Prevention

There is no known way to prevent IBD arthritis.

Treatment

There is no single best treatment for arthritis associated with IBD. Joint pain may be relieved by a non-steroidal anti-inflammatory drug (NSAID). Many doctors recommend a newer medication called celecoxib (Celebrex) instead of older anti-inflammatory medicines such as ibuprofen (Advil, Motrin and others) or naproxen (Aleve and others). Celebrex is in a class of drugs called Cox-2 inhibitors, which don't thin the blood or cause stomach ulcers as often as the older medications. IBD can cause bleeding in the intestinal tract, which can be made worse by an older medication that thins the blood. Any NSAID may worsen the intestinal inflammation caused by inflammatory bowel disease. Your doctor will consider this risk before prescribing an anti-inflammatory medication.

For more severe cases, injections of corticosteroids into the inflamed joint can provide prompt, though often temporary, relief. Other medications that may help include those that may be prescribed for the intestinal disease such as sulfasalazine (Microsulfan), azathioprine (Azasan) or oral corticosteroids. Medications used in the treatment of rheumatoid arthritis, such as methotrexate (Folex, Methotrexate LPF, Rheumatrex) can also be effective. Finally, newer agents, such as injections of infliximab (Remicade), are showing great promise in preliminary studies for IBD arthritis. Infliximab is already approved for severe Crohn's disease, so its use may improve the bowel inflammation as well as the arthritis. Preliminary research suggests that adalimumab (Humira) may have similar benefits. A related medication, etanercept (Enbrel), may improve joint symptoms but studies don't show any benefit for bowel inflammation.

If joints become severely damaged, joint surgery, including joint replacement, may help.

It's important to strike a balance between rest and exercise. Your doctor may refer you to a physical therapist, occupational therapist or podiatrist. Splints, shoe inserts or braces can provide relief in ways that medications cannot.