Arthritis is a general term used to describe any of up to 100 disorders that cause swelling and tenderness of one or more of the joints of the body.
The most common forms are osteoarthritis and rheumatoid arthritis. The first is a degenerative joint disease and the second is an autoimmune disorder that usually affects the hands or feet.
Gout is another form of arthritis and is caused by an excess buildup of uric acid in the body and the resultant formation of uric acid crystals in the bloodstream.
Other forms of arthritis can be the result of infections in the body. Arthritis can also be a secondary effect of other, unrelated diseases such as psoriasis or lupus.
The general symptoms of this disease are joint pain and stiffness. People with arthritis also usually experience joint swelling and decreased range of motion.
Arthritis is usually a chronic disease with no fundamental cure. Instead, the treatment options aim to slow the rate of progression of the disease. Treatment also aims to reduce the patient’s pain and discomfort and to help him or her maintain the best quality of life under the circumstances.
The precise causes of each form of arthritis are different. However, for the two most common types of the disease (osteoarthritis and rheumatoid arthritis.), they can be described as follows:
Osteoarthritis is the most common form of the disease. It is essentially a result of wear and tear of the cartilage of the joint..Cartilage is a tough, slick coating that covers the ends of bones where they meet to form a joint. Its purpose is to avoid direct contact between bone ends and allow them to glide frictionlessly over each other.
However, long term wear and tear of the cartilage can cause the bones to start grinding against each other. The pain can over time become severe enough to restrict joint movement.
In the past, osteoarthritis was believed to be a ‘degenerative joint disease’, a passive process associated with old age. However, it is now known that this is not the case. In addition to being a result of wear and tear of cartilage, osteoarthritis can also be a result of a previous injury to the joint, an inflammatory process that was not properly treated or even a metabolic defect. It is a multifactorial disease which can begin in middle age.
Although it begins with damage to the joint cartilage, osteoarthritis usually progresses to cause more general joint damage. Ultimately, it affects the bones themselves as well as the tissues that connect muscles to the tendons. It also attacks the lining of the joint and causes it to become inflamed. This further aggravates the pain that the patient is already feeling.
Knee osteoarthritis (and particularly patellofemoral osteoarthritis) is one of the most common forms of osteoarthritis.Other commonly affected joints include the hips and small hand joints.
This is an autoimmune form of arthritis in which the body’s immune system starts attacking the joint lining. Rheumatoid arthritis is the most common inflammatory arthritis in adults and leads to progressive joint destruction and deformity. It causes inflammation and swelling of the synovial membranes and articular structures, which in turn leads to deformity and fusion of parts of the joint. The significant socio-economic impact of the disease is highlighted by the fact that one third of people stop working within about 2 years of its onset.
Rheumatoid arthritis is fortunately a rare disease, with only 1.5 men and 3.6 women developing the condition per 10,000 people per year. It is 2 to 4 times commoner in women than in men.
This form of arthritis affects other parts and organs of the body in addition to the joints. These are called systemic features or extra-articular manifestations (EAM). The heart, lungs and eyes are commonly affected.
Although rheumatoid arthritis can affect any joint with a synovial membrane, it typically affects the small joints of the hands and feet, with both sides usually equally and symmetrically involved in the disease process.
Similarly to osteoarthritis, rheumatoid arthritis progresses over time and eventually causes more widespread damage. It ultimately attacks and starts to destroy the cartilage and bone of the joint, thus aggravating the patient’s pain and discomfort.
The factors that can increase the risk of developing arthritis are as follows:
Arthritis mainly attacks the joints and that is where its symptoms are primarily felt and observed. The symptoms vary to some degree with the exact form of the disease that is present. However, they can generally be said to include the following:
If you have one or more of these symptoms, you should seek medical advice as soon as possible.
Before making a diagnosis, a doctor will usually conduct a physical examination of the painful joint. He or she will check for swelling, warmth and possibly redness of the joint. The patient may also be asked about any stiffness or difficulty in using the affected joint. For example, is (s)he experiencing a reduced range of motion?
Even if the doctor suspects the presence of arthritis, it is still important to identify the exact type. To do this, he or she may request:
The treatment used is dependent upon the type of arthritis that the patient has. Some types need treatment only for a short time, while others may need lifelong treatment.
As mentioned above, treatment usually focuses on mitigating the symptoms and slowing the rate of progression of the disease. To achieve this, doctors may suggest the following medications:
As a home based treatment option, moist heat therapy has been shown to be extremely effective in treating some types of arthritic pain. You can read more about this form of treatment here.
In some cases, the patients can also use assistive devices such as unloader knee braces to alter the point of contact between bones of the knee. These braces will help to slow the wear and tear process that causes knee osteoarthritis. The benefits of using orthopaedic braces to relieve arthritis symptoms are discussed here.
A doctor may also refer arthritis patients to a physical therapist. The therapist can design an exercise program to improve range of motion and strengthen the muscles surrounding the joint.
If the above treatments do not succeed in reducing the patient’s arthritis pain, there are some surgical approaches that doctors can try. They include the following options:
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