Arthritis is not a single disease - it's an umbrella term for over 100 conditions affecting the joints, surrounding tissues and sometimes other organs. In Canada, some 6 million people suffer from arthritis, or nearly one in five. It's the leading cause of disability in the country, yet arthritis is often misunderstood, under-diagnosed and under-treated.
The month of March is dedicated to raising awareness of arthritis - an opportunity to learn more about the condition, distinguish between its different forms and find out about the management options available, including joint infiltrations available at many of our branches in Quebec.
Osteoarthritis vs. rheumatoid arthritis: very different diseases
Osteoarthritis is the most common form of arthritis. It is a degenerative disease linked to the progressive wearing away of the cartilage that covers joint surfaces. Without cartilage to cushion movement, bones rub against each other, causing pain, stiffness and reduced mobility. Osteoarthritis preferentially affects the knees, hips, hands and spine. It is strongly associated with age - although not an inevitability of aging - as well as with obesity, a history of joint injuries and certain genetic predispositions.
Rheumatoid arthritis is an autoimmune disease in which the immune system mistakenly attacks the synovial membrane of the joints, causing chronic inflammation. Unlike osteoarthritis, it can affect young people, often women, and frequently affects several joints simultaneously and symmetrically - both hands, both wrists. If left untreated, it can lead to progressive joint destruction and extra-articular manifestations affecting the heart, lungs or eyes.
Other common forms of arthritis
Gout is a form of inflammatory arthritis caused by the accumulation of uric acid in the blood, which crystallizes in the joints - most often the big toe, but also the ankles, knees or wrists. Gout attacks are particularly painful and often occur at night. They are associated with a diet rich in purines, alcohol consumption, obesity and certain medications. Treatment includes anti-inflammatory drugs in the acute phase and hypouricemic drugs to prevent recurrence.
Ankylosing spondylitis is an inflammatory arthritis that mainly affects the spine and sacroiliac joints. It causes prolonged morning stiffness and can progressively limit back mobility. It generally begins in young adults and is strongly associated with the HLA-B27 gene. Psoriatic arthritis, on the other hand, is associated with psoriasis and can affect any joint, including characteristically the fingers and toes.
Recognizing the signs of arthritis: when to seek medical attention
Symptoms vary according to the type of arthritis, but certain signals merit medical evaluation: joint pain persisting for more than six weeks, morning stiffness lasting more than 30 minutes, swelling, warmth or redness around a joint, unexplained fatigue associated with joint pain, or a noticeable reduction in hand strength. Waiting to consult a doctor can allow the disease to progress and reduce the treatment options available. Early diagnosis - especially for inflammatory arthritides such as rheumatoid arthritis - is key to preventing irreversible joint damage.
Available treatment options
The management of arthritis is multimodal and adapted to the type and severity of the condition. For osteoarthritis, first-line treatments include physiotherapy, maintenance of a healthy body weight, adapted physical activity - walking, swimming and stationary cycling are particularly recommended - and analgesics or anti-inflammatories as required. For inflammatory arthritis, disease-modifying drugs such as methotrexate and biotherapies are the mainstay of treatment, often leading to remission.
Joint infiltrations are an effective option for relieving pain and inflammation in a specific joint, as a complement to disease-modifying treatments. They involve direct injection into the joint space of a locally-acting corticosteroid - sometimes combined with an anesthetic - under medical guidance. Relief can last from a few weeks to several months, depending on the patient and the joint treated.
Joint infiltrations: quick access at several branches
Access to joint infiltrations in Quebec's public network often involves long waiting periods. Clinique Omicron offers this service in several of its branches in Quebec, with significantly reduced waiting times compared to the public sector. A preliminary medical consultation is held to assess the indication, rule out any contraindications and plan the procedure. Infiltrations are performed in particular on the knee, shoulder, hip and small hand joints. No external referral is required to book an appointment.
Frequently asked questions about arthritis and joint infiltration in Quebec
Can osteoarthritis be cured?
To date, there is no treatment that can regenerate the cartilage degraded by osteoarthritis or cure the disease. However, there are effective strategies to slow its progression, control pain and maintain a good quality of life over the long term. Weight loss is particularly effective in reducing the load on weight-bearing joints: every kilogram lost reduces the pressure exerted on the knee by around 4 kilograms. In advanced cases with major joint destruction, prosthetic hip or knee replacement provides excellent functional results.
How long does joint infiltration last and is it painful?
The procedure itself is rapid - usually lasting less than 10 minutes. A local anesthetic is often used to minimize discomfort. The injection may cause slight pressure or temporary burning, but the majority of patients tolerate it well. A slight worsening of symptoms in the 24 to 48 hours following the injection is possible - known as post-infiltration flare - before relief sets in. Normal activities are usually resumed the following day.
How many infiltrations can the same joint receive per year?
Recommendations vary according to the type of infiltration and the joint concerned. For corticosteroids, it is generally advisable not to exceed three to four injections per year in the same joint, to avoid local adverse effects such as cartilage or soft-tissue degradation. The interval between two injections should be at least six to eight weeks. Your doctor will assess the optimum frequency according to the evolution of your symptoms and your response to previous treatments.
Are hyaluronic acid injections an alternative to corticosteroids?
Hyaluronic acid - also known as viscosupplementation - is an option available for osteoarthritis of the knee. Its aim is to restore the lubricating properties of synovial fluid. Its efficacy is debated in the scientific literature: some studies show a moderate benefit for certain patients, particularly in less advanced stages. It does not generate the adverse effects associated with repeated corticosteroids, which may make it preferable in certain clinical situations. Your doctor will be able to discuss with you which option is best suited to your situation.
Omicron Clinic
Need to consult a doctor?
Treatment within 24-48 hours. In-clinic or telemedicine, anywhere in Quebec.
Insurance receipts. 7j/7. No family doctor required.
