Arthritis

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Senior man with knee pain (possibly from arthritis) and holding his knee.

Arthritis is a disease that can appear in more than 100 different forms but in all cases is due to inflammation of the joints. The most common forms of the disease are osteoarthritis and rheumatoid arthritis (RA). Other widespread forms are psoriatic arthritis and gout.

Although arthritis is a chronic disease that usually progresses gradually over time, it can sometimes appear suddenly and without warning.

It is usually more prevalent in older adults. However, it has been known to also appear in teenages and young adults who have suffered a joint injury or infection.

The symptoms of arthritis usually include pain, swelling and redness of the joints, together with difficulty moving them and a loss of range of motion.

There is no fundamental cure for arthritis. Instead, healthcare professionals focus on slowings its rate of progression. Other key goals of treating the disease are mitigating the pain and discomfort of affected individuals and helping them to preserve as much quality of life as possible. In severe cases, surgeons can operate to reduce joint damage and ease arthritic pain.

What Are The Causes Of Arthritis?

The precise causes of the disease depends on the type in question. We will discuss below the causes of three of the most common forms of arthritis – osteoarthritis, rheumatoid arthritis and gout.

Osteoarthritis Causes

Osteoarthritis is the most common form of arthritis and is usually a result of wear and tear to the cartilage of the joint. Cartilage is a tough but slick material that covers the ends of bones. It helps them to glide over each other smoothly and without friction when you use the joint.

However, over time, wear and tear to the cartilage causes the bone ends to become exposed, resulting in direct contact between them. This direct bone on bone grating causes the pain, swelling and inflammation that is characteristic of this type of arthritis.

Over time, the damage spreads from the cartilage to the rest of the joint and affects the bones themselves. It also spreads to the connective tissues between the joint muscles and the adjacent bones. The joint lining can also become inflamed over time.

Although most causes of osteoarthritis are due to progressive wear and tear, it can also be a result of a previous joint injury that has not healed fully.

Knee (or patellofemoral) and hip osteoarthritis are probably the forms of osteoarthritis with which most people are familiar.

Rheumatoid Arthritis Causes

This form of arthritis is autoimmune in nature. This means that it is a result of your immune system attacking the synovial lining of your joints. This lining functions to keep the joint cartilage healthy and the joint lubricated.

As a result of the autoimmune attack, you therefore gradually experience more pain in trying to use the joint. You also lose joint range of motion.

As with osteoarthritis, the damage from rheumatoid arthritis eventually spreads throughout the joint. Over time, it attacks and destroys the bones and cartilage, resulting in even more severe pain and inflammation.

Unlike osteoarthritis, which usually appears on just one side (e.g. either the left or right knee), rheumatoid arthritis usually attacks both sides simultaneously.

The fundamental cause of rheumatoid arthritis has not been firmly established. However, researchers have uncovered evidence that it may be linked to your genes. These can increase your risk of developing RA by as much as fivefold.They may be activated by environmental factors such as a virus, bacteria or physical or emotional stress.

Causes Of Gout

This is a common form of inflammatory arthritis. Commonly called “the rich man’s disease”, it is triggered by high levels of uric acid in the blood. This excess acid eventually crystallizes at the joints (most typically at the front of the foot or at the ankle). In doing so, it causes recurrent joint pain, inflammation, swelling, redness and stiffness.

There are many possible underlying causes of gout, including genetic factors, diet and failure to excrete uric acid salts.

Risk Factors

The factors that increase your risk of developing arthritis include the following:

  • Age – most cases of arthritis appear in individuals ages 65 or older;
  • Body weight – if you are overweight, your joints (particularly the weight bearing ones like the knees and hips) are under more strain. This increases that the risk that you will eventually experience arthritic symptoms;
  • Gender can also be a factor. While osteoarthritis and gout tend to be more prevalent among men than women, the reverse is true for RA.
  • If you have previously suffered a joint injury, you are more at risk of experiencing arthritis in the same joint in the future;
  • As we have mentioned above, a family history that includes certain types of arthritis can increase your predisposition to experience the same type of arthritis in the future.

Symptoms

If you have arthritis, you will likely experience the following symptoms:

  • Pain and swelling around the affected joint. The pain may be especially severe when you are participating in physical activities like running or playing sports;
  • The joint may also be tender to the touch;
  • Redness of the skin around the joint;
  • Reduced range of motion of the joint and difficulty using the joint for even everyday tasks.

If you are experiencing one or more of these symptoms, we suggest contacting your doctor or health care advisor for a physical exam and diagnosis.

Diagnosis Of Arthritis

To diagnose your illness, your doctor will probably need to physically examine the affected joint. He or she will likely be checking for warmth and redness around the joint and possibly for an accumulation of fluid. This fluid will likely indicate the presence of inflammation.

In addition to these checks, your doctor will ask about difficulty you may be experiencing using the joint, including loss of range of motion.

Tests of your blood and urine can also be helpful in pinpointing the type of arthritis you may have. For example, the presence of gout may be indicated by unusually high levels of uric acid in your blood. The presence of antibodies such as rheumatoid factor or antinuclear antibodies are similarly useful as pointers to other types of arthritis.

Imaging scans (e.g. MRIs, X Rays and CT scans) of the affected joint may also be useful in ruling out other problems such as bone spurs.that may be contributing to your pain.

Treatment Of Your Arthritis

As we have mentioned above, the initial treatment of this disease generally focuses on easing your arthritis pain and slowing the rate of progression of the disease. In general, your doctor will want to try a conservative (non surgical) treatment plan first.

Conservative Home Based Treatments

Unless your pain is severe and your doctor feels that surgery is necessary (s)he may suggest the following conservative treatment options. The specific selection may be dependent on the type of arthritis you have:

  • Oral analgesics  such as Tylenol to ease your pain (although these will not reduce inflammation);
  • Non steroidal anti inflammatory drugs (NSAIDS) such as Ibuprofen to ease both pain and inflammation;
  • Menthol based topical analgesics that try to overwhelm the pain signals from the arthritic joint;
  • Cortisone injections to reduce your joint inflammation and suppress your  immune system to prevent it from attacking your joint lining;
  • Assistive devices such as unloader knee braces can help to slow the rate of progression of knee osteoarthritis;
  • Referral to a therapist who can design a physical therapy program with the aim of  improving function of the joint;
  • Reducing weight can be helpful in easing stress on your joints and thereby reducing the speed of arthritis progression. People with arthritis often tend to reduce their physical activity to avoid pain. This can then result in increasing body weight and greater pain and discomfort from the disease;
  • Moist heat therapy can be conveniently and easily applied at home using devices like a Theratherm Moist Heat Pad.

Surgery

In extreme cases, such as if the arthritis is very advanced and resistant to home based treatments, your doctor may suggest surgery. The options here are to:

  • Smooth the ends of the bones of your joint to reduce their points of contact with each other;
  • A complete joint replacement with one made from metal or even plastic. This is particularly commonplace with hip or knee arthritis;
  • Fuse the joint bones together to prevent them rubbing against each other. This is a particularly common surgical option with smaller joints such as the ankle.

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