In osteoarthritis (OA), a degenerative disease that affects the whole joint, the protective cartilage and fluid break down over time, making joint movement difficult and painful. Eventually, bones of the joint may rub directly against one another, causing severe pain.
Rheumatoid arthritis can be one of the most painful types of arthritis; it affects joints as well as other surrounding tissues, including organs. This inflammatory, autoimmune disease attacks healthy cells by mistake, causing painful swelling in the joints, like hands, wrists and knees.
Pain from arthritis can be constant or it may come and go. It may occur when at rest or while moving. Pain may be in one part of the body or in many different parts. Some types of arthritis cause the skin over the affected joint to become red and swollen, feeling warm to the touch.
Rheumatoid Arthritis (RA) is a chronic, autoimmune disorder and is the most debilitating form of inflammatory arthritis. In RA, the body's immune system attacks its own healthy cells and tissues, specifically the synovial (joint lining) membrane, causing pain, swelling, stiffness, and limited joint mobility.
RA is symmetrical, where a patient feels symptoms in the same spot on both sides of the body, often in the joints in the feet and hands. Osteoarthritis, in contrast, begins in an isolated joint, often in the knee, fingers, hands, spine and hips. While both sides may hurt, one side is more painful.
Conventional radiographs – Routine X-ray examinations
Regardless of the joint that is affected, osteoarthritis is revealed on conventional radiographs (X-rays) by characteristics that are distinct from other joint disorders, such as rheumatoid arthritis.
Laboratory tests
The analysis of different types of body fluids can help pinpoint the type of arthritis you may have. Fluids commonly analyzed include blood, urine and joint fluid. To obtain a sample of joint fluid, doctors cleanse and numb the area before inserting a needle in the joint space to withdraw some fluid.
X-ray. Your doctor may order an X-ray—which uses electromagnetic radiation to produce images of the body—to assess the severity of joint destruction. Although this test is not useful in the early stages of rheumatoid arthritis, it can be used to monitor the progression of the disease.
If the pain continues getting worse or the symptoms don't respond to your efforts to relieve them with ice, heat or a nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen, that's a red flag that your disease may be worsening and you and your doctor may need to adjust your treatment plan and medication, she says.
NSAIDs are the most effective oral medicines for OA. They include ibuprofen (Motrin, Advil) naproxen (Aleve) and diclofenac (Voltaren, others). All work by blocking enzymes that cause pain and swelling. The problem is that some of those enzymes also help blood to clot and protect the lining of your stomach.
Delaying joint care can lead to injury and other problems
In some cases, ignoring joint pain for too long may increase pain or mobility problems, or even result in a fall or injury. “The more proactive you are in preserving your joints, the longer we anticipate they will last,” says Dr.
Acute pain in multiple joints is most often due to inflammation, gout, or the beginning or flare up of a chronic joint disorder. Chronic pain in multiple joints is usually due to osteoarthritis or an inflammatory disorder (such as rheumatoid arthritis) or, in children, juvenile idiopathic arthritis.
The pain may vary from an odd ache to a constant gnawing pain. The pain is usually not felt first thing in the morning, but it will come on with any type of activity during the day. The pain can be severe and may affect your ability to walk. Limping is not an uncommon feature of osteoarthritic pain.
OA is more common than RA. Both involve inflammation in the joints, but RA causes much more inflammation. Until recently, experts believed that inflammation was not a feature of OA, and researchers are still investigating the role that it plays in the illness — whether it is a cause or a result of the condition.
No blood test can definitively prove or rule out a diagnosis of rheumatoid arthritis, but several tests can show indications of the condition. Some of the main blood tests used include: erythrocyte sedimentation rate (ESR) – which can help assess levels of inflammation in the body.
Physical exam: The doctor will check your joints for swelling, tenderness, and range of motion. RA tends to strike several joints. Antibody blood tests: Doctors look for certain proteins that show up in your blood when you have RA. These proteins mistakenly target healthy cells and kick off the inflammation process.
Magnetic resonance imaging (MRI) and ultrasound may help diagnose rheumatoid arthritis in the early stages of the disease. In addition, these imaging tests can help evaluate the amount of damage in the joints and the severity of the disease.
Research shows diclofenac is the strongest and most effective non-steroidal anti-inflammatory medicine available.10 Diclofenec is sold under the prescription brand names Cambia, Cataflam, Zipsor, and Zorvolex. It is also available as a topical gel, Voltaren, which is available over the counter.
Consuming high-purine foods like shellfish or beer, becoming dehydrated, experiencing sudden changes in kidney function, or local trauma to a joint (like stubbing your big toe) can also trigger flares. Taking urate-lowering medicines should lessen the likelihood of having a flare due to these triggers.
If your pain medication isn't working, call your health care provider. Remember: Don't change the dosage without talking to your health care provider. Don't abruptly stop taking your medication.
Here are some diseases that mimic RA. Post-Viral Arthritis – Viral infections can cause a temporary condition – polyarthritis. The condition looks like rheumatoid arthritis. Parvovirus B19, hepatitis, and HIV can cause this condition.
Rheumatoid arthritis can be difficult to diagnose in its early stages because the early signs and symptoms mimic those of many other diseases. There is no one blood test or physical finding to confirm the diagnosis. During the physical exam, your doctor will check your joints for swelling, redness and warmth.
Methotrexate is usually the first medicine given for rheumatoid arthritis, often with another DMARD and a short course of steroids (corticosteroids) to relieve any pain. These may be combined with biological treatments. Common side effects of methotrexate include: feeling sick.