Below is a quick overview of information about treatments for arthritis.

Exercise

Exercise is important for keeping joints supple, strong and mobile and this includes joints affected by osteoarthritis. In general people with arthritis should aim to exercise every day, although there may be days when joints are particularly stiff and inflamed and it might be necessary to rest more than usual.

Activities such as swimming and cycling are ideal, as they do not put a strain on the joints, but you will need a full range of exercise to keep yourself in good health and to keep your joints mobile. If you go to exercise classes, check that they are run by a qualified teacher and that the teacher knows about your condition.

Always take exercise steadily and of course discuss what you plan to do with your doctor or physiotherapist to get their advice. Hydrotherapy can help with muscle strengthening and may be available at your local swimming pool.

Do wear soft-soled footwear that will act as a shock-absorber for your joints. Do stop exercising if you feel any pain and don't exercise if you feel unwell.

Medication

There are three main types of medication for arthritis:

1. Pain-relieving medicines (analgesics)
2. Anti-inflammatory medicines
3. Disease-modifying medicines

1. Pain-relieving medicines (analgesics) are available over the counter from the chemist; some of them come in gels, which can be rubbed directly onto the painful joint. Even though they are available without a prescription it is a good idea to talk to your doctor before using them to treat your arthritis.

Aspirin and ibuprofen help to relieve pain, but also have an anti-inflammatory effect. If you have severe pain you may be prescribed stronger analgesics such as codeine or diamorphine or a combined painkiller.

2. Anti-inflammatory medicines are prescribed if there is inflammation as well as pain in your joints. Reducing the inflammation can help to reduce the damage to joints. Options include:

• Non-steroidal anti-inflammatory drugs (NSAIDs) - These need to be taken over a long period to have any effect; they can reduce swelling and also reduce pain and stiffness. Side effects can include indigestion and stomach problems and asthma attacks for people who have asthma.
• COX –2 inhibitors - These are relatively new medicines, similar to NSAIDS, but with fewer side effects.
• Steroids - These are artificial versions of the body's natural hormones and are good for bringing severe arthritis under control. They can cause side effects if taken over the long-term.

3. Disease-modifying medicines (DMDs) affect the immune system so are used for rheumatoid arthritis. They are usually first prescribed by a hospital specialist such as a rheumatologist. They can have serious side effects so their use must be carefully monitored. DMDs need to be used for several months before it becomes clear whether or not they are working.

Complementary therapies

Osteopathy and acupuncture have been shown in studies to relieve the pain of arthritis. If you are interested in trying a complementary therapy it is vital to go to a trained and reputable practitioner. Search the British Complementary Medicine Association website for a practitioner in your area.

Whatever therapy you try it is important to see it as a complement to your medical care, rather than a replacement for it. No treatment is risk free (even the western medicine provided by your GP). Some herbal remedies can interact with other medications and although rare, it is possible to have a bad reaction to some of the other therapies such as acupuncture. It is wise to keep your doctor informed if you decide to use complementary therapies.

Read more about complementary therapies in our healthy ageing section.

Helping yourself at home

Dietary supplements - People with arthritis often take a wide range of dietary supplements. For many of these there is not yet clear evidence of whether or not they are effective. However there is good evidence for the benefits of fish oils and a supplement called glucosamine sulphate.

The fatty acids that are found in fish oil and some plant seeds may help to relieve inflammation in the joints, which should help people with rheumatoid and osteoarthritis. However, research is still ongoing. Healthy eating guidelines recommend that we eat fish twice a week and one of these helpings should be oily fish, such as salmon, mackerel, or sardines.

Research at the University of Cardiff has shown that taking cod liver oil can slow the destruction of joint cartilage in patients with osteoarthritis. The recommended dose is 5ml daily. This is a tablespoon of the liquid oil or probably several of the capsules which tend to come in 500mg (0.05ml) or 1,000mg (1.0ml) doses.

Another supplement that there is positive evidence for is glucosamine sulphate, which offers effective pain relief for mild arthritis. The downside is the cost as glucosamine is only available as a 'nutritional supplement' at a cost of about £10 a month for treatment with the recommended dose of 1500mg a day.

Hot and cold packs - Pain and stiffness can be relieved by warmth. There are creams that produce a localised heat, but a hot water bottle or heat pack warmed in a microwave are also good ideas. Make sure that the source of heat has a material cover so that it doesn't burn you.

If your joints are hot and inflamed an ice pack might help to calm them down. It's a good idea to check out with your physiotherapist or doctor whether ice will help your condition and again make sure the pack has a cover as ice can 'burn' if it is directly applied to the skin.

Rest and relaxation - Being stressed or having tense muscles can make the pain from arthritis seem worse. It is useful to develop relaxation techniques to help control this. This could be as simple as listening to music or having a bath, but complementary therapies could also play a part. Yoga, massage and aromatherapy can all be helpful in increasing relaxation.

Other options - You probably know people who swear that wearing a copper bangle on their wrist helps to relieve their arthritis. There is no scientific evidence that copper can help to relieve stiff and painful joints, but there is also no evidence that wearing a copper bangle can do any harm. The Arthritis Research campaign has an online noticeboard full of hints and tips about supplements and therapies that people with arthritis have found to be useful.

The above information is just a summary. Please visit the Arthritis Care and Arthritis Research Campaign websites for detailed information.