A normally functioning immune system is the body's first line of defense against invaders such as viruses. Occasionally, however, the immune system misfires and turns its attack on healthy cells. This is called an autoimmune disease, and when the system focuses its destruction on joints, autoimmune arthritis can result. There are several types of autoimmune arthritis, and treatment depends on the specific type and the severity of the symptoms, as well as the patient's age and medical history. Treatment may include physical therapy, surgery, pain medications, anti-inflammatory drugs or a combination of approaches.
Of all the various types of autoimmune arthritis, rheumatoid arthritis is perhaps the best known. Most patients contract rheumatoid arthritis before their 40th birthday, and the disease can even strike in childhood. Because rheumatoid arthritis is highly destructive and can lead to painful disfigurement, doctors may focus much of the treatment plan on reducing joint swelling through the use of anti-inflammatory drugs, both steroids and non-steroids, and biologics such as abatacept, etanercept and tocilzumab. In severe cases, arthroscopic surgery may be performed to clean the surfaces of the joint, and many patients eventually need to have one or more joints replaced with an artificial joint.
Reactive arthritis is an autoimmune arthritis that often occurs after certain infections, such as salmonella or chlamydia. The symptoms often disappear within months or even weeks, but some patients experience periodic bouts over many years. If the condition is severe, doctors may prescribe medications to impede the functioning of the patient's immune system, but because this can have dangerous side effects, such treatment is typically reserved for the most debilitating cases.
Related conditions to reactive arthritis include ankylosing spondylitis and psoriatic arthritis. Ankylosing spondylitis attacks the spine and often involves the hip joint. Like rheumatoid arthritis, ankylosing spondylitis usually strikes prior to the age of 40. Psoriatic arthritis normally strikes patients who have an autoimmune disorder called psoriasis, in which the body produces more skin cells than it can use and the excess cells build up on the surface in patches.
Ankylosing spondylitis is typically more severe than psoriatic arthritis, although it is possible for both autoimmune arthritis types to generate significant pain. Both varieties may be treated with anti-inflammatories, and more severe cases may benefit from drugs such as leflunomide, sulfasalazine, etanercept or infliximab. Patients with psoriatic arthritis rarely require surgical treatment, but hip replacements, spinal fusion or other surgeries may prove beneficial for some cases of spondylitis.
Regardless of the type of autoimmune arthritis, doctors normally recommend low-impact exercises such as walking. Patients with spondylitis, however, can incur serious injuries to their spines if they fall, so doctors may restrict activity levels. Doctors may recommend physical therapy to help keep the patient's joints flexible and prevent a loss of mobility.