs afterwards are factors.

For example, if cartilage has been removed from the knee, osteoarthritis almost always occurs in the knee afterwards. Osteoarthritis usually occurs at the end joints of the fingers, the base of the thumb, the knees, big toes and feet. The injury that causes the arthritis could have occurred at any time.

arthritis

Treatment

Osteoarthritis is usually treated using painkillers, anti-inflammatory medicine and exercise (depending on the joints involved). If it occurs in the hips or knees, surgery may be required, so you may not be able to exercise. It’s important to restart exercise as soon as you can to get the muscles strong again.

Usually, though, osteoarthritis sufferers must keep mobile. A physiotherapist may be able to help with joint movement.

Rheumatoid arthritis

Rheumatoid arthritis (a type of inflammatory arthritis) is an inflammation in the joints that's caused by damage to the immune system.

The white blood cells start to produce antibodies and cause inflammation in the joints, which become painful, stiff and swollen. Rheumatoid arthritis produces a soft swelling that feels boggy to the touch, as opposed to osteoarthritis, which causes joints to feel hard and knobbly.

Rheumatoid arthritis can affect any joint but usually occurs in the knuckle joint or the next joint up in the middle of the fist. Sufferers feel an aching pain in their joints and sometimes develop flu-like symptoms.

It's unclear what causes it. There may be a genetic element, but it's not hereditary. It usually affects those aged 25 to 55 but can develop in anyone, including children.

It’s important to see your GP if you have symptoms. You'll be referred to a specialist if your GP thinks you have inflammatory arthritis.

Treatment

Blood tests can diagnose full-blown rheumatoid arthritis. If you test positive you're more likely to develop joint damage and, therefore, it's more likely the condition will be treated with strong medication.

Inflammatory arthritis, including rheumatoid arthritis, can be treated using painkillers, but your specialist will also need to stop the disease process using disease-modifying drugs.

 If these fail you may be given a course of biologic drugs. This is a new class of drug which mimics the effects of substances that are naturally made by your body's immune system. Steroids may also be helpful but will not be given in the long-term due to side effects.

Treatment for inflammatory arthritis is likely to involve multi-disciplinary teams, including a physiotherapist and occupational therapist, both of whom play an important part in helping you to keep your joints moving.

Gout  

Gout occurs when uric acid crystals form in the joints. There are complex reasons why this happens, but what you eat can have an important effect.

It can be very painful and often occurs in episodes (periodically), disappearing after four or five days. People suffering from gout will get recurrent attacks.

Treatment

Acute attacks of gout can be treated with anti-inflammatory medicine. If you're having lots of recurrent attacks, your specialist may give you drugs such as allopurinol, which lower uric acid levels and could abolish attacks altogether. They could, however, have side effects.

If you have gout, it’s important to modify your lifestyle. Eat less red meat and cut out beer and products containing yeast, such as Marmite. In addition, don’t drink soft drinks that contain fructose as this increases uric acid levels.

Reproduced under the terms of Click-Use Licence number C2009000382. The content of this page has been published under a Click-Use Licence (link this to http://www.opsi.gov.uk/click-use/index) which covers the use of core Crown copyright information. The original material can be found on NHS Choices.