Arthritis

From learning about the importance of exercising regularly to fully understanding your
arthritis medications, the information contained in this section is meant to provide you
with insights, information and tips that can be used by you to help make living with
arthritis a little bit more manageable.

Click on the links below to take you to the particular part of the section.

What is arthritis?
What are the different types of arthritis?
What causes osteoarthritis?
Predisposing factors to osteoarthritis of hip
Predisposing factors to osteoarthritis of knee
What are the symptoms of arthritis?
How can a doctor diagnose arthritis?
What you can do?
What your doctor can do for you?
Treatment Options
Does exercise really help those who have arthritis?
Can special diets treat arthritis?
Summary

What is arthritis?

Arthritis is a general term covering more than 100 different conditions.

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.

There are over 100 different types of rheumatic diseases. The most common are:

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, knees, and hips.

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 or 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.

Fibromyalgia. This chronic disorder causes pain throughout the tissues that support
and move the bones and joints. Pain, stiffness, and localized tender points occur in the muscles and tendons, particularly those of the neck, spine, shoulders, and hips. Fatigue and sleep disturbances may also occur.

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.

Infectious arthritis. Arthritis can be caused by an infection, either bacterial or viral,
such as Lyme disease. When this disease is caused by bacteria, early treatment with antibiotics can ease symptoms and cure the disease.

Reactive arthritis. This is arthritis that develops after a person has an infection in the
urinary tract, bowel, or other organs. People who have this disease often have eye
problems, skin rashes, and mouth sores.

Psoriatic arthritis. Some people who have psoriasis, a common skin problem that
causes scaling and rashes, also have arthritis. This disease often affects the joints at
the ends of the fingers and can cause changes in the fingernails and toenails.
Sometimes the spine can also be affected.

Systemic lupus erythematosus. Also called lupus or SLE, this is an autoimmune
disease. When a person has an autoimmune disease, the immune system attacks itself, killing healthy cells and tissue, rather than doing its job to protect the body from
disease and infection. Lupus can inflame and damage a person's joints, skin, kidneys, lungs, blood vessels, heart, and brain. African American women are three times more
likely to get lupus than Caucasian women. It is also more common in Hispanic, Asian,
and American Indian women.

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

Polymyalgia rheumatica. Because this disease involves tendons, muscles, ligaments,
and tissues around the joint, symptoms often include pain, aching, and morning
stiffness in the shoulders, hips, neck, and lower back. It is sometimes the first sign of
giant cell arteritis, a disease of the arteries characterized by inflammation, weakness, weight loss, and fever.

Polymyositis. Causing inflammation and weakness in the muscles, this disease can
affect the whole body and cause disability.

Psoriatic arthritis. This form of arthritis occurs in some persons with psoriasis, a scaling
skin disorder, affecting the joints at the ends of the fingers and toes. It can also cause changes in the fingernails and toenails. Back pain may occur if the spine is involved.

Bursitis. This condition involves inflammation of the bursa, small, fluid-filled sacs that
help reduce friction between bones and other moving structures in the joints. The inflammation may result from arthritis in the joint or injury or infection of the bursa.
Bursitis produces pain and tenderness and may limit the movement of nearby joints.

Tendinitis. Also called tendonitis, this condition refers to inflammation of tendons
(tough cords of tissue that connect muscle to bone) caused by overuse, injury, or a rheumatic condition. Tendinitis produces pain and tenderness and may restrict
movement of nearby joints.

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.

Some people may have congenital abnormalities of the joints-for example, Perthes'
disease of the hips-that cause early degeneration and subsequently cause osteoarthritis.
 

Some conditions may predispose the hip to osteoarthritis, It tends to affect people as
they get older and particularly affects joints that have to take a lot of stresses and
strains.

• A previous fracture that involved the hip.
• Growth abnormalities of the hip (such as a shallow socket) may lead to premature arthritis.
• Some childhood hip problems later cause hip arthritis (for example, a type of childhood hip fracture known as a Slipped Epiphysis; also Legg-Perthe's Disease).
• Inactive lifestyle- Obesity (overweight) Your weight is the single most important
  link between diet and arthritis, as being overweight puts an additional burden on your hips, knees, ankles and feet.

Predisposing factors to Osteoarthritis of Knee.

Abnormalities of knee joint function resulting from fractures of the knee, torn cartilage
and torn ligaments can lead to degeneration many years after the injury. The mechanical abnormality leads to excessive wear and tear - just like the out-of-balance tire that
wears out too soon on your car.

What are the symptoms of arthritis?

There are more than 100 different forms of arthritis, symptoms vary according to the
form of arthritis. Each form affects the body differently.

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 a
joint, early morning stiffness, and skin changes, including rashes.

Doctors diagnose arthritis with a medical history, physical exam and x-rays of the hip.
There is no blood test for osteoarthritis.

What you can do?

• Consult a doctor who will determine the type of arthritis you have.
• Rest the joint until the pain subsides to prevent further inflammation.
• To ease the pain or stiffness of the joint, apply heat on the joint for about 15 minutes once or twice a day using a hot water bottle, towel or an infrared lamp.
• Take painkillers or anti-inflammatories, as recommended by your doctor.
• If you are overweight, try to reduce weight to lighten the load on weight-bearing
  joints.
• Participate in regular exercise.

What your doctor can do for you?

There is no cure for arthritis, so beware of 'miracle cures'. Your doctor may prescribe
anti-inflammatory medicine. They may recommend occupational therapy or physiotherapy,
which includes exercises and heat treatment. In severe cases, surgery may be
suggested, such as a hip or knee replacement. The type of surgery will depend on
your age and severityof the disease. In the elderly with severe arthritis, joint
replacement can give good results.

Treatment Options

Initial treatment for osteoarthritis of the hip or 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

Does exercise really help those who have arthritis?

Exercise is very important because it increases lubrication of the joints and strengthens
the surrounding muscles, putting less stress on joints. Exercise in heated swimming
pools-hydrotherapy-can bring enormous relief from pain and stiffness.
Also studies have shown that exercise helps people with arthritis by reducing joint pain
and stiffness and increasing flexibility, muscle strength and energy. It also helps with
weight reduction and offers an improved sense of well-being.

Can special diets treat arthritis?

But what if you have arthritis - are diet and nutrition still such a simple matter?
Can what you eat cure your arthritis? Can food prevent it from occurring?
Are there foods that can cause your arthritis to 'flare' or go into remission?
What role do vitamins and nutritional supplements play in the treatment of arthritis?
Will losing (or gaining) weight help ease your symptoms?
Will taking powerful anti-arthritic medications affect your appetite or your ability to eat
certain foods?

These are the sorts of questions that people with arthritis often ask, and they're valid questions.
Some questions (Can what you eat cure your arthritis?) have simple answers (No). Some
questions (Are there foods that can cause your arthritis to 'flare' or go into remission?)
aren't so straightforward (Perhaps...).

Most of what you need to know about diet and nutrition is common sense; healthy
eating is pretty much the same for anyone, whether you have arthritis or not. But there are exceptions.

Summary

From learning about the importance of exercising regularly to fully understanding your
arthritis medications, the information contained in this section is meant to provide you
with insights, information and tips that can be used by you to help make living with
arthritis a little bit more manageable.

For people with arthritis, learning to make it part of your life can be difficult. But
learning as much as you can about your particular type of arthritis and actively working with your arthritis treatment team are two very effective ways of regaining control over your life.
There is plenty of information, some specific to arthritis and some not, that can be very
helpful to someone facing the challenges associated with having a chronic or lifelong disease.

Our suggestion is - don't let arthritis beat you. Take control. How? Arm yourself with as
much information as possible. Learn from the experiences of others in similar circumstances. What we're presenting here is a virtual toolbox of tips for living well
with arthritis. Some may work for you one day and not the other. Some may work for
you but not others. That's why we've tried to cover several topics. There are plenty
of tools or tips here. Use them or refer to them when you need them. Call upon
them when you require help.