There is no single best treatment for arthritis associated with IBD. Joint pain may be relieved by a non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen or naproxen. IBD can cause bleeding in the intestinal tract, which can be made worse by a medication that thins the blood, including most NSAIDs. Any NSAID may worsen the intestinal inflammation caused by inflammatory bowel disease.
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 (Azulfidine), azathioprine (Azasan, Imuran) 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 adalimumab (Humira), certolizumab pegol (Cimzia), etanercept (Enbrel) and infliximab (Remicade), may be quite effective for IBD arthritis. Infliximab, adalimumab and certolizumab are approved for severe Crohn's disease; their use may improve the arthritis as well as the 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.
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