Do you wake up with stiffness and joint pain? Have you been wondering whether you’re injured, you’re developing arthritis or if you just need a good stretch? Even if you do have arthritis, diet and exercise may go a long way toward mitigating your symptoms. MedShadow explains.
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What Is Arthritis?
There are more than 100 types of arthritis, according to the Center for Disease Control and Prevention (CDC), but one thing they all have in common is that any arthritis damages the cartilage in your joints. In some cases, only a single joint will be affected, whereas for others, the damage will impact or can spread to several joints in a single area or throughout the body. This damage causes pain, swelling, and may limit your range of motion.
Can Arthritis Be Reversed or Cured?
Unfortunately, it’s highly unlikely for arthritis to be cured or reversed. In some cases, particularly of juvenile arthritis, you may go into remission and no longer experience symptoms. However, for most people with arthritis the goals of treatment are to slow the progression of joint damage, reduce pain and maintain mobility and daily function.
How Can I Tell If My Joint Pain is Arthritis, Tendonitis, or Bursitis?
Tendonitis and bursitis are injuries that cause pain in or near joints. They’re common in athletes and are often caused by overtraining. These injuries, if caught early enough, tend to heal within weeks or a few short months, while arthritis is a chronic condition that requires ongoing maintenance or treatment. While certain activities can worsen arthritis, it is not directly caused by overtraining.
Tendonitis pain is caused by tiny ruptures in your tendons which connect your muscles to your bones. Bursitis is inflammation of sacs that surround joints and tendons. Both bursitis and tendonitis tend to affect one large joint at a time, whereas many types of arthritis will impact several of your joints at once.
Because the conditions cause such similar symptoms, your healthcare provider may need to conduct X-rays to determine the cause of your pain.
Is Arthritis Hereditary?
Your genes play a minor role in the likelihood that you’ll develop arthritis. If you have a family member with rheumatoid arthritis, you are slightly more likely to develop the disease, for example. However, other risk factors such as age, smoking, infections, injuries and other environmental exposures that are not yet well-understood, seem to play a larger role.
Common Types of Arthritis and Their Treatments
Osteoarthritis
Osteoarthritis is the most common type of arthritis, and the one we’re most likely to think of when we hear the term “arthritis.” Adults over the age of 50 are mostly likely to experience osteoarthritis, which is caused by the breakdown of cartilage in your joints.
The symptoms of osteoarthritis come on gradually, causing increasing pain, stiffness, and swelling in your knee, hip, or hands.
Your healthcare provider may recommend these osteoarthritis treatments:
- Over-the-counter NSAIDs (non-steroidal anti-inflammatory drugs) for pain
- Increasing low impact exercise to help you maintain range of motion
- Weight loss, if you carry extra weight, to reduce the pressure on your joints.
- Prescription-strength NSAIDS
- Cymbalta (duloxetine), an antidepressant that may help chronic pain
For others, surgery is an option if your pain interferes with your independence and quality of life.
Rheumatoid Arthritis
In rheumatoid arthritis, inflammation damages the cartilage between your joints, causing it to deteriorate over time. It’s an autoimmune disease in which your immune system goes haywire and attacks your own healthy joints, particularly those in your hands, wrists, and knees. In some cases, it can damage tissues throughout your body even if they aren’t joints, such as your lungs and eyes.
Other conditions, such as lupus, may increase your risk of rheumatoid arthritis. Symptoms of rheumatoid arthritis often flare up on occasion and die down at other times based on triggers in your environment.
Your healthcare provider may recommend these rheumatoid treatments:
- Increasing low impact exercise or mobility exercises to help you maintain range of motion
- Over-the-counter NSAIDs (non-steroidal antiinflammatory drugs) for pain
- Prescription-strength NSAIDS
- Corticosteroid injections
- Disease Modifying Drugs (DMARD) such as Methotrexate (Rheumatrex, Trexall) to slow further inflammation
- Janus Kinase (JAK) inhibitors, another type of DMARD, such as Xeljanz (tofacitinib)
Juvenile Arthritis
Juvenile idiopathic arthritis is any type of arthritis that affects children 16 and younger. Many of the children outgrow the illness with age, while others go on to develop adult types of arthritis, such as psoriatic arthritis or rheumatoid arthritis.
Though it can present in several ways, juvenile arthritis is typically caused by an overactive immune system and is treated with many of the same techniques as rheumatoid arthritis. If only a single joint is affected, periodic local corticosteroid injections may be sufficient to treat the symptoms.
Your healthcare provider may recommend these rheumatoid treatments:
- Increasing low impact exercise or mobility exercises to help you maintain range of motion
- Over-the-counter NSAIDs (non-steroidal anti-inflammatory drugs) for pain
- Prescription-strength NSAIDS
- Corticosteroid injections
- Disease Modifying Drugs (DMARD) such as methotrexate (Rheumatrex, Trexall) to slow further inflammation
Psoriatic Arthritis
Psoriatic arthritis is another type of arthritis that’s affiliated with the skin disease, psoriasis. Like rheumatoid arthritis, psoriasis is caused by an overactive immune system. It attacks the skin and causes scaly, itchy, and painful rashes on the body.
In some psoriasis patients, the immune system also starts to attack the joints beneath the skin, causing pain and swelling.
Anti-inflammatory diets may also be helpful. Psoriasis is often associated with other illnesses such as cardiovascular disease, diabetes, or depression that also benefit from specific diets such as low-sodium, low-cholesterol or the Mediterranean diet.
Your healthcare may prescribe the following drugs for psoriatic arthritis:
- Increasing low impact exercise or mobility exercises to help you maintain range of motion
- Over-the-counter NSAIDs (non-steroidal anti-inflammatory drugs) for pain
- Prescription-strength NSAIDS
- Corticosteroid injections
- Disease Modifying Drugs (DMARD) such as methotrexate (Rheumatrex, Trexall) to slow further inflammation
- Biologic DMARDs such as Humira (adalimumab)
- Additional DMARDs, Janus Kinase (JAK) inhibitors such as Xeljanz (tofacitinib)
- Otezla (apremilast) which controls inflammation by blocking an enzyme inside cells
Gout
Gout is a form of inflammatory arthritis caused by uric acid crystals building up in your joints. It most commonly affects the feet, starting with your big toe, and is often associated with diabetes, though scientists aren’t positive why the two are connected.
Your body produces uric acid as it breaks down the foods you eat. Diet can be especially helpful in managing gout, since certain foods, such as seafood, red meats, alcohol, and high-fructose corn syrup are known to produce higher quantities of uric acid. In addition to over-the-counter pain relievers such as Advil (ibuprofen), your healthcare provider might prescribe drugs to reduce the levels of uric acid in your blood.
Your healthcare provider may also prescribe:
- Over-the-counter NSAIDs (non-steroidal anti-inflammatory drugs) for pain
- Corticosteroid injections
- Drugs that lower your uric acid levels such as colchicine, probenecid, allopurinol, febuxostat and pegloticase
Side Effects of Common Arthritis Medications
NSAIDs – For All Types of Arthritis
You may take NSAIDs as needed to treat acute arthritis pain. NSAIDs are common painkillers such as ibuprofen, naproxen and aspirin. These drugs are known for their potential to cause gastrointestinal issues by irritating the lining of your stomach. In rarer cases, they could cause swelling, blood urine, liver damage, light sensitivity, high blood pressure and more. The longer you take the drugs and the higher the dose, the greater your risk.
Make sure you don’t take more than the recommended dose, and stick with the smallest dose you can for the least amount of time. A 2018 study, conducted by the manufacturer of Tylenol, a competitor of NSAIDs, suggested that up to 15% of people take more than the recommended dose of NSAIDs.
While rare, it is possible to overdose on NSAIDs. Symptoms of an NSAID overdose include blurry vision, headaches, sweating, seizures, low blood pressure, dizziness, diarrhea and vomiting and loss of consciousness. If you are experiencing these symptoms, call 9-11 immediately.
Corticosteroids – For Rheumatoid, Juvenile, Psoriatic Arthritis and Gout
The most common side effects of oral corticosteroids are:
- Weight gain
- Reflux
- Swelling
- Mood changes.
Over time, these drugs can cause weakening of your bones, high blood sugar, slowed wound healing, an increased risk of infections and hormone imbalances.
Experts say that if your arthritis only affects one or two joints, injections into those specific joints are less likely to cause side effects that impact the rest of your body than drugs you have to take orally.
Corticosteroid injection side effects include:
- Joint infections
- Temporary rise in blood sugar
- Weakened tendons
- Damaged cartilage or bone
- Lightened skin around the injection
“When I completed my course of prednisone without any other side effects, I thought I was in the clear. I was wrong,” writes Shawna De La Rosa, explaining that she started experiencing panic attacks severe enough that she thought she was having a heart attack.
Read Shawna De Le Rosa’s first-hand account of the psychological effects of corticosteroids.
DMARDs For Rheumatoid, Juvenile and Psoriatic Arthritis
Disease-modifying antirheumatic drugs (DMARDs) are drugs designed to slow or stop the inflammatory process before it damages joints or other tissue in people with arthritis. These are often taken regularly to prevent flare ups, as opposed to in response to acute symptoms. The most common side effects of these arthritis drugs are nausea and vomiting and an increased risk of serious infections. Over time, these drugs can irritate your liver. Your physician will likely monitor your liver enzymes using blood tests. If these enzymes appear to be elevated, your healthcare provider may suggest stopping or changing your medications so your liver can heal.
Methotrexate is one of the most commonly prescribed DMARDs for arthritis. When Angela started taking methotrexate, her arthritis symptoms remained debilitating, but she also started getting side effects of methotrexate like nausea. Blood tests showed her liver function had declined. Her doctor took her off the medicine, but claimed it was only temporary, while her liver healed. Instead of starting to take the drug again, Angela found that her diet could help.
Read Angela’s story about how she used her diet to keep her rheumatoid arthritis symptoms at bay.
Some common DMARDs include:
- Methotrexate
- Hydroxychloroquine
- Leflunomide
- Sulfasalazine
JAK Inhibitors are also DMARDs. Some of the most common JAK inhibitors are:
- Tofacitinib (Xeljanz)
- Baricitinib (Olumiant)
- Upadacitinib (Rinvoq)
In addition to the side effects of other DMARDs, some JAK inhibitors may raise your risk of developing blood clots. Tofacitinib currently carries a black box warning from the FDA regarding blood clots and an increased risk for certain cancers. A trial published in 2022 clarified the risk of developing cancer. For every 55 people aged 50 or over who took the drug for five years, one additional person might develop cancer. Lymphoma, lung cancer and skin cancers were the most likely.
Apremilast, which is used specifically for psoriatic arthritis is a DMARD.
The most common side effects of apremilast are nausea, diarrhea, respiratory infections and headaches. The drug label also mentions that depression and unintentional weight loss can be side effects of apremilast.
Some DMARDs are biologic drugs. See MedShadow’s explanation of biologic drugs, “What Are Biologics.”
Uric Acid Lowering Drugs For Gout
Your healthcare provider may recommend treating symptoms of gout only when it flares up, using NSAIDs or corticosteroids, But if your flares are more frequent, they may recommend using drugs regularly to lower the level of uric acid in your blood.
The most common side effects of uric acid lowering drugs are similar to those of other drugs used to treat arthritis. They include nausea, stomach pain and liver dysfunction. They may also cause kidney stones and rashes, and occasionally raise your risk of cardiovascular events. Watch patients discuss their experiences on these drugs.
Your healthcare provider may monitor your uric acid levels and liver function with blood tests and while you take uric acid lowering drugs.
Do Creams Help Arthritis Symptoms?
Topical arthritis creams may help relieve some joint pain associated with arthritis, according to a 2017 review of 15 clinical studies on people with osteoarthritis. When participants used topical NSAID creams on their osteoarthritic joints for 6-12 weeks, some reported a 50% reduction in pain. Be sure to thoroughly clean your hands after you apply any medicated creams to make sure you don’t unintentionally get the drugs in your eyes or mouth.
Questions to Ask Your Doctor About Arthritis Drugs
- How does this drug work?
- How will we evaluate whether or not this arthritis treatment is working?
- Are there other options I might try first that could cause fewer side effects?
- What are the most common side effects?
- What are the most dangerous side effects, and what are the signs I should be monitoring?
- Are there any risks that are specific to me, for example because of my gender or other factors?
- What might interact with this medicine? Be sure to ask about other prescription drugs, over the counter drugs, supplements, and even foods.
- What types of diet and exercise might help?
Lifestyle Interventions that May Ease Arthritis
The good news is drugs are not your only option for treating arthritis. Diet, exercise and other lifestyle changes may limit your pain alone or in combination with other treatments.
Exercise for Arthritis
Experts say that exercise is one of the most important aspects of any arthritis treatment plan. It’s important that you listen to your body, and don’t push it too hard, especially on days when you’re in pain.
Low-impact exercises such as walking, cycling and swimming can help, as can physical therapy or exercises such as yoga that can help you retain your flexibility and joint mobility.
Diet for Arthritis
Many types of arthritis are caused by an overactive immune system. An anti-inflammatory diet may help reduce the inflammation in your body and reduce future joint damage.
Some arthritis patients find that avoiding nightshade plants in their diets helps their symptoms, though studies haven’t backed it up. A study in 2020 in the United Kingdom found that these foods did not tend to make a major difference in arthritis symptoms.
If you have gout, your healthcare provider may recommend that you limit specific foods likely to raise your uric acid levels such as:
- Red meat
- Alcohol
- Sweets
- Seafood
- Asparagus or spinach
Meditation and Quality Sleep
Rest and relaxation are crucial to helping you manage the pain associated with arthritis. Check out these breathing exercises and meditations to help you rest.
What Makes Arthritis Worse
Arthritis is a chronic condition, but each day can be different. Each individual may have different triggers that can worsen their arthritis. What works best for you may not be the same as what helps someone else with arthritis. Below are some of the most common arthritis triggers. Using a symptom tracker can help you determine whether avoiding alcohol or other dietary, environmental or lifestyle triggers could help you manage your arthritis.
Does Alcohol Cause Arthritis Flares?
Alcohol affects everyone differently. For some people, it increases inflammation, which can worsen your arthritis.
Both alcohol and some arthritis drugs, like methotrexate can damage your liver, so if you do choose to drink, it’s important to do so in moderation and keep in mind that your liver may be more vulnerable due to the treatments you’re using.
A Change in Weather
Many people cite changes in temperature or atmospheric pressure as worsening their arthritis symptoms. Scientists haven’t pinpointed the cause, though some say it could have to do with the expansion and contraction of tendons, muscles and bones. Others say that certain types of weather make us less active (for example, if it’s cold and rainy, you’re more likely to be inside on the couch than if it’s 73 degrees and sunny) which could lead to more pain.
Sudden Increases in Exercise
A frequently-cited rule for runners is not to increase your mileage by more than 10% each week. Increasing your distance slowly can help you avoid overuse injuries. The same is true for osteoarthritis. While exercise can help you maintain and increase your joint mobility, doing too much too soon can cause stiffness and swelling.
Allergies and Inflammatory Foods
Allergies, which cause inflammation can lead to arthritis flare ups, especially of rheumatoid or juvenile arthritis. You may also be sensitive to certain inflammatory foods. You can track which foods seem to trigger your flare ups, or consider following an anti-inflammatory diet. Start with MedShadow’s anti-inflammatory diet guide.
