Annual medication costs for arthritis treatment can reach $15,000 to $20,000 per patient.
Defined as an inflammation around the joints, arthritis appears in two primary forms: osteoarthritis and rheumatoid. Osteoarthritis is the most common form of this condition, and is caused by a breakdown in cartilage over time; after enough of the tissue is damaged, the protective barrier they create dissolves, resulting in bones rubbing against each other at the joints. Rheumatoid arthritis is the result of the body’s immune system attacking the membrane encasing the joints. Once this becomes inflamed, movement becomes difficult; over time, the inflammation begins to destroy the cartilage as well as the bones in the inflamed joint.
Despite the different forms of damage, the resulting symptoms are the same: those with arthritis experience pain, stiffness and swelling in the joints, making even the simplest daily task difficult. The pain itself often ebbs and flows during the early stages of arthritis, yet becomes more frequent, and movement more difficult, over time.
The initial stage of testing consists of a physical exam, where a doctor visually inspects for swelling, redness, and a higher level of warmth along various joints and gauges a patient’s mobility. From here, a doctor may call for labs to analyze blood, urine and the fluid around the joints, the latter being achieved by withdrawing some fluid with a syringe, often with an ultrasound machine to guide needle placement. Because the different types of arthritis create different markers in this fluid, this procedure is a relatively noninvasive way of narrowing down the type of arthritis a patient has.
Once arthritis is diagnosed, doctors use testing to determine how much damage has already been caused. This often consists of X-rays to pinpoint cartilage loss; CT scans to view the bone and surrounding soft tissue; MRIs to garner a clear picture of soft tissues, and ultrasounds to check the fluid-containing structures in the joints and bones. When non-invasive imaging isn’t enough, doctors often turn to an arthroscopy, which involves inserting a small, flexible tube outfitted with a camera near the joint to view a live feed of the joint as well as capture still images.
As with most treatment plans, doctors tend to stick to conservative choices at first, especially if arthritis is diagnosed during the early stages. A variety of medications can be used to limit swelling and thus further damage to the cartilage and joints, while other medications can help with pain or slow down the immune system’s attack on the joint’s membrane.
But when these measures fail or the damage is already extensive, surgery may be in order. The most common procedures used to treat arthritis are joint replacement and joint fusion. Replacement surgery involves removing damaged joints and replacing them with artificial ones, a treatment most often used for the hips and knees. Damage to smaller joints is often treated with fusion therapy, wherein the surgeon removes the two ends of the two bones making up the joint and locks them together to create one unit. When coupled with physical therapy, patients often experience a dramatic increase in mobility as well as a decrease in discomfort following surgery.