Arthritis

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Over time, many people begin to feel pain and stiffness in their bodies. It is natural to wonder if these symptoms are a normal part of aging or if in fact they are indicative of something bigger.

If you are having problems with your joints and find that they are sore, swollen or hard to move – you may have arthritis. Arthritis is caused by inflammation in and around the body’s joints and is an umbrella term used to describe more than 100 diseases and conditions.

Arthritis is often overlooked by the public because it is not a cause of death like heart disease or cancer. Yet it can take a huge toll on a person’s quality of life through the pain and problems that it causes.

If you or a loved one has been diagnosed with arthritis, it is important to learn more about the disease and its potential impact. In this section, you can get acquainted with the facts about arthritis, the many different types of arthritis and the symptoms it can cause. Learn about risk factors and the steps you can take to keep your joints healthy and prevent arthritis.

For those who want to know more about the tests used to identify arthritis, an overview is available in the diagnosis section. While arthritis can be painful, there are many things you can do to feel better. Relief is available through treatment options offered by doctors and specialists. These can help you live better with the disease.

What is Arthritis?

Arthritis is inflammation in and around the body’s joints. While arthritis is often referred to as a single disease, it is in fact a term used to describe more than 100 diseases and conditions that affect the musculoskeletal system, specifically joints. A joint is where two or more bones meet, such as the hip or the knee.

Arthritis is common in adults over the age of 65, however can affect people of all age groups. The main symptoms of arthritis include joint pain and stiffness, which typically worsen with age. This can result in joint weakness, instability and deformities that may interfere with the most basic daily tasks such as walking, dressing or driving a car.

The most common types of arthritis are osteoarthritis, rheumatoid arthritis and gout.

What causes arthritis?

Although the cause of arthritis is not yet known, there are several risk factors for arthritis:

  • Age: The risk of arthritis, in particular osteoarthritis, increases with age.
  • Family history: Certain types of arthritis can run in families, so you may be at more risk of developing arthritis if a blood relative also has the disorder.
  • Gender: Generally, arthritis tends to occur more frequently in women than in men.
  • Weight: Carrying excess weight puts stress on joints, particularly your knees, hips and spine. As a result, being overweight increases your likelihood of developing arthritis.
  • Previous injury: People who have injured a joint, perhaps while playing a sport, are more likely to eventually develop arthritis in that joint.
  • Work factors: Some jobs that require repetitive movements or heavy lifting can cause stress in the joints and/or an injury, which can lead to arthritis.
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Depending of the type of arthritis you have, the symptoms of arthritis can vary. However, the most common signs and symptoms involve the joints. These may include:

  • Pain
  • Stiffness
  • Swelling
  • Redness
  • Tenderness
  • Decreased range of motion
  • Fatigue, fever or a rash alongside joint inflammation

If you are suffering from any of the above symptoms, it is important to see your doctor.

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There are over 100 different types of arthritis, but below is an overview of four of the most common forms of this disease.

  • Osteoarthritis: Osteoarthritis is the most widespread form of arthritis. It is a chronic condition that develops when the joint’s cartilage deteriorates. Cartilage is the part of the joint that cushions the ends of the bones and allows for easy movement. The breakdown in cartilage eventually leads to friction and joint damage, causing stiffness, pain and loss of movement in the joint. Osteoarthritis often affects more than one joint, and occurs quite commonly in the hip, knee, lower back, neck and certain joints in the finger.
  • Rheumatoid arthritis: Rheumatoid arthritis is quite different from osteoarthritis. It’s an inflammatory form of arthritis and a chronic autoimmune disease. In rheumatoid arthritis, for reasons no one fully understands, the immune system starts to attack its own tissues lining the joints. As a result of the attack, fluid builds up in the joints, leading to flare-ups that make the joints swell and cause parts of the body to ache. Fatigue is also a common symptom of rheumatoid arthritis. In rheumatoid arthritis, small joints are typically affected first, such as the joints of the fingers and toes.
  • Gout: Gout develops when tiny, needle-like crystals of uric acid (a biological waste product) accumulate in joints. This causes swelling and extreme sensitivity, making it a painful and potentially debilitating form of arthritis. Gout occurs much more frequently in men than women, and its incidence increases with age. This disorder usually affects one joint at a time, most often the big toe, but also occasionally a knee, ankle, wrist, foot or finger. Lifestyle changes, including losing excess body weight and limiting consumption of alcohol, are important in controlling the symptoms of gout.
  • Psoriatic arthritis: Psoriatic arthritis is a form of arthritis that affects some people who have psoriasis, a chronic skin condition characterised by red patches of skin topped with silvery scales. Most people are first diagnosed with psoriasis and then develop psoriatic arthritis later, although is some people the arthritis can occur before the skin condition appears. Psoriatic arthritis can affect any part of the body, and symptoms range from relatively mild to severe. Common symptoms are joint pain, stiffness and swelling, and disease flares may alternate with periods of remission. Psoriatic arthritis, like psoriasis, is life-long so the focus is on managing symptoms and preventing damage to the joints.
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Diagnosing arthritis can be challenging due to the many possible conditions that can cause joint discomfort. For that reason, a doctor must rely heavily on your medical history, description of symptoms, as well as a physical exam. During a physical exam, your doctor will check your joints for swelling, redness and warmth, and will also need to see how well you can move your joints.

Doctors can usually determine at the first appointment whether your symptoms are caused by arthritis or another musculoskeletal problem. But it may take several visits to make a more specific diagnosis regarding the particular type of arthritis. Depending on the type of arthritis suspected, your doctor may suggest the following tests:

  • Laboratory tests: This involves analysing different bodily fluids, including blood, urine and joint fluid, to help determine the type of arthritis you may have.
  • Imaging: Imaging tests are used to identify joint damage that may be causing your symptoms. Some forms of imaging commonly used for arthritis are:
    • X-rays: Joint abnormalities such as cartilage loss, bone damage and bone spurs are often visible in X-rays. However, damage caused at the onset of arthritis may not be detected using X-rays.
    • Computerised tomography (CT): CT scanners take X-rays from different angles, assembling the information into a three-dimensional picture. CT scans can visualise both bone and surrounding tissues and are used to evaluate joints for hidden fractures, torn cartilage and other structural abnormalities.
    • Magnetic resonance imaging (MRI): MRI can produce more detailed images of soft tissues and is helpful to assess cartilage, tendons, ligaments and joint inflammation.
    • Ultrasound: Many doctors are using ultrasound to identify inflammation and joint damage. This technology uses sound waves to evaluate fluid in soft tissues and to see abnormalities in muscles and tendons.
  • Arthroscopy: During this procedure, your doctor will insert a small flexible tube through an incision near your joint to look for possible joint damage. The tube, called an arthroscope, then transmits images from inside the joint to a video screen.
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Treatment options depend on the type and severity of arthritis. In general, arthritis treatment focuses on relieving painful symptoms and increasing joint mobility. There are several different types of treatments, and you may need to try a combination of these to figure out what works best for you.

  • Medications: Medications commonly used to treat arthritis include:
    • Analgesics: These help to minimise pain, but do not work on reducing inflammation.
    • Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs reduce both pain and inflammation. Some types of NSAIDs are available over-the-counter, such as ibuprofen, while others are available only by prescription. They can also be purchased as creams or gels for topical use.
    • Counterirritants:  Ointments that contain menthol or capsaicin can be rubbed on the skin over your joint. These help to relieve pain by interfering with the pain signals sent from the joint.
    • Disease-modifying antirheumatic drugs (DMARDs): Often used to treat rheumatoid arthritis, DMARDs slow or stop your immune system from attacking your joints. These have been shown to reduce the signs and symptoms of rheumatoid arthritis as well as slow the progression of the disease.
    • Corticosteroids: These anti-inflammatory agents may be injected into the affected joints to temporarily relieve osteoarthritis pain. They are not recommended for more than 2 to 4 treatments per year. These can also be taken orally for the treatment of rheumatoid arthritis.
  • Alternative treatments: Massage therapy, acupuncture, yoga and tai chi are sometimes recommended to relieve pain associated with arthritis, improve range of motion and strengthen the muscles surrounding joints.
  • Surgery: If conservative measures aren’t enough, your doctor may suggest surgery, such as joint replacement or joint fusion. Joint replacement, most commonly performed on hips and knees, is a procedure that removes your damaged joint and replaces it with an artificial one. Joint fusion is used most often for smaller joints, such as those in the wrist, ankle and fingers. It removes the ends of the two bones in the joint and then locks those ends together until they heal into one rigid unit.
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There are a few simple steps you can take to prevent arthritis:

  • Be physically active: Regular and moderate, low-impact exercises are helpful in reducing your risk of developing arthritis. Experts especially recommend strength training, stretching and water workouts. The stronger the muscles are around your joints, the greater the pressure they take off those joints.
  • Maintain a healthy weight: Maintaining a healthy weight reduces stress on your weight-bearing joints and limits future joint injury.
  • Protect your joints: Protecting your joints, especially during sports or high-impact activities, is an important way to reduce the risk of developing arthritis in the future.
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