TREATMENT OF ARTHRITIS
Accurate diagnosis and proper treatment usually follow naturally from the history, physical
exam, and laboratory tests and from consideration of the pathophysiologic mechanisms. Infectious arthritis usually responds dramatically to appropriate antibiotics. The noninfectious
inflammatory diseases are treated with drugs that suppress
inflammation. Many of these drugs, for example, aspirin, indomethacin, and ibuprofen, appear to work by inhibiting synthesis of prostaglandins, body chemicals that mediate inflammation. Although certain adrenal cortical steroids are powerful inhibitors of inflammation, toxic side effects limit their usefulness. Similarly, drugs that inhibit undesirable inflammation may also inhibit desired inflammatory responses, increasing the frequency of secondary infections. More specific therapy depends on knowledge of the precise biochemical mechanisms of disease pathogens.
Despite the wear-and-tear origin of osteoarthritis, it may respond well to anti-inflammatory drugs, which may act as analgesics (pain-killers) or decrease the secondary inflammation that follows joint trauma. Methotrexate has proved to be an effective agent in long-term management of rheumatoid arthritis. In addition to drug therapy, emotional support, physical therapy, and occasionally surgery are mainstays of treatment of patients with arthritis.