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 arthritis and psoriatic arthritis are forms of inflammatory arthritis.

On this page

Causes of inflammatory arthritis

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

The cause of inflammatory arthritis is not known.

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.

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.

Septic arthritis

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 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.

Each person responds differently to arthritis medicines so it is important to work with your healthcare provider to find the treatment that works best for you.

Medications for inflammatory arthritis

Open all

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 (a doctor who specialises in arthritis and related conditions). 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)

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.

Important NSAID safety information

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

Pain relief medicines for adults

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.

Open all

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 regular DMARD treatment, and you will need to have regular blood tests.

Doing this can improve how well some medications work for you. It also helps reduce pressure on your joints, particularly in your legs.

Discuss with your pharmacist whether any supplements might be helpful, such as omega-3 fish oil, curcumin or probiotics.

Stop smoking, as smoking can increase your risk of inflammatory arthritis.

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. Your healthcare provider can refer you to a physiotherapist for more detailed advice on specific exercises.

Find a physiotherapist — Healthpointexternal link

Find a physio — Physiotherapy New Zealandexternal link

Wear shoes with thick, soft soles that act as shock absorbers for your legs and back. Avoid wearing high heels as these put extra strain on your joints.

Splints and therapy gloves may be useful to support your joints. There may also be equipment that can help you do everyday tasks. Your healthcare provider can refer you to an occupational therapist for advice on these.

Find an occupational therapist — Healthpointexternal link

Find a therapist — Occupational Therapy New Zealandexternal link

Arthritis NZ offers a range of services to people affected with all types of arthritis.

They run programmes that cover many aspects of living with this group of conditions.

You can also talk to them about individual self-management with a trained arthritis educator.

Arthritis NZexternal link