FAQs on Arthritis

Arthritis is so common that it is reported to affect up to 10% of all adults. This chronic bone and joint disease is the most common cause of disability. There are more than 100 types of arthritis, but osteoarthritis and rheumatoid arthritis are the most common kinds.

How common is arthritis?

Around 1 out of 2 people develop osteoarthritis of the knee by age 85 years. In addition, 1 out of 4 people develop painful hip arthritis by the 8th decade. It is estimated that 42.5 million adults in the U.S. have some type of arthritis. Additionally, 294,000 children under age 18 have some type of arthritis.

What are the most common types of arthritis?

  • Osteoarthritis – The most common type of arthritis affects around 27 million adults in the U.S.
  • Rheumatoid arthritis – An estimated 1.5 million adults have this type of arthritis.
  • Gout – Around 3 million adults have gout.
  • Fibromyalgia – Around 5 million adults suffer with this chronic condition.

What causes arthritis?

Arthritis is the result of loss of cartilage, which is a firm, flexible tissue in the joints. Cartilage protects the joints by absorbing pressure and shock. Normal wear-and-tear occurs with osteoarthritis, which is the most common form of arthritis. In addition, joint injury and infection can exacerbate the cartilage and cause arthritis. Rheumatoid arthritis is an autoimmune disorder, and it occurs when the body’s immune system attacks body structures, such as joint tissues and cartilage.

What are the symptoms of arthritis?

The symptoms of arthritis develop gradually, occurring over a period of several years. Arthritis mostly affects older adults, but it can occur in younger adults and teens. In addition, arthritis is more common among women and people who are obese or overweight. Joint stiffness, pain, and swelling are the most common arthritis symptoms. Many patients report decreased range of motion, joint redness, and loss of strength. The pain is often consistent, severe, and aching. With rheumatoid arthritis, the patient often complains of loss of appetite, fatigue, and severe pain.

How is arthritis diagnosed?

Diagnosing arthritis is done using diagnostic imaging, such as x-rays, magnetic resonance imaging (MRI), and computed tomography (CT) scans. The doctor will also take a medical history and conduct a physical examination. If the joint has accumulated fluid, the doctor may aspirate this for evaluation.

What are my treatment options?

Treatment of arthritis depends on the underlying cause of pain. The goal of treatment is to control pain, alleviate associated symptoms, and improve quality of life. Options include:

  • Medications – These include nonsteroidal anti-inflammatory drugs (NSAIDs), topical agents (capsaicin and menthol), and analgesics. For severe RA, the doctor can prescribe special medications that stop further joint damage.
  • Surgery – To replace an affected joint, the specialist may recommend a joint replacement procedure.
  • Physical therapy – This involves exercises that strengthen the muscles and tissues around the affected joint. The therapist also uses heat, cold packs, ultrasound, and electrical stimulation to control pain.
  • Epidural steroid injection (ESI) – This is used to treat chronic lower back and extremity pain related to arthritis. The doctor injects an anesthetic and corticosteroid into the epidural space. Clinical studies show the success rate of ESI is around 85-90%.
  • Facet joint injection – The facet joints are tiny joints along the posterior aspect of the spine. The FJI involves injecting these joints with a steroidal agent and possibly an anesthetic. According to clinical studies, the success rate is around 77% for this procedure.
  • Neurotomy – For spinal arthritis and sacroiliac joint arthritis, the doctor can use radiofrequency to generate heat, which eliminates a portion of the nerve root. Neurotomy involves inserting small needles into the skin above the spine. A special needle probe is inserted near the nerves, and the electric current is used to destroy the nerves.

Resources

Ackerman WE & Ahmad M (2007). The efficacy of lumbar epidural steroid injections in patients with lumbar disc herniations. Anesthesia Analogs, 104(5):1217–22.

Lutz GE, VAd VB, & Wisneski RJ (1998). Fluoroscopic transforaminal lumbar epidural steroids: an outcome study. Archives of Physical Medicine Rehabilitation, 79,1362-1366.

Manchikanti L, Manchikanti KN, Manchukonda R, Cash KA, Damron KS, Pampati V, McManus CD (2007). Evaluation of lumbar facet joint nerve blocks in the management of chronic low back pain: preliminary report of a randomized, double-blind controlled trial: clinical trial NCT00355914. Pain Physician, 10(3):425-40. 31.

Manchikanti L, Singh V, Falco FJ, et al. (2010). Evaluation of lumbar facet joint nerve blocks in managing chronic low back pain: a randomized, double-blind, controlled trial with a 2-year follow-up. Int J Med Sci, 7(3):124-35. 32.

Weinstein SM & Herring SA (2003) NASS. Lumbar epidural steroid injections. Spine Jounral, 3(3 Suppl):37S-44S.