Arthritis

Did you know that arthritis affects millions of people worldwide? This common condition causes pain, stiffness, and inflammation in various joints, making everyday activities challenging for those who live with it. Arthritis can significantly affect quality of life, but understanding its symptoms, causes, and treatment modalities can help individuals manage their condition more effectively. This article explores the various kinds of arthritis, their symptoms, and potential causes. 

What is Arthritis?

Arthritis literally means joint inflammation. It refers to a group of diseases that affect the joints, causing pain, stiffness, and swelling. Joints are where two bones meet, like the elbow, fingers, or knee. The primary symptoms of arthritis include pain, stiffness, limited range of mobility, and swelling in the joints and surrounding tissues.

Types of Arthritis

Arthritis encompasses over 100 different forms, each affecting joints in unique ways. The most common types include: 

• Osteoarthritis
• Rheumatoid arthritis 
• Psoriatic arthritis 
• Fibromyalgia 
• Gout 
• Other types include lupus, which can affect joints and multiple organs, and juvenile arthritis, occurring in children under 16.

Symptoms of Arthritis

Arthritis manifests through various symptoms, primarily affecting the joints. 

• The most common signs include:
• Joint pain, ranging from mild to severe 
• Stiffness or reduced range of motion
• Swelling or inflammation in the affected area
• Tenderness or sensitivity to touch 
• People with arthritis may notice skin discolouration around their joints, typically appearing red or inflamed. 
• Some individuals experience a feeling of heat or warmth near their joints, which can be a sign of active inflammation.

Causes of Arthritis

Arthritis has various causes, depending on the specific type, including: 

• Osteoarthritis, the most common form, occurs naturally as people age. It results from wear-and-tear damage to the cartilage that cushions the ends of bones in joints. Over time, this damage can lead to bone grinding directly on the bone, causing pain and restricted movement. Joint injuries or infections can hasten this process.
• On the other hand, rheumatoid arthritis is an autoimmune disease. The body's immune system mistakenly attacks the lining of the joint capsule, causing inflammation and swelling. This inflammation can eventually destroy cartilage and bone within the joint.
• Gout develops when there's too much uric acid in the blood. 
• Viral infections, including COVID-19, can trigger viral arthritis. 
• Sometimes, arthritis occurs without a clear cause, which doctors call idiopathic arthritis.

Risk Factors for Arthritis

Arthritis can affect anyone, but certain factors increase the likelihood of developing this condition, such as: 

• The risk of many types of arthritis (osteoarthritis, rheumatoid arthritis, and gout) rises as people age.
• Women are more prone to osteoarthritis, rheumatoid arthritis, and fibromyalgia, while men face a higher risk of gout.
• People with parents or siblings who have arthritis may be more likely to develop the condition themselves.
• Obesity puts extra stress on joints, particularly the knees, hips, and spine, increasing the risk of knee osteoarthritis.
• Previous joint injuries, such as those sustained during sports activities, can lead to osteoarthritis in the affected joint later in life.
• Smoking raises the risk of rheumatoid arthritis and can worsen existing arthritis symptoms.
• Certain infections cause joint inflammation, potentially increasing arthritis risk.
• Some occupations that involve repetitive joint stress or exposure to certain substances may increase the risk of arthritis.

Diagnosis of Arthritis

Diagnosing arthritis can be challenging due to the existence of over 100 different types with similar symptoms. Orthopaedic doctors use a comprehensive approach to make an accurate diagnosis. 

• Medical History: Doctors review the patient's medical history, asking about previous illnesses, injuries, family history of arthritis, and current medications. They also inquire about specific symptoms, including pain location, duration, intensity, and factors that worsen or alleviate it.
• Physical Evaluation: Doctors will check joints for swelling, redness, and warmth. They assess the patient's range of motion and overall joint function. 
• Laboratory Tests: 
  • Blood Tests: Blood picture helps measure antibody levels, complete blood count, and markers of inflammation like C-reactive protein and erythrocyte sedimentation rate. 
  • Joint Fluid Analysis: Analysing aspirated joint fluid through arthrocentesis can provide valuable insights.
  • Imaging Techniques: X-rays, MRIs, and CT scans offer a clearer picture of joint health. 
  • Arthroscopy: In some cases, doctors may perform arthroscopy to examine the joint's interior directly.

Treatment for Arthritis

While there's no cure for arthritis, various short-term and long-term remedies for arthritis help manage the condition effectively.

• Short-term Treatments: 
  • Medications like nonsteroidal anti-inflammatory drugs (NSAIDs) to alleviate pain and inflammation
  • Heat and cold therapy
  • Joint immobilisation and massage
  • Transcutaneous electrical nerve stimulation (TENS)
  • Acupuncture or the use of counterirritants like creams containing menthol or capsaicin
• Long-term Treatments:
  • Disease-modifying antirheumatic drugs (DMARDs) to slow the progression of rheumatoid arthritis and prevent joint damage
  • Corticosteroids and hyaluronic acid therapy are other options
  • In some cases, surgery may be necessary, including joint repair, replacement, or fusion

Complications of Arthritis

Arthritis can cause various complications if left unattended or poorly managed, such as:

• Without proper arthritis treatment, inflammation can cause permanent damage to nearby bone, cartilage, and tendons. 
• Rheumatoid arthritis can lead to inflammation in other body parts, including the lungs, heart, eyes, and blood vessels, leading to numerous conditions, such as pleurisy, pericarditis, scleritis, and vasculitis.
• Carpal tunnel syndrome is another common complication, particularly in people with rheumatoid arthritis. This condition causes aching, numbness, and tingling in the hands due to median nerve compression.
• Cardiovascular disease risk increases in people with rheumatoid arthritis, potentially leading to life-threatening problems like heart attacks and strokes. 
• Long-term rheumatoid arthritis can increase the risk of cervical myelopathy, a serious condition affecting the spine that may require surgery.
• In severe cases, arthritis can make daily tasks challenging, affecting a person's ability to walk comfortably or maintain proper posture. 

When to See a Doctor

It's advisable to make an appointment with a doctor if:

• Joint symptoms persist for three days or more
• Several episodes of joint symptoms occur within a month
• Home treatments haven't helped after about a week
• Pain affects multiple joints
• Joints hurt severely
• Pain doesn't subside after rest
• Joints suddenly turn red or hot

Prevention

While arthritis can't always be prevented, people can take steps to diminish their risk of developing painful joints as they age. 

• Maintaining a healthy body weight is vital, as excess pounds put pressure on weight-bearing joints. Losing just 1 pound can take 4 pounds of pressure off the knees in people with knee osteoarthritis.
• Regular exercise plays a vital role in arthritis prevention. It strengthens muscles around joints, stabilising them and protecting against wear and tear. Doctors or physical therapists may recommend a combination of exercises:
  • Endurance exercises like walking or swimming (30 minutes, five days a week)
  • Strength exercises using weights or resistance bands (2 sessions weekly)
  • Flexibility exercises such as stretching or yoga (4-5 days a week)
  • Balance exercises like tai chi (a few times weekly)
• Other preventive measures include:
  • Using proper safety equipment during sports
  • Quitting smoking, which can lower the risk of rheumatoid arthritis
  • Setting up ergonomic workspaces to prevent joint strain
  • Controlling blood sugar, as diabetes is linked to an increased risk of osteoarthritis

Conclusion

While arthritis may not always be preventable, individuals can take proactive steps to diminish risk and manage symptoms effectively. Maintaining a healthy weight, exercising regularly, and adopting healthy lifestyle habits are essential to protect joint health. By staying informed about arthritis and working closely with doctors, people can develop personalised strategies to live well with this condition and minimise its effects on their lives.

FAQ's

1. How common is arthritis?

Arthritis affects millions of people worldwide. It's estimated that more than 15% of the population have arthritis in their joints. Osteoarthritis, the most common type, affects approximately 80% of adults older than 55, with about 60% experiencing noticeable symptoms.

2. At what age does arthritis usually start?

Arthritis can develop at any age, even in children and teenagers. However, the onset age varies depending on the type:

• Osteoarthritis typically affects adults over 50.
• Rheumatoid arthritis often starts between ages 30 and 60.
• Gout can affect men in their mid-20s and women after menopause.
• Ankylosing spondylitis usually occurs between ages 20 and 30.

3. What is the fastest way to relieve arthritis pain?

To quickly relieve arthritis pain, try:

• Taking over-the-counter painkillers 
• Applying heat or cold therapy
• Using topical NSAID creams
• Engaging in gentle exercises
• Trying relaxation techniques

4. Do certain types of weather make arthritis worse?

Many people report that weather affects their arthritis pain. Cold, rainy days and changes in barometric pressure often trigger flare-ups. Some studies have shown a correlation between joint pain and humidity, air pressure, and wind speed. However, the scientific evidence is mixed, and the effects can vary from person to person.

Dr. Mir Zia Ur Rahaman Ali

MBBS, D.Ortho, DNB Ortho, MCh Orth (UK), AMPH (ISB)
CARE Medical Center, Tolichowki, Hyderabad, CARE Multispeciality Clinic, Srinagar Colony, Hyderabad, CARE Hospitals Outpatient Centre, Banjara Hills, Hyderabad

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+91 406 810 6585