Arthritis medication: The Optum Perks Guide

Table of Contents:

1. What is arthritis?
2. What are common types of arthritis and related conditions?
3. How common is arthritis?
4. What are the symptoms of arthritis?
5. What medications are used to treat arthritis?
6. Will I need surgery for arthritis?

Arthritis brings pain to millions of Americans. In fact, 24% of all adults in the U.S. (58.5 million people) have arthritis. Thankfully, many medications and treatments are available.

The best way to start is to find a rheumatologist. That’s a doctor who specializes in the diagnosis and treatment of diseases that affect the muscles, bones, joints, ligaments and tendons. They can help you choose the medication that’s right for your situation.

(Be sure to download our free Optum Perks mobile app to find the best price on your medications at a pharmacy near you.)

What is arthritis?

“Arthritis is a medical disease that impacts our joints,” says Brett Smith, DO. He’s a rheumatologist at Tennessee Direct Rheumatology and East Tennessee Children’s Hospital in Knoxville. 

“Typically, a joint is smooth and glides in a couple of directions,” he explains. “When arthritis occurs, there can be inflammation surrounding or inside the joint. This could lead to temporary symptoms or permanent damage.”

What are common types of arthritis and related conditions?

These common types of arthritis and related conditions have their own causes and symptoms.

Osteoarthritis

“When most people use the term ‘arthritis,’ they’re referring to osteoarthritis. It’s the most common form of arthritis,” says Jason Liebowitz, MD. He’s a rheumatologist with Skylands Medical Group in Rockaway, New Jersey. 

With osteoarthritis, cartilage begins to break down within joints. Cartilage is the strong, flexible connective tissue that protects joints and bones. When it breaks down, it leads to pain, stiffness and swelling. (Check out Sweet relief: 5 ways to treat stiff and achy joints for helpful tips.)

Osteoarthritis affects more than 32.5 million Americans, according to the Centers for Disease Control and Prevention (CDC).

Rheumatoid arthritis

Rheumatoid arthritis, which is less common than osteoarthritis, impact the hands, feet, wrists, elbows, knees and ankles.

Recommended reading: What to eat (and avoid) when you have rheumatoid arthritis.

Psoriatic arthritis

This form of arthritis impacts some people with psoriasis, a skin condition that causes itchy red patches topped with silver scales. Psoriatic arthritis also causes painful, swollen joints that can feel warm to the touch.

Psoriatic arthritis affects about 1.5 million people in the U.S.

Gout

Gout is also known as metabolic or gouty arthritis. It’s caused by a buildup of uric acid crystals in the joints. It typically affects the big toe but can happen in any joint.

Uric acid is a byproduct of purines. These substances occur naturally in the body, but they’re also found in red meat, organ meats, some seafood and alcohol. The body normally eliminates the crystals. But with gout, uric acid builds up in joints, fluids and tissues.

Lupus

Lupus is an autoimmune disease that can lead to arthritis and joint pain. The disease makes your immune system attack healthy tissue. This can cause pain and inflammation throughout the body. It’s often treated with the same medications used for arthritis.

How common is arthritis?

According to the CDC, about 1 in 4 adults over 18 have been diagnosed with a form of arthritis.

“Different types of arthritis can be more common than others,” says Dr. Smith. “For example, rheumatoid arthritis impacts about 1% to 2% of the population. Juvenile arthritis impacts around 0.4% of children. And osteoarthritis impacts over 32 million adults.”

What are the symptoms of arthritis?

It depends on the type of arthritis. But overall, joint pain is the hallmark of arthritis. Dr. Smith notes that this often includes stiffness, swelling and reduced range of motion. It could happen in a single joint, a few joints or in many joints.  

Recommended reading: Arthritis treatment for fingers.

What medications are used to treat arthritis?

There are many medications for treating arthritis. They’re often prescribed based on the patient’s type of arthritis. These include:

Prescription non-steroidal anti-inflammatory drugs (NSAIDs) (celecoxib, meloxicam, diclofenac)

“These are the mainstay of pain management for patients with osteoarthritis,” says Dr. Liebowitz.

NSAIDs work by limiting the release of chemicals in the body called prostaglandins. These promote inflammation and the resulting pain. NSAIDs limit these chemicals by blocking 2 enzymes: COX-1 and COX-2. They play a critical role in making prostaglandins. When fewer prostaglandins are produced, patients have less pain and swelling.

But they treat only the symptoms of arthritis, not the cause. “NSAIDs do not reduce progression of arthritis. They are only for lessening symptoms and pain management,” says Dr. Smith.

Steroids (prednisone, hydrocortisone)

Steroids are another type of anti-inflammatory medication. “Steroids reduce inflammation generally but are not very specific,” explains Dr. Smith. “Imagine an archery target. Steroids are like throwing a bucket of paint at the target. They hit everything, even the undesired areas.”  

Steroids are typically a short-term treatment option. “For conditions like rheumatoid arthritis or lupus, short courses of steroids may sometimes be indicated.”

That’s because they come with side effects. These can include weight gain, high blood sugar, cataracts and bone loss/fracture risk, says Dr. Smith. 

Biologics (infliximab), conventional synthetic DMARDs (methotrexate), targeted DMARDs (such as tofacitinib)

Biologics are a specific kind of immune system suppressant. They decrease inflammation caused by autoimmune disease.  

“These medications hit the bull’s-eye on the archery target,” says Dr. Smith. “They block very specific parts of the immune system. But they don’t shut the entire system down.”

Some come in the form of pills or self-injectables. Others are administered through an intravenous injection.

Dr. Liebowitz explains that methotrexate is the first-line treatment for rheumatoid arthritis. Biologic disease-modifying antirheumatic drugs (DMARDs) may be used if patients don’t respond to methotrexate. These medications include infliximab and tofacitinib.  

“The FDA has approved different biologics for different forms of inflammatory arthritis. Deciding which treatment to use depends on the disease process,” says Dr. Liebowitz. “You must also consider comorbidities and medications that were tried in the past.”

Hyaluronic acid injections (Euflexxa®, Hyalgan®, Orthovisc®)

These are for patients with knee osteoarthritis. But they can also be used for hip osteoarthritis. They are typically given once or twice a year.   

 “These ‘gel shots’ are useful for reducing pain and improving stiffness for at least 6 months in many patients,” adds Dr. Smith.

 Opioids (codeine, hydrocodone, tramadol)

“Opioids are not typically directly useful for arthritis. They are only considered for short-term pain control after surgery or injury,” says Dr. Smith. “They can be used in select patients with uncontrolled pain for whom other therapies have failed.”

“In general, medical doctors have tried to steer clear of opioids in recent years,” says Dr. Liebowitz. “Tramadol may be a choice for patients with osteoarthritis who cannot take NSAIDs.”

Dr. Smith adds that “opioids tend to be prescribed by pain specialists, rather than rheumatologists.”

Will I need surgery for arthritis?

Not everyone requires surgery for arthritis, but in some cases, it might be needed.

“Osteoarthritis patients may get a knee or hip replacement,” says Dr. Liebowitz. “Rheumatoid arthritis and other forms of autoimmune arthritis are typically treated with medications.”  

Surgery is often considered a last resort when other treatments have failed. “It’s for patients with arthritis who have already tried medications, physical therapy and injections,” says Dr. Smith.

If you have arthritis pain, don’t suffer in silence. Speak with your doctor or seek out a rheumatologist. He or she can help find medications that can lessen your pain.

Remember: Use your free prescription discount card any time you go to the pharmacy. You don’t want to miss out on potential savings.

Additional sources:
Arthritis stats: Centers for Disease Control and Prevention
Osteoarthritis: Centers for Disease Control and Prevention
Arthritis by the numbers: Arthritis Foundation
Rheumatoid arthritis: Cleveland Clinic
Psoriatic arthritis: Johns Hopkins Arthritis Center
Lupus: Arthritis Foundation