Q: I was recently diagnosed with arthritis by my family doctor, who prescribed an NSAID for me. I have heard that there are all kinds of new arthritis treatments, including something called biologics. Do you think NSAIDs are enough to help me? 

A: I wonder if your doctor told you which form of arthritis you have. Although we casually use the term arthritis to refer to one of many different conditions, arthritis (literally meaning "joint inflammation") is really more a symptom than a disease itself. 

Joint involvement can occur in more than 100 different diseases, including osteoarthritis (OA), rheumatoid arthritis (RA), lupus, ankylosing spondylitis and gout, just to name a few. Treatment depends on the form of arthritis or related disease, and the sooner you discover which form you have and begin appropriate treatment, the better you will do in the long run.

The drug your doctor prescribed is just one of many of a class called nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs work by limiting the body's production of hormone-like substances called prostaglandins, which are involved in causing inflammation (which, over time, can lead to joint destruction) and pain. 

For many arthritis-related diseases NSAIDs provide some symptomatic relief and therefore can be an important part of a treatment plan. But for many types of arthritis, NSAIDs should not be the sole medical treatment. Some doctors, unfortunately, don't realize this.

If you have RA, for example, you will benefit from more powerful drugs early on. Not too many years ago, most doctors – even those highly experienced in treating arthritis – used NSAIDs as the first line of treatment against RA. They might have used a number of different NSAIDs over several years. When it became obvious that the disease was progressing and causing joint damage, the doctor would then start a disease-modifying drug such as gold.

Now we know that most of the joint damage of RA occurs within the first two to three years. So it's important to control the inflammation affecting the joints before they are damaged. NSAIDs won't do that.