Arthritis

Diagnosis

During a physical exam, your healthcare professional checks your joints for swelling, a change in skin color and warmth. They also will check to see how well you can move your joints.

Laboratory tests

Testing body fluids can help determine the type of arthritis you may have. Commonly tested fluids include blood, urine and joint fluid. To obtain a sample of joint fluid, a healthcare professional first cleans and numbs the area. Then a needle is used to withdraw fluid from the joint space.

Imaging

Imaging tests can identify joint conditions that may be causing your symptoms. They often are used to rule out other conditions. Examples include:

• X-rays. X-rays use low levels of radiation to capture images of bones. They can show cartilage loss, bone damage and bone spurs. While early arthritis changes may not always be visible, X-rays are useful for monitoring disease progression.
• Computerized tomography, also called CT. CT scanners take X-rays from many different angles and combine the information to create cross-sectional views of internal structures. CTs provide clear images of both bones and surrounding soft tissues.
• Magnetic resonance imaging, also called MRI. MRIs use radio waves and a strong magnetic field to produce highly detailed cross-sectional images of soft tissues such as cartilage, tendons and ligaments.
• Ultrasound. This imaging method uses high-frequency sound waves to visualize soft tissues, cartilage and fluid-filled sacs that cushion the joints, called bursae. Ultrasound also is used to guide needle placement during joint fluid removal or medicine injections.

Treatment

Arthritis treatment focuses on relieving symptoms and improving joint function. You may need to try several different treatments or combinations of treatments before you find what works best for you.

Medicines

The medicines used to treat arthritis vary depending on the type of arthritis. Commonly used arthritis medicines include:

• NSAIDs. Nonsteroidal anti-inflammatory drugs, also called NSAIDs, can relieve pain and reduce inflammation. Examples include ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve). Stronger NSAIDs are available by prescription. NSAIDs you take by mouth can cause stomach irritation and may increase your risk of heart attack or stroke. They can affect liver and kidney function and need to be used with caution. NSAIDs also are available as creams or gels, which can be rubbed on joints.
• Counterirritants. Some creams and ointments contain menthol or capsaicin, the ingredient that makes hot peppers spicy. When applied to the skin over a painful joint, these ingredients may help block pain signals, providing temporary relief.
• Steroids. Corticosteroid medicines, such as prednisone, reduce inflammation and pain. And they may slow joint damage. Corticosteroids may be given as a pill or as an injection into a painful joint. Side effects may include thinning of bones, weight gain and diabetes.
• Disease-modifying antirheumatic drugs, also called DMARDs. These medicines can slow the progression of rheumatoid arthritis and change the course of the condition. This may save the joints and other tissues from permanent damage. In addition to conventional DMARDs, there also are biologic agents and targeted synthetic DMARDs. Side effects vary, but most DMARDs increase your risk of infections.

Therapy

Physical therapy can be helpful for some types of arthritis. Exercises can improve range of motion and strengthen the muscles surrounding joints. Sometimes, splints or braces may be recommended for added support and stability.

Surgery

If medicines and therapy don't help, your healthcare professional may recommend surgery. Common surgeries to treat arthritis include:

• Joint repair. In some people, joint surfaces can be smoothed or aligned again to reduce pain and improve function. These procedures are often done arthroscopically, using small incisions over the joint.
• Joint replacement. This procedure removes the damaged joint and replaces it with an artificial implant. The most commonly replaced joints are hips and knees.
• Joint fusion. Typically used for smaller joints, such as those in the wrist, ankle and fingers, joint fusion removes the ends of two bones and fuses them together. This allows them to heal into a single, rigid unit to relieve pain.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Lifestyle and home remedies

Arthritis symptoms can often be lessened with the following measures:

• Weight loss. Excess weight puts extra stress on weight-bearing joints. Losing weight may improve mobility and limit future joint injury.
• Exercise. Regular physical activity helps keep joints flexible. Swimming and water aerobics are good choices because the buoyancy of the water reduces stress on weight-bearing joints.
• Heat and cold therapy. Heating pads or ice packs may help relieve arthritis pain.
• Assistive devices. Tools such as canes, shoe inserts, walkers and raised toilet seats help protect joints and make daily activities easier.

Alternative medicine

Many people use alternative treatments for arthritis, but strong scientific evidence is lacking for many of these approaches. Talk with your healthcare professional about alternative treatments and how they may benefit you. The most common alternative remedies for arthritis include:

• Acupuncture. This therapy uses fine needles inserted at specific points on the skin to reduce pain, including pain caused by certain types of arthritis.
• Glucosamine. Research results are mixed. Some studies have found that glucosamine works no better than a placebo. But both have been shown to relieve osteoarthritis pain better than taking nothing, particularly in people with moderate to severe knee pain.
• Chondroitin. Chondroitin may provide modest pain relief from osteoarthritis, although study results are mixed.
• Fish oil. Some preliminary studies have found that fish oil supplements may reduce the symptoms of certain types of arthritis. But fish oil can interfere with medicines, so talk with a healthcare professional before taking fish oil.
• Yoga and tai chi. These gentle, stretching-based practices may improve joint flexibility and range of motion.
• Massage. Light stroking and kneading of muscles may increase blood flow and warm affected joints, temporarily relieving pain. Be sure to tell your massage therapist which joints are affected by arthritis.

Preparing for your appointment

While you might first discuss your symptoms with your primary healthcare professional, they may refer you to a rheumatologist for further evaluation. A rheumatologist is a doctor who specializes in the treatment of many forms of arthritis.

What you can do

Before your appointment, make a list that includes:

• Detailed descriptions of your symptoms.
• Information about medical conditions you've had in the past.
• Information about the medical conditions of your parents or siblings.
• All the medicines and dietary supplements you take.
• Questions you want to ask the healthcare professional.

What to expect from your doctor

Your healthcare professional may ask some of the following questions:

• When did your symptoms start?
• Does activity make the pain better or worse?
• Which joints are painful?
• Do you have a family history of joint pain?