Arthritis

ARTHRITIS

Arthritis is a word used to describe pain, swelling and or stiffness in joints. Arthritis itself is not a single, specific condition. There are several and different types.

It can affect people of all ages, however, some forms of arthritis are more common in older people.

There is no definite cure for arthritis but treatment procedures have improved greatly within the past few years. For many types of arthritis, especially inflammatory arthritis, the benefits in starting treatment at an early stage are clearly huge.

It is usually difficult to determine the cause of any type of arthritis due to the fact that there are several factors that can increase the risk of each type of arthritis. Even genes inherited from parents or grandparents made one more likely to get arthritis.

Arthritis can make life tough by causing pain and making it harder to move about. Symptoms of arthritis varies immensely. Many of the types, are long-term conditions (e.g. osteoarthritis and rheumatoid arthritis).

However, with the right treatment and approach symptoms can be managed.

Remaining physically active will help a patient in whatever condition to stay mobile which will be good for general health.

WHAT IS A JOINT?

Wherever two or more bones meet in the human body is called a joint. (E.g. knees, fingers, and shoulders. Joints work to hold bones in place and allow them to move freely within limits.

Majority of the joints in the human body are surrounded by capsules. The capsules are filled with a thick fluid that serves as lubricant to the joint. These capsules with the help of ligaments hold the bones in place.

Within a joint, the ends of the bones are lined with cartilage. This is a smooth but tough layer of tissue that allows bones to glide over one another when in motion.

To be able to move a bone, the brain signals the muscle, which then pulls a tendon which is attached to the bone. Muscles therefore have very important role in supporting joints.

The main symptoms of arthritis are joint pain and stiffness, which typically worsens with age as we grow. There are many types, but the most common types of arthritis are;

• Osteoarthritis and
• Rheumatoid arthritis.

Osteoarthritis causes the hard, slippery tissue that covers the ends of bones where they form a joint (cartilage) to break down. Rheumatoid arthritis is a disease in which the joints and the lining of joints are attacked by the immune system.

Uric acid crystals form when there's too much uric acid in a persons blood. This can cause gout. Infections or underlying diseases, such as psoriasis or lupus, can also cause other types of arthritis.

Treatments will depend on the type of arthritis however, the main goal of arthritis treatments is to reduce symptoms and generally improve quality of life.

TYPES OF ARTHRITIS

• Gout - A common and complex form of arthritis, Gout can affect anyone. It is characterized by sudden, severe attacks of pain, swelling, redness and tenderness in the joints, often the joint at the base of the big toe.
• Ankylosing spondylitis - An inflammatory disease. If not treated, it can cause some of the small bones in the spine (vertebrae) to fuse over time. This can result in a hunched-forward posture because the fusing makes the spine less flexible.
• Psoriatic arthritis - A form of arthritis that affects some people who have psoriasis (red patches of skin topped with silvery scales). Most people who develop psoriasis are later diagnosed with psoriatic arthritis. In some cases however, the joint problems begin before the skin patches appear.
• Osteoarthritis This happens to be the most common form of arthritis. It affects millions of people worldwide. It occurs when the protective cartilage that cushions the ends of bones wear down over time. Though osteoarthritis can damage any joint, it commonly affects joints in the spine, hands, hips and knees.
• Reactive arthritis - Joint pain and swelling triggered by an infection in another part of the body (often the intestines, genitals or urinary tract). This type of arthritis usually targets the joints of the ankles and feet as well as the knees.
• Rheumatoid arthritis It is a chronic inflammatory disorder that can affect more than just the joints. The condition can damage a wide variety of the body systems, (e.g. skin, eyes, lungs, heart and blood vessels) in some people. A disorder which occurs when the immune system mistakenly attacks the body's own tissues.
• Juvenile idiopathic arthritis - Formerly known as juvenile rheumatoid arthritis, is the most common type of arthritis in children under age 16. This condition causes persistent joint pain, swelling and stiffness. In some children, the symptoms will be for a short period, while others might have to live with the symptoms for the rest of their lives.
• Septic arthritis This type of arthritis is a painful infection in a joint. The cause can be from germs that travel through the bloodstream from another part of the body. It can also occur when because of a penetrating injury, germs are delivered directly into the joint. Infants and older adults are most likely to develop septic arthritis. Knees are most commonly affected, but septic arthritis also can affect hips, shoulders and other joints.
• Thumb arthritis Also common with aging, this occurs when cartilage wears away from the ends of the carpometacarpal (bones that form the joint at the base of the thumb). Thumb arthritis can cause severe pain, swelling, and decreased strength among others that makes it difficult to do simple tasks like turning doorknobs and opening jars. Severe thumb arthritis might require surgery.

CAUSES

There are two main types of arthritis

• Osteoarthritis and
• Rheumatoid arthritis

However these two damage joints in different ways.

Osteoarthritis

The most common type of arthritis which is Osteoarthritis, involves the wear-and-tear damage to joint cartilage. Cartilage cushions the ends of the bones and allows near frictionless joint motion, but damage can result in bone grinding directly on bone, which causes pain and restricts movement. The wear and tear can occur over many years, otherwise it can be brought about quickly by a joint injury or infection. This type of arthritis also affects the entire joint.

Rheumatoid arthritis

With this type, the body's own immune system attacks the lining of the joint capsule, a tough membrane that encloses all joints. This lining (the synovial membrane) becomes inflamed and swollen. The disease can eventually destroy cartilage and bone within the joint.

SYMPTOMS

Depending on the type of arthritis, signs and symptoms may include:

• Pain
• Decreased range of motion
• Redness
• Stiffness
• Swelling

WHEN TO SEE A DOCTOR?

It is common to have aches and pains in the muscles and joints sometimes. This may especially be true if engages in unusual or strenuous physical activities. Telling the difference between the early signs of arthritis and normal pain and stiffness may be difficult.

One should see a doctor if he/she sees an unexplained swelling or stiffness that doesn't go away in a few days. The earlier the diagnosis and treatment, the better the outcome will be.

These might help one to decide if there is need to see a doctor:

Persistence of symptoms

• The pain is not due to an injury or if the pain persists.
• The pain came on after unusual exercise or physical activity (in which the pain should ease in a matter of days).
• How and when the pain started.

Swelling of joints

• In case a joint becomes swollen, but is not due to an injury, one should see a doctor, more especially if the patient is also unwell or has a fever.
• One should see a doctor if he is unable to do everyday tasks due to joint or muscle pain.
• If one has lifted something heavy and hurt their back, and the pain does not ease after a couple of weeks or so, he should see a doctor.
• One should see a doctor if he sees any new symptoms or has any trouble with medicines he is taking.

RISK FACTORS AND COMPLICATIONS

Risk factors for arthritis include:

Family history One may be more likely to develop arthritis if his/her parents or siblings have the disorder. Some types of arthritis runs in families, as such ones genes can make him/her more susceptible to certain factors that may trigger arthritis.

Age - The risk of most types of arthritis increases with age.

Gender - Women are generally more likely to develop rheumatoid arthritis than men. However, most of the people who have gout, which is a type of arthritis, are men.

Previous joint injury - People who have previously injured a joint are more likely to eventually develop arthritis in that joint.

Obesity - People are obese have a high risk of developing arthritis. Carrying heavy load puts stress on a persons joints, particularly the knees, hips and spine.

Severe arthritis If Arthritis affects particularly the hands or arms, can present a lot of difficulties in doing daily tasks. Arthritis in the weight-bearing joints can also keep one from walking or sitting up straight.

DIAGNOSING ARTHRITIS

The doctor will check the joints for swelling, redness and warmth. He or she will also want to see how well the patient can move his/her joints.

Depending on the type of arthritis that is suspected, the doctor may suggest some of the tests that follows;

Laboratory tests

An analysis of different types of body fluids like blood, urine and joint fluid can help pinpoint the type of arthritis a patient has. To obtain a sample of joint fluid, the doctor will cleanse and numb the area before inserting a needle in your joint space to withdraw some fluid for the analysis.

Imaging

Diagnostic imaging can detect problems within the joint that may be causing the symptoms. Examples include:

Computerized tomography (CT) - The scanners take images from many different angles and combine the information to create views of internal structures. This type of imaging can visualize both bone and the surrounding soft tissues.

X-rays This uses low levels of radiation to visualize bone. X-rays can show cartilage loss, bone damage and bone spurs. It may not reveal early damage but they are often used to track the progression of the disease.

Ultrasound - This technology makes use of high-frequency sound waves to image soft tissues, cartilage and fluid-containing structures near the joints (bursae). Ultrasound is also used to guide placement of needle for joint aspirations and injections.

Magnetic resonance imaging (MRI) - Radio waves combined with a strong magnetic field which can produce more-detailed cross-sectional images of soft tissues such as cartilage, tendons and ligaments.

TREATMENT

The primary aim of treatment is to reduce the amount of pain that is being experienced and to prevent additional damage to the joint(s). Some people resort to heating pads and ice packs because they find them to be soothing. Other patients use mobility assistant devices (canes or walkers) to help take pressure off the sore joints.

Improving function of joints is equally important. The doctor may prescribe a combination of treatment methods to achieve the best results.

• Medication

A number of different types of medication can treat arthritis:

Analgesics -These are effective for pain management, but they do not help to decrease inflammation. (E.g. acetaminophen (Tylenol) or hydrocodone (Vicodin).

Nonsteroidal anti-inflammatory drugs (NSAIDs) With examples as ibuprofen (Advil) and salicylates, they help control pain as well as inflammation. However, Salicylates can thin the blood, so it should be used very cautiously. Menthol or capsaicin creams block the transmission of pain signals from the joints.

Immunosuppressant drugs - E.g. Prednisone or Cortisone helps to reduce inflammation.

• Surgery

Replacing the joint with an artificial one through surgery may be an option. Surgery is most commonly performed to replace hips and knees.

If the arthritis is severe in the fingers or wrists, the doctor may rather perform a joint fusion. This is a procedure in which the ends of a persons bones are locked together until they heal and become one.

• Physical therapy

A core component of arthritis treatment, physical therapy will involve exercises that help strengthen the muscles around the affected joint.

LIFESTYLE CHANGES

• Weight loss and maintaining a healthy weight reduce the risk of developing Osteoarthritis and can reduce symptoms if already present.
• Choosing a diet with lots of antioxidants, such as fresh fruits, vegetables, and herbs, can help reduce inflammation. Other inflammation-reducing foods include fish and nuts.
• If one has arthritis, foods to minimize or avoid will include fried foods, processed foods, dairy products, and high intake of meat.
• Regular exercise will keep the joints flexible. Swimming for example is often a good form of exercise for arthritis patients for the reason that it does not put pressure on the joints like running and walking does.