It's not uncommon to hear people say "I have arthritis." Generally speaking, they are correct, but more accurately, they have a specific type of arthritis.
There are over 100 types of arthritis. Most of the 100 types are rare diseases. You can count on two hands the types you have probably heard of at all, and on two fingers the ones most referred to and considered most common: (osteoarthritis and rheumatoid arthritis).
Symptoms That Suggest Arthritis
People who are experiencing early, vague symptoms related to joint pain, joint stiffness, joint swelling, or limited range of motion may suspect arthritis. But arthritis symptoms, especially early arthritis symptoms, can overlap with other conditions.
It is important to have a doctor assess your symptoms and accurately diagnose your condition. Before x-rays are taken or blood tests are ordered, you may not know if you are dealing with an acute joint injury or a chronic disease. To determine the cause of your symptoms, your doctor must take your medical history, perform a physical examination, and order diagnostic tests. While the pattern of symptoms will give clues, symptoms alone do not formulate a diagnosis.
The Importance of Diagnosing the Right Condition
When it comes to initial symptoms, people tend to self-treat before consulting a doctor. Perhaps no harm comes from taking a stab at self-treatment, but there's likely no significant benefit either. Typically, people try common over-the-counter treatments, hoping something will make a difference. Many people who choose to self-treat find that symptoms persist. They realize they are treading water, if not getting worse, without doctor's input. Others continue to self-treat or just live with their symptoms, risking the consequences that come from delaying appropriate treatment.
The Centers for Disease Control and Prevention estimate that while more than 10 million Americans have chronic joint symptoms, most have not been evaluated or treated by a doctor. Of the 2.2 million people believed to have rheumatoid arthritis in the U.S., more than 700,000 have not been diagnosed or treated. Of the 1.5 million who have been diagnosed with rheumatoid arthritis, more than 800,000 are under the care of a primary care physician, not a rheumatologist (a specialist in arthritis and rheumatic diseases).
Few joints may be involved at the initial consultation with a doctor. There may not be much revealed when results come back from blood tests or x-rays. But your doctor will order more extensive tests until a diagnosis can be made.
Early, Disease-Modifying Treatment Brings Best Results
Some types of arthritis are inflammatory, while others are non-inflammatory. Rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis are examples of inflammatory arthritis. Osteoarthritis is a type of arthritis that has been classified as non-inflammatory (although newer research has suggested there may be an inflammatory process involved with osteoarthritis).
A class of drugs known as disease-modifying anti-rheumatic drugs (DMARDs) are effective for many patients with inflammatory types of arthritis. When DMARDs are indicated, early treatment is essential. A meta-analysis of 14 clinical trials involving more than 1,400 patients established that early DMARD use was important, and that held true regardless of the type of DMARD prescribed. Patients who received DMARD therapy early had a better outcome than those who delayed treatment -- and the best chance for preventing joint damage.
Researchers are working on the development of disease-modifying osteoarthritis drugs (DMOADs), too. At this point, there are no osteoarthritis drugs that can slow progression of the disease. Drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs) and pain medications mostly impact symptoms, not disease progression. When only one or few joints are involved, injections of (cortisone or hyalgan may be used to bring inflammation under control.
The Bottom Line
It's important to know your type of arthritis so that you can receive the proper treatment. Early, aggressive treatment is essential for bringing arthritis under control and slowing progression of the disease. Your doctor will guide you to the best treatment option with the goal of controlling symptoms and preventing permanent joint damage. Whether you start with NSAIDs (nonsteroidal anti-inflammatory drugs), corticosteroids, DMARDs, biologics, or a combination -- early treatment is the way to go.
Rheumatoid Arthritis: Early Diagnosis and Treatment. Pages 77-83. John J. Cush MD, Michael E. Weinblatt MD, Arthur Kavanaugh, MD. Third Edition. Professional Communications Inc. Copyright 2010.
Primer on the Rheumatic Diseases. Chapter 2 - Evaluation of the Patient. John J. Klippel. Arthritis Foundation. Thirteenth Edition.