Arthritis

Arthritis

Arthritis (rheumatoid arthritis) is a chronic inflammatory disease that causes stiff, swollen and painful joints. There are no drugs that can cure the disease, but they can reduce the pain and delay the development of the disease.

What is arthritis?

Arthritis, also called rheumatoid arthritis, is an autoimmune disease. In an autoimmune disease, the body's immune system reacts to an unknown substance and initiates a chronic inflammatory reaction inside the joints. This results in stiff, swollen and painful joints. Without treatment, the joints are destroyed, and quality of life and life expectancy are reduced.

Causes of arthritis

The reason why some people get arthritis is unknown, but some risk factors are known:

• Heredity - It is possible that there is an infection (with a virus or bacteria) that triggers the disease in those people who have a hereditary risk

• Gender - 3 times as many women as men are affected

• Old age - Arthritis can affect all age groups, including children (juvenile idiopathic arthritis), but the most common age of onset is 45-60 years

• Smoking

Symptoms of arthritis

The most common symptoms of arthritis are that the joints become stiff, swollen and painful. The stiffness is usually worst in the morning, and often decreases somewhat when you are moving. Joints in the fingers, wrists, toes and knees are most frequently affected. Usually the inflammation occurs in the same joints on the right and left side of the body, but the pain can still be felt worse on one side. Many people also suffer from general fatigue.

Symptoms such as weight loss, fever and weakness (flu feeling) may be prominent at the start of the course of the disease. As the disease progresses, joint cartilage and bones will break down. This can lead to damage to the bone tissue/skeleton. Early diagnosis and treatment is therefore important.

Good advice for arthritis

• Exercise and physical activity can soften stiff joints and limit the pain

• A warm bath can relieve pain

• Relieve swollen and inflamed joints by changing habits and working positions. There are also various technical aids that can make everyday life easier

• Physiotherapy is useful for strengthening the muscles around the joints that have been attacked

• A healthy and varied diet is recommended. Dietary supplements with calcium and omega-3 fatty acids can be helpful

• Some people may react to certain foods. Known reaction foods for rheumatism are pork, smoked meat and fish, tomatoes, strawberries, oranges, red peppers, chocolate and also red wine. It can be difficult to figure this out on your own, but a nutritionist can then help

Symptom-relieving treatment

The symptom-relieving treatment consists of pain-relieving and anti-inflammatory drugs. Mainly different types of NSAIDs (non-steroidal anti-inflammatory drugs) are used. NSAIDs have a rapid effect on swelling, pain and stiffness. The medicines can also make physical activity possible, which is important both for the course of the disease and for increasing the quality of life. As an additional medicine for pain, preparations with paracetamol are sometimes also used.

Glucocorticoids have an anti-inflammatory and pain-relieving effect, and are used as an alternative to NSAIDs. Glucocorticoids can be taken as tablets or as an injection directly into the inflamed joint. In low doses, the medicines can be used over a long period of time.

Treatment

Medical treatment must be started by a doctor who is a specialist in arthritis, and all the medicines used must be prescribed. The purpose of the treatment is to reduce pain, reduce inflammation and prevent destruction of bones and joints. Early start of treatment gives a better prognosis of the disease. There are two main forms of treatment; symptom-relieving and disease-modifying treatment. Symptom-relieving treatment should reduce symptoms such as pain and stiffness. Disease-modifying treatment should prevent or slow down the development of the disease.

Disease-modifying treatment

Disease-modifying drugs, also called DMARDs (Disease Modifying AntiRheumatic Drugs), should only be started by specialists in rheumatic diseases. There are many different medicines within this group, including methotrexate, sulfasalazine and TNF-alpha inhibitors (also known as biological medicines).

Disease-modifying drugs slow down joint degradation, but also have an effect on symptoms and functional ability. It takes time to get the full effect (3-6 months), and the effect tends to wear off over time. In some people, treatment with DMARDs has little or no effect. The medicines are often used in combination with the symptom-relieving medicines, and many people use several different DMARDs at the same time.

When should you contact a doctor for arthritis?

In case of stiffness or pain in joints that lasts over time or if for other reasons you suspect that you may have arthritis

If you have arthritis and use medication that you experience no effect from or get side effects from

Sources: Norwegian drug handbook for healthcare personnel, Norwegian electronic medical handbook, Norwegian Rheumatism Association and Norwegian health informatics for healthcare personnel.