Arthritis | Hand and Elbow | MedStar Health

Arthritis, meaning joint inflammation, encompasses more than 100 different diseases, most commonly causing pain, stiffness, and swelling in or around the joints. Affecting one in three Americans — old and young alike — this long-term problem can make it difficult to perform daily activities; arthritis pain is disabling and can result in psychological as well as physical issues.

The specialists at MedStar Health, however, can help you find ways to reduce arthritis pain and keep moving. Our orthopaedic and rheumatology teams work with your primary care physician to provide the best possible diagnosis and treatment for your arthritis pain — so that you can get on with the business of living with minimum pain and maximum mobility.

Risk factors

Most arthritis pain results from years of accumulated wear and tear on joints and tends to occur in the elderly in hips, knees, and finger joints. Other risk factors are obesity, a history of trauma, and various genetic and metabolic diseases. Although arthritis is mainly a disease of adults, children also may have it. It also affects women nearly three times as often as men.



Osteoarthritis is the most common type of arthritis and often the most destructive. It's a degenerative joint disease, gradually wearing away the cartilage surrounding the joint, that occurs equally in men and women and often appears in athletes who have had many joint injuries in their past. Contributing factors include age, genetics, and excess weight, lack of exercise, and injury or trauma.

The hands, hips, knees, neck, and lower back are often affected by this condition, and, in most cases, just one joint is affected (as opposed to rheumatoid arthritis, where both sides of the joint are affected). However, spinal osteoarthritis is the most common type, presenting symptoms that include debilitating neck and low-back pain, accompanied by tingling and numbness in the arms or legs.

Regardless of the cause, osteoarthritis conditions are often chronic and require good diagnosis and proper posture, daily exercise, and anti-inflammatory medications as part of a good treatment plan. Surgery to repair or replace joints is often necessary in severe cases


Osteomyelitis is an acute or chronic bone infection. It most commonly occurs after open fractures or after closed injuries have been treated surgically; patients usually have a history of prolonged debilitation and multiple surgical procedures.

The orthopaedic specialists at MedStar Health will use a combined approach of surgical, reconstructive, and therapeutic techniques to treat osteomyelitis. Through a combination of specialists and state-of-the-art techniques, the chance of cure from chronic osteomyelitis, with good return of limb function, is significantly increased.


Osteonecrosis, also called avascular necrosis, is a type of arthritic bone disorder that causes decreased blood supply to the affected area. This decreased circulation causes cells in the bone and bone marrow to die, which may cause bones to collapse. When bones are fractured or dislocated, they can block or damage arteries in the area, leading to osteonecrosis. Symptoms include:

  • Joint stiffness
  • Limited motion
  • Pain

Osteonecrosis usually occurs in large joints such as the ankles, knees, hips, and shoulders. It's more prevalent in people between the ages of 30 and 50, and most commonly affects the hip. Osteonecrosis of the knee occurs more often in women between ages 50 and 60. People with certain fractures of the hip; alcoholics; those taking certain steroids; and individuals with sickle cell anemia, lupus, or pancreatic conditions are at a higher risk of developing osteonecrosis.

Diagnosis is very important in its earliest stages so MedStar Health specialists can provide the best individual treatment plan. Surgery may be recommended when patients have lost function in their joint or have unmanageable pain.

Rheumatoid arthritis

Rheumatoid arthritis, a chronic disease affecting 2.1 million Americans, is an inflammation of the lining (synovium) of the joints that can lead to long-term damage and disability. The inflammation puts pressure on the surrounding tissues, which can produce chemicals that can ruin the joint surface. This, in turn, can cause deformities. Connective tissues that support internal organs are also susceptible to this form of arthritis.

Although rheumatoid arthritis can be a serious disease, many treatment options help reduce its severity and longevity in every individual. We work to assist patients in leading lives with more mobility, activity, and tolerance.

Learn more about rheumatoid arthritis treatments, as well as MedStar Health’s rheumatology experts who are specially trained and equipped to diagnose and treat diseases of the joints, muscles, and bones.


  • Joint pain and/or swelling
  • Early morning stiffness
  • Warmth around a joint
  • Redness of the skin around a joint
  • Inability to move the joint
  • Unexplained weight loss, fever or weakness that occurs with joint pain
  • Nearby joints become unusually flexible to compensate for the affected joint
  • Feeling or hearing grinding of the joint
  • Appearance of cysts 
  • A weak grip
  • Difficulty using the hand
  • Pain in the knuckles


MedStar Health is a pioneering force in the field of arthritis. We know a proper diagnosis is the first step in helping patients live without arthritis pain. That is why we take a multidisciplinary team approach to every patient right from the start.

To accurately diagnose arthritis, a physician will take a complete medical history, complete a physical examination that evaluates any symptoms, take X-rays to determine joint damage, and possibly perform other laboratory and blood tests to determine the exact type of arthritis and its severity.

Managing arthritis pain

Arthritis pain may stop people from moving, walking, climbing stairs, bathing, working, or playing. It can interfere with thinking and concentration, or even with being close to other people. When arthritis pain interferes with sleep, mood, or appetite, it can affect all parts of your life, especially when it lasts a long time. Pain that won't go away can change the way you feel about yourself and others.

To get treatment that will alleviate your pain, it is important that your physician understands precisely what you are feeling. But, because only the person with pain knows what it is like, describing the pain is the key to understanding pain. Describing pain is not easy, however, so we’ve put together this guide to help you—so you can get the relief you need.

One of the best ways to measure pain and pain relief is to use a rating scale. Rating pain using a scale makes your pain easier for others to understand.

  • Numerical Scale
    • Example: 0 to 10 scale
    • The person rates the pain from zero (0), meaning no pain, to ten (10), meaning the worst pain possible. When using a numerical scale of 0 to 10, pain ratings of 5 or above mean that pain limits activities for most people
  • Words Scale
    • Examples: no pain, a little pain, a lot of pain, aching, burning, annoying, uncomfortable, dreadful, horrible, agonizing
    • These words mean different things to different people. Annoying pain for one person may be dreadful to another. Because of this, the words must be defined: everyone involved must use the same words and know their meaning

Discussing pain

Don't be afraid to talk about your pain—describing how pain limits your life will help your doctor or nurse set goals with you for dealing with your pain. Each time you see your doctor tell them:

  • Where the pain is
    • Does it hurt in more than one place?
    • Does the pain feel like it's on the inside or on the outside of your body?
    • (It may help to indicate these places on a drawing of the outline of a body)
  • When the pain starts
    • When does the pain happen?
    • How long does it last?
    • Does the pain come and go or is it there all the time?
  • What helps to relieve the pain
    • What have you tried to relieve the pain?
  • Relaxation, meditation, heat, cold, mild exercise, etc.
    • List all over-the-counter medications you take and what medicines have been prescribed for you by another doctor. Some medicines can't be taken together, and medicines with different names may contain the same chemicals and could be harmful if too much is taken
  • What makes the pain worse
  • Any changes in pain
    • Is this pain new?
    • Have you ever had this pain before?
  • Any changes in mobility or function
    • What activities does it keep you from doing?
    • Does the pain interrupt your sleep?
    • Does the pain change your mood?
    • Does the pain affect your appetite?

Family members and friends can help if you're not able to write your own pain assessment. Bring a family member or friend along for doctor's visits. Let them help you tell others about your pain and pain relief.

Coping with pain

Living with arthritis pain can be difficult. The specialists at MedStar Health want to help. Here are a few things you can try on your own to help through the pain:

  • Make sure you get a good night's sleep (8-10 hours a night). When you are well-rested, you have more energy to get well, to enjoy life, and to do the things that are important to you
  • Eat a healthy diet
  • Keep a pain assessment notebook
  • Find the physician who is right for you
  • Join a support group


A wide variety of treatments are available for arthritis pain, and your team at MedStar Health will customize the treatment plan that best suits your symptoms and situation.

Treatment plans often include:

  • Medication
  • Physical therapy
  • Exercise
  • Applying heat and/or cold to the site
  • Consciously alternating activity with rest
  • Learning to use joints correctly (ex: using your palms rather than your fingers to carry groceries)
  • Losing excess weight to reduce pressure on the joints
  • Walkers, canes, and other assistive devices

It's important to remember that arthritis doesn't mean an inactive lifestyle. Inactivity can weaken and stiffen the muscles surrounding the joints and impair your joints permanently.


When certain treatments fail, an orthopedic surgeon will perform surgery to help reduce the arthritis pain. Surgery may be used to realign joints or to remove the joint lining which has become damaged or pulled out of place due to the wearing away of cartilage and bone.

In joint replacement, also called arthroplasty, the physician replaces the joint with metal or plastic parts. Joint replacement has been especially effective with hips and knees and has also been used for shoulders, ankles, elbows, and knuckles.

Arthritis rehabilitation services

The Arthritis Program offers rehabilitation services for individuals who have had:

  • Arthritis, including osteoarthritis, rheumatoid arthritis, polymyositis, and systemic lupus erythematosus.
  • Arthroplasty (joint replacement) for hips, knees, shoulders, and other joints.
  • Hip-fracture surgery
  • Multiple orthopaedic trauma
  • Cancer surgery
  • Other musculoskeletal conditions

Medical care is directed by physicians who are board-certified in physical medicine and rehabilitation, orthopaedic surgery, internal medicine, and rheumatology. Depending on the patient's needs and goals, our rehabilitation team members may also include specialists in occupational therapy, orthotics and prosthetics, hydrotherapy, pain management, physical therapy, psychology, rehabilitation engineering, rehabilitation nursing, social work, therapeutic recreation and vocational rehabilitation.

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Dr James Tozzi poses for a photo with an xray in an exam room

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Additional information

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