Oh, My Aching Joints

If your morning starts out with joint stiffness, do you just chalk it up to your age or blame the gardening you did over the weekend? Or, is it possible that what is causing the discomfort is some form of arthritis? According to Rheumatologist Dr. Manpreet Tiwana of Shore Physicians Group, it is important to understand what is causing that discomfort because some forms of arthritis, if left untreated, may result in irreversible damage.

“Any form of arthritis can be life changing, as it impacts quality of life, but with so many advancements and treatment options, better outcomes can be achieved. Early diagnosis and control of arthritis along with being compliant with treatment is very important for overall good joint health,” said Dr. Tiwana.

Types of arthritis

There are more than 100 types of arthritis according to the Arthritis Foundation, but the three most common types of arthritis are osteoarthritis, rheumatoid arthritis and psoriatic arthritis. All three varieties of the disease will cause joint stiffness and pain and will often be accompanied by swelling, but what they can do to the joints and how they are treated are different.


Dr. Tiwana said osteoarthritis is the result of the regular wear and tear on our joints from injuries and aging. It is a degenerative condition, which means it gets worse over time as the smooth cartilage that cushions the joint breaks down. Bone spurs at the side of the joints can form and the bone underneath the cartilage hardens. These changes cause pain, swelling and problems moving the joint.

There is no cure for osteoarthritis, and Dr. Tiwana said treatment of the disease is more about treating the symptoms -trying to reduce discomfort with various medications or joint injections with the goal of improving the patient’s range of motion. In some cases surgical intervention is a consideration.

Rheumatoid Arthritis

Rheumatoid arthritis is an inflammatory arthritis that is associated with the autoimmune process. That means that the body’s immune system begins to start fighting its own joints. If left untreated, rheumatoid arthritis can cause permanent deformities in the joints.

Once a diagnosis of rheumatoid arthritis is confirmed, Dr. Tiwana said she works quickly to control the inflammation in the effort to avoid permanent joint damage. She added that every patient is unique and will need a plan that includes immunosuppressive medications to block the mechanism leading to swelling and joint damage tailored specifically to them that works in conjunction with any other medical conditions they may have.

Psoriatic arthritis

Like rheumatoid arthritis, psoriatic arthritis is an autoimmune disorder. The swelling and joint pain is also often accompanied by a rash. Nearly 30 percent of people who have psoriasis, a skin condition that causes red, scaly, thick patches on the skin that often form over joints, are likely to develop psoriatic arthritis according to the Arthritis Foundation. It can affect any joint in the body. Dr. Tiwana said that medication for this autoimmune disorder is tailor made for each patient utilizing a variety of medications. Various treatment options can lead to remission of the condition but medications will most need to be taken most likely lifelong. Professional golfer Phil Mickelson has psoriatic arthritis and attributes his physician, the use of nonsteroidal anti-inflammatory drugs (NSAIDS) and other antirheumatic drugs for getting him back on the golf course, according to Golf Magazine.

See your Rheumatologist

There have been tremendous advancements in the treatment of arthritis. Dr. Tiwana said it is important for people who are waking up in the morning with stiffness to determine how long it is affecting them. If the joint pain is associated with visible swelling in joints or persisting for more than six weeks with morning stiffness lasting longer than one hour, it is advisable for that person to consider seeing a physician for evaluation, said Dr. Tiwana.

The physician added, if left untreated, rheumatoid arthritis and psoriatic arthritis patients may develop permanent damage to joints and they can lose complete joint function and risk losing the capacity to walk..

Diet and Exercise

Dr. Tiwana said diet and exercise are vital to good arthritis control. “There is a component of inflammation in all variations of arthritis, whether it is osteo, rheumatoid or psoriatic. Foods which have anti-inflammatory properties like fish or fish oil and turmeric have all been found to be beneficial. Foods which are fried, processed and have processed sugars are found to increase inflammation. Exercise is vital for any type of arthritis as it maintains good muscle tone and health that promotes good joint function,” according to Dr. Tiwana.

To discuss symptoms or to set up at appointment with Dr. Tiwana, who is certified in both internal medicine and rheumatology, or a member of the Shore Physicians Group Rheumatology team located at 700 Shore Road in Somers Point, call 609-365-6212.