Arthritis

What is Arthritis?

There are more than 100 types of arthritis. Common arthritis symptoms of stiffness, pain and inflammation are usually the result of osteoarthritis or degenerative arthritis. Other types of arthritis include gout and rheumatoid arthritis, lupus and scleroderma to name a few.

More than 43 million Americans have been diagnosed with arthritis; while another 23million suffer with joint pain but have not yet been diagnosed with the condition. According to the Arthritis Foundation, women suffer with arthritis more than men. Currently, 25.9 million women have doctor diagnosed arthritis, whereas men with doctor diagnosed arthritis is approximately 17 million.

Symptoms of Arthritis

• Those suffering with arthritis may experience:
• Pain in the joint
• Swelling around the joint
• Reduced ability to move the joint
• Redness or discoloration of the skin around the joint
• Stiffness, particularly in the morning
• Warmth around the joint

What Causes Arthritis?

There is no definitive cause of arthritis. Some medical professionals attribute certain forms of arthritis to heredity, while others can be possibly attributed to deficiencies in the immune system, overuse of a certain joint, physical trauma to the joint(s), obesity, and/or physical inactivity.

Diagnosis of Arthritis

Signs and tests

A doctor will take a detailed medical history to determine if arthritis or another musculoskeletal problem is the likely cause of persons’ symptoms. A thorough physical examination may indicate that there is fluid collecting in and around the joint. If the joint is infected, there may be redness and warmness particularly with autoimmune and infectious arthritis. A limited range of motion or the inability to turn the joint in some directions may be determined through range of motion tests.

Tests for arthritis are based on the symptoms a person may present with and dependent on the suspected cause of the condition. A physician may perform joint x-rays and blood tests as a part of the diagnostic process. To determine if there is an infection present causing the symptoms, a physician may draw fluid from the joint and examine the fluid under a microscope.

Treatment of Arthritis

Treatment of arthritis depends on a number of factors including which joints are affected, how the condition affects daily living, age, occupation and severity of the symptoms.

If there is an underlying cause of the condition, that will be the primary focus of treatment. However, because the cause of the condition is not necessarily something that can be cured, treatment works to reduce discomfort and pain and preventing further deterioration. Some forms of arthritis can be treated without medication. However, if medication is recommended it should be accompanied by certain lifestyle changes.

Exercise such as low impact aerobics, strength training, and range of motion exercises are recommended to reduce fatigue and pain, relieve stiffness and maintain healthy joints.

Proper rest can be just as important as exercise in addressing arthritis. Sleeping 8 to 10 hours per night can help a person recover from a flare-up faster. Also consider:

• Avoiding staying in one position for too long a time.
• Avoiding movements or positions that places added stress on the affected joint(s).
• Modifying the home to make mobility easier and safer.
• Reducing stress

Medications

A physician will choose from a variety of medications to address arthritis and will most likely select a medication that does not require a prescription first. These include:

• Acetaminophen (Tylenol) – recommended by the American College of Rheumatology and the American Geriatrics Society as the first recommended treatment for osteoarthritis.
• Aspirin, ibuprofen, or naproxen – non-steroid anti inflammatory medication that can be effective in fighting pain. However, for some, there are risks involved with taken this medication, and as such, a physician should be consulted.

Prescription medicines include:

• Biologics – for the treatment of rheumatoid arthritis.
• Corticosteroids (“steroids”) -suppress the immune system and symptoms of inflammation. Corticosteroids are often injected into painful osteo-arthritic joints.
• Cyclooxygenase-2 (COX-2) inhibitors – block inflammation and COX-2.
• Disease-modifying anti-rheumatic drugs – primarily for use with rheumatoid arthritis
• Immunosuppressants – are used for rheumatoid arthritis when other medications have been ineffective.

It is very important to take medications as prescribed by your physician. In some cases, however, surgery is required to rebuild or replace the joint. Surgery is most often recommended when all other options for resolution have been exhausted

In the normal joint, synovial fluid is present that lubricates the joint. For some, synovial fluid is not produced in sufficient quantities to keep the joint properly lubricated. A physician may determine it is necessary to inject the joint with synthetic synovial to provide temporary relief and stave off surgery temporarily.

How to Prevent and Manage Arthritis

There are a few arthritis related conditions that can be completely cured with proper treatment. However, most types of arthritis are chronic and long term conditions. If arthritis is diagnosed and treated early enough, joint damage may be averted. If there is a history of arthritis in the family, inform the doctor even if there are no current joint symptoms.

Excess weight increases the risk for the development of osteoarthritis particularly in the hips and knees. Working with a physician in conjunction with a nutritionist or dietitian to address the weight issues may significantly reduce arthritis symptoms.

References:

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Glass GG. Osteoarthritis. Dis Mon. 2006;52:343-362.

Gregory PJ, Sperry M, Wilson AF. Dietary supplements for osteoarthritis. Am Fam Physician. 2008;77:177-184.

Smolen JS, Aletaha D, Koeller M, Weisman MH, Emery P. New therapies for treatment of rheumatoid arthritis. Lancet. 2007;270(9602):1861-74.