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.

The most common types of arthritis include:

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 and knees.

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 and 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.

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.

Ankylosing Spondylitis

This disease most often affects the spine, causing pain and stiffness. It can also cause arthritis in the 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.

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.

What are the symptoms of Arthritis?

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 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 knee. There is no blood test for osteoarthritis.

Treatment Options

• Initial treatment for osteoarthritis of the 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