Arthritis Treatment in Hyderabad, India

PACE Hospitals stands out as the best hospital for arthritis in Hyderabad, India,  offering specialized care for individuals affected by rheumatoid arthritis, psoriatic arthritis, and other inflammatory and degenerative joint conditions. Our multidisciplinary team of rheumatologists and orthopedic specialists ensures early diagnosis and individualized treatment strategies using advanced imaging and lab diagnostics.

We manage all forms of arthritis through a combination of medical therapy, lifestyle guidance, physiotherapy, and surgical interventions when necessary. Whether it's controlling chronic inflammation in rheumatoid arthritis, managing joint pain and skin symptoms in psoriatic arthritis, or treating osteoarthritis-related joint degeneration, our goal is to restore mobility, reduce pain, and improve long-term joint health. With a patient-centric approach and state-of-the-art infrastructure, PACE Hospitals continues to be a trusted destination for arthritis treatment in Hyderabad, India.

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Arthritis Treatment

Why Choose PACE Hospitals for Arthritis Treatment?

Diagnosis of Arthritis is difficult because there are different types of arthritis which has similar symptoms among the various conditions that affect the joints.. Medical history and physical examinations play a crucial role in evaluating arthritis, determining the type of arthritis, and differentiating symptoms from non-articular (non-joint) etiologies. 

Orthopedic doctors consider the following before selecting the appropriate arthritis diagnostic tests:

• Medical history 
• Physical examination 

Medical history

In the diagnosis of arthritis, obtaining a through medical history is vital. The orthopedician begins by asking the following questions regarding symptoms, including:

• Onset of pain and how long it has lasted.
• Whether it follows a specific pattern, such as worsening in the morning or after periods of inactivity.
• Nature of pain (sharp, dull, or constant)
• Distribution 
• Number of joints involved 
• Fever 
• Fatigue 
• Weight loss 
• Family history
• Previous joint injuries 

Physical examination

During the physical examination, orthopaedic specialists need to inspect affected joints for swelling, redness, and deformity, which may indicate fluid accumulation or synovial thickening within the joint. Additionally, they need to look for redness and warmth, which are common signs of active inflammation or infection. Orthopedician will palpate the joints to determine tenderness and warmth, which can help differentiate between types of arthritis and assess the severity of inflammation and also assess the range of motion, both active and passive, to determine functional impairments, decreased range of motion (ROM), and obvious joint deformity can also be observed in arthritis.

Diagnostic Evaluation of Arthritis

Based on the above information, an orthopedician advises the diagnostic tests to detect arthritis. The following are the tests that might be recommended to diagnose arthritis: 

• Blood tests 
• Complete blood count (CBC)
• Serum creatinine
• Hematocrit
• Antinuclear antibody (ANA) test
• Uric acid 
• Rheumatoid factor (RF) 
• CCP (cyclic citrullinated peptide) antibody test
• C-reactive protein (CRP)test 
• Erythrocyte sedimentation rate 
• Imaging tests 
• Bone X-ray (radiography)
• Musculoskeletal MRI (magnetic imaging resonance scan)
• Direct arthrography 
• Ultrasound 
• Computed tomography (CT) scan
• Other Diagnostic Procedures 
• Joint aspiration (arthrocentesis) 
• Urine test 
• Muscle and skin biopsies 
• Synovial fluid analysis 
• HLA tissue typing
  

Blood tests

• Complete blood count: It measures the quantity of white blood cells (WBC), red blood cells (RBC), and platelets in a blood sample. Certain types of arthritis and the medications used to treat them are associated with low platelet counts (thrombocytopenia), low red blood cell counts (anaemia), or low white blood cell counts (leukopenia).
  
• Serum creatinine: A blood test to monitor for underlying kidney disease. A slight elevation in mean serum creatinine (SCr) levels was observed in studies of patients with rheumatoid arthritis treated with Janus kinase (JAK) inhibitors. These serum creatinine (SCr) changes were investigated, and potential mechanisms were explored.
  
• Hematocrit: PCV (packed cell volume) is the hematocrit. It measures the proportion of red blood cells in a blood sample. Anaemia, or low red blood cell counts, is common in patients with certain forms of arthritis.
  
• Antinuclear antibody (ANA) test: This test measures blood levels of various antibodies that may be present in individuals with certain types of arthritis.
• Uric acid: It is elevated in gout. Long-term accumulation of excessive urate levels in the body can lead to gout, characterized by the formation of needle-shaped crystals within and around the joints. This causes the joint to become inflamed and develop arthritis.
• Rheumatoid factor (RF): This is a blood test used to help diagnose rheumatoid arthritis (RA). RF is a protein made by the immune system that can attack healthy tissue. Over half of the people with RA have high RF levels at the onset of their disease. However, RF (Rheumatoid factor) can also be elevated in other conditions, so it is used in combination with other tests and clinical findings.
• CCP (cyclic citrullinated peptide) antibody test: CCP antibodies, also called anti-CCP antibodies. Healthy joint tissues are the target of CCP antibodies. Joints, including the elbows, wrists, and knees, are the points on the body where two bones meet. Rheumatoid arthritis may be indicated if CCP antibodies are detected in the blood. Most patients with rheumatoid arthritis have CCP antibodies. However, people without the condition rarely have these antibodies.
• C-reactive protein (CRP): It is a substance produced by the liver in response to inflammation. CRP levels in the blood increase when there is acute or chronic inflammation in the body. In medical conditions such as rheumatoid arthritis, psoriatic arthritis, and other inflammatory forms of arthritis, CRP levels are often elevated. They can serve as a valuable marker to assess disease activity, monitor treatment response, and aid in diagnosing inflammatory joint conditions.
• Erythrocyte sedimentation rate: This test measures how rapidly red blood cells sink to the test tube's bottom. Additionally, it is higher when the body is inflamed. In certain forms of arthritis, this occurs.

Imaging tests 

• Bone x-ray (radiography): X-rays are commonly used in the diagnosis and monitoring of arthritis. This imaging technique can reveal structural changes within the joints that are characteristic of certain types of arthritis. These changes may include joint space narrowing, bone erosion, and the formation of bone spurs (also known as osteophytes). Over time, X-rays can help track the progression of joint damage, allowing healthcare providers to assess how the disease is advancing and how well treatments are working.
• Musculoskeletal MRI (magnetic resonance imaging): It is a highly advanced imaging technique that provides detailed, multiplanar images of the body's internal structures. It is especially valuable in assessing joint health because it can visualize a wide range of joint components, including the synovium (the lining of the joint), tendons, ligaments, bones, and cartilage. This makes MRI particularly useful for detecting both early and advanced changes associated with various joint disorders, such as arthritis. 
• Direct Arthrography: Arthrography is an imaging test used to examine joints like the shoulder, knee, or hip when standard X-rays don't provide enough detail. A contrast dye (or air, if the dye isn't suitable) is injected directly into the joint using a thin needle. Then, X-rays are taken in various positions to get clearer images of the joint structures. It helps detect problems like cartilage damage or ligament tears and uses only a small amount of radiation.
• Ultrasound: Ultrasound uses high-frequency sound waves (not radiation) to provide real-time images of joints and surrounding soft tissues. It effectively visualises the synovium, tendons, ligaments, and bone surfaces. This technique can detect inflammation, fluid buildup, and tissue damage. 
• Computed tomography (CT) scan: It is the gold standard for evaluating bone changes in arthritis. Computed tomography (CT) can also provide comprehensive information about the severity and extent of the condition. This is especially true in areas like the sacroiliac joint, temporomandibular joint, and sternum or manubrium that are difficult to assess with radiography.
  

Other Diagnostic Procedures

• Joint aspiration (arthrocentesis): A tiny needle is inserted into a joint area to remove synovial fluid for diagnostic testing. The fluid is then examined for anomalies such as cell count, crystal presence, infection symptoms, and other indicators. Gouts, different types of arthritis, and joint infections are among the illnesses that are frequently used to assist in diagnosis. It can also occasionally reduce joint pain and swelling.
  
• Urine test: Laboratory tests are performed on a urine sample to evaluate kidney function and identify any possible issues. Among other types of arthritis, this test is crucial for identifying kidney involvement that could be associated with lupus, vasculitis, or rheumatoid arthritis. Urine is tested for abnormal substances, such as protein, blood, and white blood cells, that could indicate infection, inflammation, or impaired kidney function.
  
• Muscle and skin biopsies: It is a diagnostic procedure used to identify muscle diseases by examining a small sample of muscle tissue under a microscope. The tissue is typically collected using a needle; however, if a larger sample is necessary, an open biopsy may be performed, which involves making a small incision in the skin to remove a larger section of muscle. The specific muscle selected for the biopsy depends on the location of symptoms, such as pain or weakness, with common sites including the biceps (upper arm muscle), deltoid (shoulder muscle), or quadriceps (thigh muscle).
• Synovial fluid analysis: This test examines joint fluid to help diagnose joint disorders. It includes checking the fluid's color and thickness, chemical tests for glucose, protein, and uric acid levels, and microscopic examination for crystals, bacteria, and other substances.
• HLA tissue typing: The process of HLA tissue typing is used to find genetic markers linked to ankylosing spondylitis and other types of arthritis. To better understand a person's susceptibility to inflammatory arthritis, this test looks for human leukocyte antigens (HLAs) linked to an elevated risk of the condition.

Arthritis Differential Diagnosis

The differential diagnosis involves distinguishing arthritis from other articular and non-articular disorders, and differentiating between the various types of arthritis, which include:

• Fibromyalgia: Fibromyalgia is a chronic (long-lasting) condition that results in fatigue, difficulty sleeping, and pain and tenderness throughout the body. 
• Myofascial pain syndrome: It is a musculoskeletal condition characterized by regional pain within the muscle, fascia, or surrounding soft tissue. This condition often presents with localized or referred pain, typically associated with hyperirritable trigger points within taut bands of skeletal muscle.
• Neuropathy: A nerve condition that results in various body areas experiencing pain, tingling, swelling, numbness, or muscle weakness. Usually, it starts with the hands or feet and gets worse with time.
• Tendinitis: The swelling (inflammation) of a tendon following an injury is known as tendinitis. It can impair a tendon's range of motion, resulting in joint pain and stiffness.
• Complex regional pain syndrome: Long-lasting pain and inflammation following an injury or medical event, such as surgery, trauma, stroke, or heart attack, can be referred to as complex regional pain syndrome. Complex regional pain syndrome (CRPS) typically affects the hand, foot, arm, or leg, though it can occur anywhere in the body.
• Osteoarthritis: It is a degenerative joint condition in which the joint's tissues deteriorate over time. It is the most prevalent kind of arthritis.
• Rheumatoid arthritis: It is a chronic illness that makes the joints painful, swollen, and stiff. The hands, feet, and wrists are typically affected.
• Crystal-induced arthritis: An inflammatory disease characterized by joint pain and swelling caused by the deposition of crystals in the joints, which can trigger an inflammatory response, leading to the characteristic symptoms of acute arthritis.
• Septic arthritis: It is an inflammation of the joints caused by an infectious agent, such as bacteria, fungi, mycobacteria, viruses, or other pathogens.
• Systemic lupus erythematosus: An autoimmune illness which can affect the kidneys, brain, joints, skin, and other organs when the body's immune system mistakenly targets healthy tissue.

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The treatment of arthritis is individualized based on the type, severity, and patient-specific factors. The main approaches are outlined below, integrating evidence-based guidelines and clinical recommendations.

• Nonpharmacological treatment
• Pharmacological treatment 
• Surgical treatment 

Nonpharmacological treatment 

Nonpharmacological treatment includes managing symptoms and increasing quality of life without the use of medications.

Examples of such treatments include:

• Patient education and self-management: Empowering patients to understand their condition, practice self-care, and set realistic goals is key to arthritis management, promoting independence and active involvement in treatment.
• Exercise: Exercise preserves or restores a range of motion and flexibility around the affected joints, enhances muscle strength and endurance, and improves aerobic conditioning in order to elevate mood and reduce the health risks associated with a sedentary lifestyle.
  
• Weight loss: One well-known risk factor for arthritis, particularly knee osteoarthritis (OA), is being overweight. Population-based studies have shown a strong association between excess weight and the development of knee OA. Even mild weight loss can significantly reduce the risk of developing the condition. In individuals who already have knee osteoarthritis (OA), weight loss has been shown to alleviate pain and discomfort greatly. This is especially important for managing knee and hip OA in overweight or obese individuals.
  
• Thermal modalities (Heat and cold): Applying dry heat (such as a heating pad) or moist heat (like a warm bath or shower) to the joint can help reduce pain. Applying a cold compress (an ice pack wrapped in a small towel) to the joint can help reduce pain and swelling.
  Immobilization:  Using a splint or brace for knee supporting a joint is a therapeutic technique that protects against further damage and allows the joint to rest. This technique helps reduce pain and inflammation by reducing movement, allowing the joint to heal, and avoiding further harm or strain while recovering.
  

Pharmacological treatment 

At present, there is no known cure for arthritis. Treatment is based on the type of arthritis, its symptoms, age, and overall health to effectively manage the condition and improve quality of life. Arthritis medications include:

• Analgesics: Analgesics help relieve pain associated with arthritis, thereby improving comfort and daily function. They may include general pain relievers and topical agents, and are chosen based on the severity of symptoms and individual needs.
• NSAIDs (nonsteroidal anti-inflammatory medications): In addition to lowering fever, NSAIDs are frequently used to treat arthritis, especially osteoarthritis and rheumatoid arthritis, by reducing pain and inflammation. By blocking cyclooxygenase (COX) enzymes, these drugs reduce the synthesis of prostaglandins, which are chemicals linked to fever, discomfort, and inflammation. By reducing the pain and swelling brought on by different forms of arthritis, NSAIDs improve mobility and quality of life for affected individuals.
• Corticosteroids: These are effective in reducing pain, swelling, and inflammation associated with arthritis and can be administered orally or by injections. Injections often provide faster relief for severe flare-ups. However, due to its potential side effects like increased blood glucose and joint damage, these are usually recommended for short-term use and require careful monitoring for long-term therapy.
  
• Disease-modifying antirheumatic drugs (DMARDs): These are prescription medications that slow or stop the progression of inflammatory arthritis by targeting immune processes that cause joint damage. They help reduce inflammation, prevent tissue damage, and improve long-term outcomes, especially in autoimmune conditions like rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis.
  
• Hyaluronic acid therapy: It involves injecting joint fluid that is naturally found in the body but often breaks down in people with osteoarthritis. When injected into joints, such as the knee, it helps to lubricate the joint, improve mobility, and reduce pain, thereby easing the symptoms of osteoarthritis.

Surgical management 

A variety of techniques are used in the surgical care of arthritis to reduce discomfort, enhance joint function, and stop deterioration. The severity of the disease, the damaged joint, age, and general health all influence the surgical option. The main surgical options are listed below:

• Joint Replacement (Arthroplasty): Arthroplasty is a surgical procedure used to restore joint function and mobility. Resurfacing the bones can help repair a joint. Another option is a prosthesis or artificial joint. The joints can be affected by different types of arthritis. 
• Joint fusion (arthrodesis): This procedure involves uniting the two bones that together make up the joint. The fused joint is no longer painful since it cannot be moved. This type of surgery is most commonly performed on the ankles, wrists, fingers, or thumbs.
• Osteotomy: Any procedure where a bone is cut to correct deformity. This type of operation may be necessary to repair a broken joint. It can also be used to extend or shorten a deformed bone that isn't aligned correctly with a joint.
• Synovectomy: The term synovectomy describes the open or arthroscopic removal of the joint's synovial lining. In diseases like rheumatoid arthritis, when the synovium is actively inflamed, removing the pathologic tissue may lessen symptoms and prevent cartilage destruction.
• Arthroscopy: An arthroscope is inserted through a tiny skin incision during the surgery. More incisions could be created to introduce tiny instruments for cutting, probing, or grasping. The arthroscope's end uses fibre optics to transmit light, and a screen shows images taken from inside the joint. During the diagnostic process, corrective surgery may be carried out if necessary.
  

Arthritis Prognosis

Arthritis prognosis depends on the type of arthritis, its severity, and personal characteristics like age and general health. 

• There is currently no known cure for osteoarthritis, a degenerative condition. The number of joints and the severity of the disease determine the prognosis. Older patients who are obese, have internal deformities or have many joint involvements are more prone to experience rapid development. Although joint replacements have outstanding results, no prosthesis is permanent. Therefore, revision may be required ten to fifteen years later. 
  
• Although the prognosis for rheumatoid arthritis has improved considerably with recent therapeutic developments, the disease's morbidity and death rate are much greater than that of the general population, primarily because of its extra-articular symptoms.

Frequently Asked Questions (FAQs) on Arthritis

What is Arthritis?

Any ailment that results in joint inflammation, discomfort, stiffness, and decreased range of motion is referred to as arthritis. It's not a single illness but rather an extensive collection of joint-related disorders that frequently result in stiffness, pain, and swelling.

Is fatigue a symptom of arthritis?

Yes, a common and important symptom of arthritis, especially rheumatoid arthritis (RA), is fatigue and intense feeling of fatigue or exhaustion is one of its symptoms, which can negatively impact a person's everyday activities and general quality of life. Because of the disease's systemic inflammation, this fatigue is frequently chronic and doesn't always go away with rest.

What causes arthritis?

Different types of arthritis have different causes. Arthritis is a term that includes a variety of illnesses that cause inflammation and pain in the joints. Injuries, infections, metabolic problems, autoimmune reactions, joint wear and tear, and even heredity are common reasons.

What are the symptoms of arthritis in the knee?

Pain, stiffness, swelling, and a clicking or grinding sound (crepitus) when moving are frequent symptoms of knee arthritis. Reduced range of motion, instability, and trouble walking are possible additional symptoms. These problems, which impair general mobility and day-to-day functioning, are brought on by inflammation and gradual cartilage degradation within the joint.

What is reactive arthritis?

Reactive arthritis is a kind of inflammatory arthritis that frequently affects the joints, eyes, and urinary tract and is brought through an infection elsewhere in the body. It usually appears for a few weeks following an infection and is characterized by joint discomfort and swelling.

Is gouty arthritis an autoimmune disease?

No, gouty arthritis is not an autoimmune disease. It is an inflammatory condition characterized by the accumulation of uric acid crystals in the joints, resulting in intense pain, redness, and swelling. Unlike autoimmune diseases such as rheumatoid arthritis, where the immune system unintentionally targets the body's tissues; gout occurs when the body is unable to effectively eliminate excess uric acid, leading to the formation of crystals and subsequent joint inflammation.

What is the difference between osteoarthritis and rheumatoid arthritis?

The most common kind of arthritis, osteoarthritis, mainly affects people 65 and older. The degeneration of cartilage, the substance that protects the ends of bones in a joint, is a hallmark of this chronic, degenerative joint disease. Pain, stiffness, and decreased movement are the results of this degeneration . On the other hand, rheumatoid arthritis (RA) is a chronic autoimmune disease that causes joint stiffness, pain, and inflammation and can affect different parts of the body as well. Although neither condition has a cure, proper medication and lifestyle changes can help manage joint degeneration and significantly improve the quality of life.

How long does reactive arthritis last?

The symptoms of reactive arthritis typically resolve within three to six months, but they can occasionally persist. A small proportion of people may acquire a chronic version of the disease or endure symptoms for up to a year. If symptoms last longer than six months, there may be a chronic or more permanent component.

How to avoid arthritis?

Maintaining a healthy weight, exercising regularly, protecting joints from harm, and eating a well-balanced, nutrient-dense diet are all significant ways to lower the chance of getting arthritis. Furthermore, since smoking is linked to rheumatoid arthritis, quitting smoking can also reduce the risk.