Arthralgia or joint pain is a symptom of an underlying disease rather than a disease in itself that can be treated. The management of arthralgia thus depends on the cause, type and severity of the condition.
Therapy goals
The therapy goals include:-
- Management according to the cause of the arthralgia rather than the symptoms of pain alone.
- More than one therapy alternative may be tried to treat the underlying cause as suitable for the patient.
- Most arthritis causing arthralgia is not curable. Realistic therapy goals help reduce frustration.
- The main therapy goals are to improve joint function and relieve pain in order to improve the quality of life of the patient.
- There should be a follow up and feedback on treatment from the patient. This is considered as valuable in diagnosis and management.
Treatment modalities
Treatment modalities of arthralgia include: –
- Rest
- Pain relief using medications - analgesics or pain relievers are drugs including Acetaminophen (Paracetamol), Ibuprofen, Diclofenac etc. They belong to the class Non steroidal anti-inflammatory drugs or NSAIDs.
Pain relievers may be applied locally over the joint as creams, ointments and sprays or may be taken as pills.
These NSAIDs have a dual action of relieving pain as well as reducing inflammatory changes. However long term use of these agents are not recommended as they may carry the risk of severe side effects including gastric ulcers, kidney damage, heart disease etc.
Another class of pain relievers are opioids that do not have any effect on inflammation but are better pain relievers.
Long term use of these agents is also not recommended as they may lead to a risk of dependence and abuse apart from several other side effects.
- Physical and occupational therapy, monitored exercises and joint mobilization – exercises include stretching and strengthening exercises that increase muscle strength and maintain optimum joint mobility. This reduces and retards the progress of joint stiffness and immobility due to pain.
- Antibiotics are prescribed in case of infected joints leading to arthralgia.
- Corticosteroids are also used in many rheumatic and autoimmune conditions because they reduce swelling and block or slow down the immune system.
- A major group of drugs include Disease-modifying antirheumatic drugs (DMARDs) and Biologic response modifiers. These agents are extensively used in rheumatoid arthritis and other inflammatory arthritis conditions.
- Lifestyle changes like adopting a healthy diet, losing weight and maintaining a normal weight etc.
- Hyaluronic acid substitutes and nutritional supplements like Calcium and Vitamin D supplements are used to prevent bone loss and Allopurinol is an enzyme inhibitor that is used in gout.
- Alternative exercise therapies include water therapy and heat and cold fomentation therapy.
- Use of medical devices such as splints, braces, crutches, wheelchairs etc. for improved mobility.
- Surgical therapy for restoration of function, relieve pain and to introduce prosthetic joint replacements for better mobility.
Further Reading