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Arthritis
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 What is arthritis?
The term arthritis literally means inflammation of a joint, but
is generally used to describe any condition in which there is damage
to the cartilage. Inflammation is the body's natural response to
injury. The warning signs that inflammation presents are redness,
swelling, heat and pain.
The cartilage is a padding that absorbs stress. The proportion
of cartilage damage and synovial inflammation varies with the type
and stage of arthritis. Usually the pain early on is due to inflammation.
In the later stages, when the cartilage is worn away, most of the
pain comes from the mechanical friction of raw bones rubbing on
each other.
What are the different types of arthritis?
There are over 100 different types of rheumatic diseases. The most
common are:
Osteoarthritis. Also called degenerative joint disease, this is
the most common type of arthritis, which occurs most often in older
people. This disease affects cartilage, the tissue that cushions
and protects the ends of bones in a joint. With osteoarthritis,
the cartilage starts to wear away over time. In extreme cases, the
cartilage can completely wear away, leaving nothing to protect the
bones in a joint, causing bone-on-bone contact. Bones may also bulge,
or stick out at the end of a joint, called a bone spur.
Osteoarthritis causes joint pain and
can limit a person's normal range of motion (the ability to freely
move and bend a joint). When severe, the joint may lose all movement,
causing a person to become disabled. Disability most often happens
when the disease affects the spine, knees, and hips.
Rheumatoid arthritis. This is an autoimmune
disease in which the body's immune system (the body's way of fighting
infection) attacks healthy joints, tissues, and organs. Occurring
most often in women of childbearing age (15-44), this disease inflames
the lining (or synovium) of joints. It can cause pain, stiffness,
swelling, and loss of function in joints. When severe, rheumatoid
arthritis can deform, or change, a joint. For example, the joints
in a person's finger can become deformed, causing the finger to
bend or curve.
Rheumatoid arthritis affects mostly joints of the hands and feet
and tends to be symmetrical. This means the disease affects the
same joints on both sides of the body (like both hands or both feet)
at the same time and with the same symptoms. No other form of arthritis
is symmetrical. About two to three times as many women as men have
this disease.
Fibromyalgia. This chronic disorder causes
pain throughout the tissues that support and move the bones and
joints. Pain, stiffness, and localized tender points occur in the
muscles and tendons, particularly those of the neck, spine, shoulders,
and hips. Fatigue and sleep disturbances may also occur.
Gout. When a person has gout, they have
higher than normal levels of uric acid in the blood. The body makes
uric acid from many of the foods we eat. Too much uric acid causes
deposits, called uric acid crystals, to form in the fluid and lining
of the joints. The result is an extremely painful attack of arthritis.
The most common joint gout affects is the big toe. This disease
is more common in men than in women.
Infectious arthritis. Arthritis can be
caused by an infection, either bacterial or viral, such as Lyme
disease. When this disease is caused by bacteria, early treatment
with antibiotics can ease symptoms and cure the disease.
Reactive arthritis. This is arthritis
that develops after a person has an infection in the urinary tract,
bowel, or other organs. People who have this disease often have
eye problems, skin rashes, and mouth sores.
Psoriatic arthritis. Some people who have
psoriasis, a common skin problem that causes scaling and rashes,
also have arthritis. This disease often affects the joints at the
ends of the fingers and can cause changes in the fingernails and
toenails. Sometimes the spine can also be affected.
Systemic lupus erythematosus. Also called
lupus or SLE, this is an autoimmune disease. When a person has an
autoimmune disease, the immune system attacks itself, killing healthy
cells and tissue, rather than doing its job to protect the body
from disease and infection. Lupus can inflame and damage a person's
joints, skin, kidneys, lungs, blood vessels, heart, and brain. African
American women are three times more likely to get lupus than Caucasian
women. It is also more common in Hispanic, Asian, and American Indian
women.
Ankylosing spondylitis. This disease most
often affects the spine, causing pain and stiffness. It can also
cause arthritis in the hips, shoulders, and knees. It affects mostly
men in their late teenage and early adult years.
Juvenile rheumatoid arthritis. The most
common type of arthritis in children, this disease causes pain,
stiffness, swelling, and loss of function in the joints. A young
person can also have rashes and fevers with this disease.
Polymyalgia rheumatica. Because this disease
involves tendons, muscles, ligaments, and tissues around the joint,
symptoms often include pain, aching, and morning stiffness in the
shoulders, hips, neck, and lower back. It is sometimes the first
sign of giant cell arteritis, a disease of the arteries characterized
by inflammation, weakness, weight loss, and fever.
Polymyositis. Causing inflammation and
weakness in the muscles, this disease can affect the whole body
and cause disability.
Psoriatic arthritis. This form of arthritis
occurs in some persons with psoriasis, a scaling skin disorder,
affecting the joints at the ends of the fingers and toes. It can
also cause changes in the fingernails and toenails. Back pain may
occur if the spine is involved.
Bursitis. This condition involves inflammation
of the bursa, small, fluid-filled sacs that help reduce friction
between bones and other moving structures in the joints. The inflammation
may result from arthritis in the joint or injury or infection of
the bursa. Bursitis produces pain and tenderness and may limit the
movement of nearby joints.
Tendinitis. Also called tendonitis, this
condition refers to inflammation of tendons (tough cords of tissue
that connect muscle to bone) caused by overuse, injury, or a rheumatic
condition. Tendinitis produces pain and tenderness and may restrict
movement of nearby joints.
What
causes osteoarthritis?
Osteoarthritis is caused by the wearing out of the cartilage covering
the bone ends in a joint. This may be due to excessive strain over
prolonged periods of time, or due to other joint diseases, injury
or deformity.
Primary osteoarthritis is commonly associated with ageing and general
degeneration of joints.
Secondary osteoarthritis is generally the consequence of another
disease or condition, such as repeated trauma or surgery to the
affected joint, or abnormal joint structures from birth.
Uric acid crystal build-up is the cause of gout and long-term crystal
build-up in the joints may cause deformity.
Some people may have congenital abnormalities of the joints-for
example, Perthes' disease of the hips-that cause early degeneration
and subsequently cause osteoarthritis.
Predisposing factors to Osteoarthritis of hip.
Some conditions may predispose the hip to osteoarthritis, It tends
to affect people as they get older and particularly affects joints
that have to take a lot of stresses and strains.
- A previous fracture that involved the hip.
- Growth abnormalities of the hip (such as a shallow socket) may lead
to premature arthritis.
- Some childhood hip problems later cause hip arthritis (for example,
a type of childhood hip
fracture known as a Slipped Epiphysis; also Legg-Perthe's Disease).
- Inactive lifestyle- Obesity (overweight) Your weight is the single
most important link between diet and arthritis, as being overweight
puts an additional burden on your hips, knees, ankles and feet.
Predisposing factors to Osteoarthritis of Knee.
Abnormalities of knee joint function resulting from fractures of
the knee, torn cartilage and torn ligaments can lead to degeneration
many years after the injury. The mechanical abnormality leads to
excessive wear and tear - just like the out-of-balance tire that
wears out too soon on your car.
What are the symptoms of arthritis?
There are more than 150 different forms of arthritis, symptoms vary
according to the form of arthritis. Each form affects the body differently.
Arthritic symptoms generally include swelling and pain or tenderness
in one or more joints for more than two weeks, redness or heat in
a joint, limitation of motion of a joint, early morning stiffness,
and skin changes, including rashes.
How can a doctor diagnose arthritis?
Doctors diagnose arthritis with a medical history, physical exam
and x-rays of the hip.
There is no blood test for osteoarthritis.
What you can do?
Consult a doctor who will determine the type of arthritis you
have.
Rest the joint until the pain subsides to prevent further inflammation.
To ease the pain or stiffness of the joint, apply heat on the joint
for about 15 minutes once or twice a day using a hot water
bottle, towel or an infrared lamp.
Take painkillers or anti-inflammatories, as recommended by your
doctor.
If you are overweight, try to reduce weight to lighten the load
on weight-bearing joints.
Participate in regular exercise.
What your doctor
can do for you?
There is no cure for arthritis, so beware of 'miracle cures'. Your
doctor may prescribe
anti-inflammatory medicine. They may recommend occupational therapy
or physiotherapy,
which includes exercises and heat treatment. In severe cases, surgery
may be suggested, such as a hip or knee replacement. The type of
surgery will depend on your age and severity of the disease. In
the elderly with severe arthritis, joint replacement can give good
results.
Treatment Options
Initial treatment for osteoarthritis of the hip or knee is conservative,
consisting of rest,
avoidance of vigorous weight bearing activities, and the use of
non-narcotic analgesic and or anti inflammatory medications. With
worsening symptoms a cane or a knee brace may be helpful. For more
severe symptoms, an injection of cortisone into the joint is frequently
advised and can be quite helpful. When conservative measures have
been exhausted and are no longer helpful, and the arthritis has
become disabling, surgery may be recommended.
Treatment of osteoarthritis focuses on decreasing pain and improving
joint movement, and may include:
- Exercises to keep joints flexible and improve muscle strength
- Many different medications are used to control pain, including
corticosteroids and NSAIDs. Glucocorticoids injected
into joints that are inflamed and not responsive to NSAIDS.
- For mild pain without inflammation, acetaminophen may be used.
- Heat/cold therapy for temporary pain relief
- Joint protection to prevent strain or stress on painful joints
- Surgery (sometimes) to relieve chronic pain in damaged joints
- Weight control to prevent extra stress on weight-bearing joints
Does exercise really help those who have arthritis?
Exercise is very important because it increases lubrication of
the joints and strengthens the surrounding muscles, putting less
stress on joints. Exercise in heated swimming
pools-hydrotherapy-can bring enormous relief from pain and stiffness.
Also studies have shown that exercise helps people with arthritis
by reducing joint pain and stiffness and increasing flexibility,
muscle strength and energy. It also helps with weight reduction
and offers an improved sense of well-being.
Can special diets treat arthritis?
But what if you have arthritis - are diet and nutrition still such
a simple matter?
Can what you eat cure your arthritis? Can food prevent it from occurring?
Are there foods that can cause your arthritis to 'flare' or go into
remission?
What role do vitamins and nutritional supplements play in the treatment
of arthritis?
Will losing (or gaining) weight help ease your symptoms?
Will taking powerful anti-arthritic medications affect your appetite
or your ability to eat
certain foods?
These are the sorts of questions that people with arthritis often
ask, and they're valid questions. Some questions (Can what you eat
cure your arthritis?) have simple answers (No). Some questions (Are
there foods that can cause your arthritis to 'flare' or go into
remission?) aren't so straightforward (Perhaps...).
Most of what you need to know about diet and nutrition is common
sense; healthy eating is pretty much the same for anyone, whether
you have arthritis or not. But there are exceptions.
Summary
From learning about the importance of exercising regularly to fully
understanding your arthritis medications, the information contained
in this section is meant to provide you with insights, information
and tips that can be used by you to help make living with arthritis
a little bit more manageable.
For people with arthritis, learning to make it part of your life
can be difficult. But learning as much as you can about your particular
type of arthritis and actively working with your arthritis treatment
team are two very effective ways of regaining control over your
life. There is plenty of information, some specific to arthritis
and some not, that can be very helpful to someone facing the challenges
associated with having a chronic or lifelong disease.
Our suggestion is - don't let arthritis beat you. Take control.
How? Arm yourself with as much information as possible. Learn from
the experiences of others in similar circumstances. What we're presenting
here is a virtual toolbox of tips for living well with arthritis.
Some may work for you one day and not the other. Some may work for
you but not others. That's why we've tried to cover several topics.
There are plenty of tools or tips here. Use them or refer to them
when you need them. Call upon them when you require help.
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