Arthritis explained

Arthritis is a general term that refers to many musculoskeletal conditions that affect the muscles, bones and joints.

Some common conditions that fall under the banner of arthritis are osteoarthritis, back pain, rheumatoid arthritis, fibromyalgia, osteoporosis, gout, polymyalgia rheumatica, lupus and ankylosing spondylitis.

Anyone can get arthritis, including children and young people. It can affect people from all backgrounds, ages and lifestyles.

Your musculoskeletal system

To understand how arthritis and other musculoskeletal conditions work, it’s helpful to know a little about the muscles, bones and joints that make up your musculoskeletal system.

Joints are places where bones meet. Bones, muscles, ligaments and tendons all work together so that you can bend, twist, stretch and move about.

The ends of your bones are covered in a thin layer of smooth tissue called cartilage. It acts like a slippery cushion that helps your joint move smoothly.

Around most of your joints is a joint capsule. This keeps your bones in place. Inside the capsule is a thick fluid which nourishes and lubricates your joint (like oil for a squeaky hinge).

Ligaments hold the joint together by joining one bone to another. Your muscles are attached to the bones by tendons. As your muscles contract, they pull on the bones to make the joint move.

Arthritis and other musculoskeletal conditions affect the functioning of the joints, muscles, bones and surrounding structures. The way this happens will depend on the condition you have.

Symptoms of arthritis

Arthritis affects people in different ways and each condition will have specific symptoms. However, common symptoms are:

• pain
• swelling, redness and warmth in a joint
• muscular aches and pain
• stiffness or reduced movement of a joint
• general symptoms such as fatigue and feeling unwell.

Sometimes, these symptoms are called 'rheumatism'. Rheumatism isn’t a disorder in itself, but the word is occasionally used to describe any sort of joint or muscle pain.

Diagnosing arthritis

If you think you have a type of arthritis and you’ve been experiencing joint or muscle pain, it’s important that you discuss your symptoms with your doctor.

Getting a diagnosis as soon as possible means that treatment can start quickly. Early treatment will give you the best possible outcomes.

Having a correct diagnosis will mean you get the most appropriate care, as treatment, especially medication, can differ a lot depending on the type of arthritis you have.

Because there are so many types of arthritis, your doctor may do a number of exams and tests to diagnose which one you have, including:

• medical history – this will include finding out about your symptoms, your family history, other health problems you've experienced in the past
• physical examination – your doctor will look for redness and swelling in and around the joint, and will check out the range of movement of your joints. Depending on the type of arthritis your doctor thinks you may have, they may also look for rashes, check your eyes and throat, and measure your temperature
• scans and other tests – again, depending on the type of arthritis your doctor thinks you have, you may have blood tests to check for levels of inflammation in your blood or specific genetic markers. You may also have scans such as x-rays, ultrasound, CT (computed tomography) or MRI (magnetic resonance imaging) to get a clearer picture of what’s happening inside your joints
• referral to a specialist – if appropriate your doctor will refer you to a specialist, often a rheumatologist, for diagnosis and specialised management of your condition.

Managing your arthritis

Living with arthritis can be different from person to person, and symptoms can vary from day to day. Treatment and management options vary with the type of arthritis, its severity and the parts of the body affected.

There is no cure for arthritis. Management options can include medical treatment and medication, physiotherapy, exercise and self-management techniques.

Your arthritis healthcare team

A range of health professionals are able to help you manage your arthritis, including:

• general practitioner (GP) – your GP is central to your care and will help you manage day-to-day, as well as helping you access other health professionals and services
• rheumatologist – a doctor who specialises in diagnosing and treating musculoskeletal conditions
• physiotherapist – will use physical means, including exercise, to help keep your body moving and functioning as well as possible
• dietitian – will provide information and advice on food and nutrition
• occupational therapist – can help you learn better ways to do everyday activities such as bathing, dressing, cooking, working, eating or driving
• exercise physiologist – will help to improve your health and fitness through exercise programs tailored to your specific situation
• podiatrist – will assess, diagnose and treat any foot and lower limb problems you may have
• pharmacist – can help you with information and advice about medications – both prescription and over-the-counter
• psychologist – can help you to work through your feelings, particularly if you are feeling anxious or depressed.

Medications for arthritis

Different types of arthritis are treated by different medications. Some arthritis medications aim to reduce pain and inflammation. Others work on the disease process itself and aim to slow down or stop damage to the joints.

The medications your doctor prescribes will depend on your type of arthritis and the severity of your symptoms.

Let your doctor know about any other medications or treatments you’re taking – even if you’ve purchased them from a supermarket, health store or complementary therapist (such as a naturopath or homeopath).

The most common types of medications used to treat arthritis include:

• pain-relieving medications (analgesics, such as paracetamol) – can provide temporary pain relief
• creams and ointments – can be rubbed into the skin over a painful joint to provide temporary pain relief
• non-steroidal anti-inflammatory medications (NSAIDs) – to control inflammation and provide pain relief
• corticosteroids – to quickly control or reduce inflammation
• disease-modifying anti-rheumatic medications (DMARDs) – control your overactive immune system
• biologics and biosimilar medicines (bDMARDs) – are biological disease-modifying drugs that work to control your immune system, but in a much more targeted way.

Self-management of arthritis

There are many things you can do to manage your arthritis including:

• Learn about your condition – what type of arthritis or musculoskeletal condition do you have? What are the treatment options? What can you expect in the future? Knowing as much as possible about your condition means that you can make informed decisions about your healthcare and play an active role in the management of your condition.
• Stay active – physical activity is the key to maintaining muscle strength, joint flexibility and managing your pain. A physiotherapist or exercise physiologist can help design an individual program for you. This can be arranged by your doctor on a GP Management Plan as part of managing chronic illness.
• Learn ways to manage pain – there are many things you can do to manage pain and different strategies will work for different situations. For example, heat packs can help ease muscle pain, cold packs can help with inflammation, and gentle exercise can help relieve muscle tension. Try different techniques until you find the things that work best for you.
• Watch your diet – while there is no diet that can cure arthritis, a healthy and well-balanced diet is the best for general good health. Keeping to a healthy weight is also important as any extra weight puts added strain on your joints, in particular load-bearing joints such as your hips, knee and ankles.
• Protect your joints – find out about aids, equipment and gadgets that can make tasks easier. An occupational therapist can give you advice on aids, equipment and home modifications. Independent Living Centres can also be a very useful contact for information and advice.
• Work with your healthcare team – the best way to live well with arthritis is by working closely with all the practitioners who make up your healthcare team.
• Stay at work or at school – they’re both good for your health and wellbeing. Talk to your doctor or allied healthcare professional about ways to help you get back to or to stay at work or school.
• Join a peer support group – dealing with a chronic condition can be isolating. Being able to speak with others who understand your condition can be a great relief. Peer support groups exist for people with all different forms of arthritis. Contact Musculoskeletal Health Australia for details of your nearest group.

Where to get help

• Your GP (doctor)
• Rheumatologist
• Exercise physiologist
• Physiotherapist
• Dietitian
• Medicines Line Tel. 1300 633 424 or 1300 MEDICINE
• Independent Living Centres Australia Tel. 1300 885 886
• Musculoskeletal Health Australia B.A.M Helpline Tel. 1800 263 265 or email helpline@muscha.org.