Inflammatory arthritis

Inflammatory arthritis happens when your body mistakenly uses its immune system to attack the area between your joints. This can damage your joints, and cause joint pain and loss of joint function. Rheumatoid and psoriatic arthritis are forms of inflammatory arthritis.

Symptoms of inflammatory arthritis

The symptoms of inflammatory arthritis are:

  • joint pain, tenderness and swelling
  • stiffness when getting up in the morning or after periods of inactivity
  • other symptoms not related to the joints, such as tiredness, skin changes, and weight loss.

However, these symptoms can also occur in other forms of arthritis and other diseases.

Causes of inflammatory arthritis

Rheumatoid arthritis can start at any age although it most commonly starts in middle age. It affects more women than men.

The cause of rheumatoid arthritis is not known.

Diagnosing inflammatory arthritis

Inflammatory arthritis can be difficult to diagnose as other conditions can have the same symptoms.

Your healthcare provider may ask you about your symptoms and how long you have had them. They will also examine your affected joints.

They may want to rule out other conditions such as septic arthritis and gout.

If your healthcare provider suspects you have inflammatory arthritis, or is concerned about your symptoms, they may suggest you have some blood tests. You may also have joint x-rays to see if your joints are being damaged by your arthritis. Sometimes you will also have an MRI scan to look at the joints in more detail.

You will be usually be referred to a rheumatology specialist to confirm the diagnosis.

Treating inflammatory arthritis

Inflammatory arthritis treatment aims to both treat the symptoms and prevent the disease from getting worse. The sooner you start medication for inflammatory arthritis the better.

Medications for inflammatory arthritis

These medicines change the underlying condition rather than just treating the symptoms. They slow down the disease and its effects on your joints.

DMARDs should be started as early as possible after inflammatory arthritis has been diagnosed. They can only be started by a rheumatologist. You will need to have regular blood and urine tests to:

  • look for possible side effects
  • assess how well the medicine is working.

There are 2 main groups of DMARDs — conventional DMARDs and biological therapies.

Conventional DMARDs

Conventional DMARDs include:

Most people are started on methotrexate because it is often the most effective and is well studied.

It may take 2 to 6 months of treatment before the medication is fully effective.

Biological therapies

Biological therapies, also called biologics, include tumour necrosis factor (TNF) inhibitors:

They can be used if other treatments have not worked well, and are usually used in combination with other DMARDs.

Biologics (TNF Inhibitors) — HealthInfo.

NSAIDs such as ibuprofen, diclofenac and naproxen reduce inflammation and swelling of your joints. They start working quickly and relieve pain and swelling but do not reduce damage to your joints.

Taking NSAIDs is safe, but extra care is needed if you have high blood pressure, high cholesterol, diabetes, stomach ulcers, kidney problems or if you smoke.

Pain relief medicines such as paracetamol and codeine are often used with other medication.

Corticosteroids are used at the start of treatment to reduce the pain and swelling of your joints, while waiting for other medication to take effect. They may also be used to treat sudden flare-ups.

You may take these as tablets, such as prednisone, or as injections directly into the joint or a muscle or vein.

Self care with inflammatory arthritis

Although there is no cure for inflammatory arthritis, there are many things you can do to reduce pain and stiffness and to help prevent joint damage and disability.

  • Have regular check ups with your healthcare provider. They can advise you on treatment options and other things you can do to help reduce pain, swelling and inflammation. They will monitor you after you start on preventative maintenance treatment, and you will need to have regular blood tests.
  • Try some non-drug treatments, such as physiotherapy, hydrotherapy and occupational therapy. Ask your healthcare provider or rheumatologist about these options, and how you can access them.
  • Stop smoking as this can increase your risk of inflammatory arthritis.
  • Eating well and aiming for a healthy weight can improve your overall health and wellbeing.
  • Keep physically active to help keep your joints flexible and your muscles strong. Your healthcare provider will be able to give you general advice about physical activity. Tai chi, walking, swimming and gentle exercise classes are all excellent for arthritis. They can refer you to a physiotherapist for more detailed advice on specific exercises.
  • Contact Arthritis New Zealand (external link)
    They offer a range of services to people who are affected with all types of arthritis, and several programmes that cover aspects of managing this group of conditions. You can also discuss individual self-management with a trained arthritis educator.

Clinical review

This content was written by HealthInfo clinical advisers. It has been adapted for Health Information and Services.

Clinical advisers — HealthInfo (external link)