Ask a Doctor
I started getting pain in my knee after my daily run. I thought I might have tweaked a tendon or something, but my doctor told me I have the early stages of arthritis in the knee. I’m not even 40 yet, so if I start taking arthritis medications now, I could potentially be taking them for 40 more years! I don’t want to alter my routine too much or take a bunch of pills. What if I just don’t do anything right now? What will happen if arthritis is left untreated?
Arthritis is a chronic condition that causes pain and inflammation of the joints. In general, the earlier treatment begins, the better the prognosis.
Untreated arthritis may affect your ability to perform daily activities or care for yourself. It may make it difficult to walk. If some types of arthritis are left untreated, joint deformity and permanent damage to the joints may occur. Untreated rheumatoid arthritis (RA) can lead to complications such as cardiovascular disease, lung problems, and eye inflammation.
Treatment may not be necessary for arthritis with minimal or no symptoms. When symptoms are troubling and persist, however, home remedies might include pain and antiinflammatory medications as below. Furthermore, heat/cold applications and topical pain creams can be helpful.
- As a first step, rest, heat/cold applications, and topical pain creams can be helpful. For osteoarthritis, the over-the-counter food supplements glucosamine and chondroitin have been helpful for some, though their benefits are still controversial according to national research studies. These supplements are available in pharmacies and health-food stores without a prescription. If patients do not benefit after a three-month trial, I tell them that they may discontinue these supplements. The manufacturers sometimes make claims that these supplements "rebuild" cartilage. This claim has not been adequately verified by scientific studies to date.
- For another type of dietary supplementation, it should be noted that fish oils have been shown to have some anti-inflammation properties. Moreover, increasing the dietary fish intake and/or fish oil capsules (omega-3 capsules) can sometimes reduce the inflammation of arthritis. Obesity has long been known to be a risk factor for osteoarthritis of the knee. Weight reduction is recommended for patients who are overweight and have early signs of osteoarthritis of the hands, because they are at a risk for also developing osteoarthritis of their knees. Of note, even modest weight reduction can be helpful.
- Pain medications that are available over the counter, such as acetaminophen (Tylenol), can be very helpful in relieving the pain symptoms of mild osteoarthritis and are often recommended as the first medication treatment. Since acetaminophen has fewer gastrointestinal side effects than nonsteroidal anti-inflammatory drugs (NSAIDS), especially in elderly patients, acetaminophen is generally the preferred initial drug given to patients with osteoarthritis.
- Some patients get significant relief of pain symptoms by dipping their hands in hot wax (paraffin) dips in the morning. Hot wax can often be obtained at local pharmacies or medical supply stores. It can be prepared in a special warming device for use at home and be reused after it hardens as a warm covering over the hands by peeling it off and replacing it into the melted wax. Warm water soaks and wearing nighttime cotton gloves (to keep the hands warm during sleep) can also help ease hand symptoms. Gentle range of motion exercises performed regularly can help to preserve function of the joints. These exercises are easiest to perform after early morning hand warming.
- Pain-relieving creams that are applied to the skin over the joints can provide relief of daytime minor arthritis pain. Examples include capsaicin (ArthriCare, Zostrix, Capsagel), diclofenac cream (Voltaren gel), salicin (Aspercreme), methyl salicylate (Bengay, Icy Hot), and menthol (Flexall). For additional relief of mild symptoms, local ice application can sometimes be helpful, especially toward the end of the day. Occupational therapists can assess daily activities and determine which additional techniques may help patients at work or home.
- There are a few forms of arthritis, such as gout, that can be impacted by dietary changes.
- Finally, when arthritis symptoms persist, it is best to seek the advice of a doctor who can properly guide the optimal management for each individual patient.
If joint pain, swelling, stiffness, redness, loss of motion or deformity occurs, medical evaluation by a health care professional is warranted.
Even minor joint symptoms that persist unexplained for over one week should be evaluated.
For many forms of arthritis, it is essential that patients have an early evaluation as it is clear that this can both prevent damage and disability as well as make optimal treatment easier.