Living with Rheumatoid Arthritis
Rheumatoid arthritis is an autoimmune disease of the joints. The disease involves inflation of joint lining tissues which produce lubricant and nutrients in the joints. Osteoarthritis is caused by injury to the joint, either through trauma or wear and tear as we age. Both cause joint pain and lead to a breakdown of the cartilage.
In the early years of rheumatoid and osteoarthritis, the first response is generally the use of anti-inflammatory and pain relief drugs. However, as these diseases, progress and people experience a loss of function and more intensive pain medical practitioners have developed other interventions in the hope of assisting their patients.
Injections
Viscosupplementation
Synovial fluid, which contains hyaluronic acid, forms naturally in the knee and helps to reduce friction through its shock absorbing and lubricating properties (elastoviscosity). This fluid can decrease as cartilage wears in osteoarthritis.
Viscosupplementation involves the injection of hyaluronic solutions into the knee to replace lost synovial fluid in the hope improving the elastoviscosity of the synovial fluid.
Stem Cell Therapy
Stem cell therapy for osteoarthritis is part of a new medical approach, known as regenerative medicine. Like other procedures, it offers the hope of reduced pain and the ability to be more like you were.
For people suffering from the symptoms of osteoarthritis, stem cell therapy seeks to use the body’s own stems cells to repair damaged tissue. Importantly, this intervention is not a cure but may help to reduce the need for other responses such as surgery. The data while showing significant promise involving stem cell therapy are inconclusive in defining or measuring the clinical efficacy of stem cell treatment for osteoarthritis.
[Find out how stem cell therapy can help you]
Exercise and manipulation
Exercise
Arthritis Queensland fact sheet on exercise reports that Exercise also maintains bone health in adulthood, helps to prevent or slow bone loss after menopause and helps to improve balance and co-ordination in the elderly to reduce the risk of falls. Exercise can also help speed rehabilitation following a fracture.
Find out more from Arthritis Australia.
Manipulation
Remedial massage therapy involving manipulation of soft tissue is used to reduce pain and soothe sore joints and muscles. While understanding of why massage may be of benefit is limited, the growing body of evidence has found improvements in pain, stiffness, range of motion and walking following massage.
Osteopathy is a system of complementary medicine involving the treatment of medical disorders through the manipulation and massage of the skeleton and musculature. Osteopathy recognises the important link between the structures of your body and the way it works. Osteopaths focus on how your skeleton, joints, muscles, nerves and circulation work together to improve your health and well-being.
Find out more from Osteopathy Australia.
Chiropractics are described as the system of complementary medicine based on the diagnosis and manipulative treatment of misalignments of the joints. It is concerned with the diagnosis, management, and prevention of mechanical disorders of the musculoskeletal system, and the effects of these disorders on the function of the nervous system and general health.
Find out more from the Chiropractics’ Association of Australia.
Physiotherapy
Physiotherapists assess, diagnose, treat, and prevent a wide range of health conditions and movement disorders. Physiotherapy is used to repair damage, reduce stiffness and pain, increase mobility, and improve the quality of life for people with musculoskeletal conditions such as neck and back pain. Techniques include addressing underlying problems, preventing strain and injury, and prescribing exercises and other interventions to promote mobility.
Find out more from the Australian Physiotherapists Association.
You can find out more about research into managing pain and disability associated with musculoskeletal conditions from the National Health and Medical Research Council.
Medication for osteoarthritis
There are a range of osteoporosis medicines available in Australia, which are grouped into three main categories based on their active ingredients:
- Denosmab used to slow the rate at which bone is broken down
- Strontium ranelate used to improve bone formulation and reduce bone loss; and
- Bisphosphonates – used to increase bone density.
Other medication responses for menopausal women can include hormone replacement terparatide to stimulate bone forming cells,
You should refer to your doctor for advice concerning the use of these medications and dietary supplements.
Find out more from Arthritis Australia.
Diet and Dietary supplements
Glucosamine and Chondroitin
Chondroitin sulfate and glucosamine have become popular as dietary supplements used to treat the pain and loss of function associated with osteoarthritis. However, most studies assessing their effectiveness show modest to no improvement compared with placebo, in either pain relief or joint damage.
Vitamin D and Calcium also play an important role in maintaining bone health.
Some research suggests that fish oil containing omega 3 may relieve tender joints and early research suggests that other plant based foods may be helpful in reducing symptoms
Find out more from Arthritis Australia and the National centre for Complementary and Integrative Health.
Surgery – arthroscopic
Arthroscopic lavage
Arthroscopic involves the washing out or cleaning out the contents (blood, fluid, or loose debris) inside a joint space with aim of reversing the damage of early arthritis. This procedure does not improve pain or function for people suffering with osteoarthritis of the knee.
Partial meniscectomy
Arthroscopic partial meniscectomy is the most common orthopedic procedure used to relieve symptoms attributed to a meniscal tear (cartilage that provides a cushion between your thighbone ‘femur’ and shinbone tibia’) The aim is to remove torn meniscal fragments and trimming the cartilage back to a stable rim. Most treated meniscal tears are associated with degenerative knee disease such as osteoarthritis.
This treatment has been used for many years with doctors and patients reporting varying levels of improvement in pain and function. However, a 2013 study involving 145 middle aged or older patients with knee pain caused by non-traumatic degenerative disease such as osteoarthritis, involving sham surgery control groups. This study recorded marked improvement in the first 12 months in patients who received a partial menisectomy, but only a small inconsequential benefit 12 months after surgery.
