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Arthritis What Should You Know

Arthritis: Causes, Symptoms, Diagnosis, and Treatment

Arthritis What Should You Know

Arthritis is the swelling and tenderness of one or more of your joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. The most common types of arthritis are osteoarthritis and rheumatoid arthritis.

Arthritis is a common disorder that affects your joints. It can cause pain and inflammation, making it difficult to move or stay active. There are many types of arthritis. Each form causes different symptoms and may need different treatments. While arthritis usually affects older adults, it can develop in men, women and children of any age.

Osteoarthritis causes cartilage — the hard, slippery tissue that covers the ends of bones where they form a joint — to break down. Rheumatoid arthritis is a disease in which the immune system attacks the joints, beginning with the lining of joints.

he most common form of arthritis is osteoarthritis. Other common rheumatic conditions related to arthritis include gout, fibromyalgia, and rheumatoid arthritis (RA).

Rheumatic conditions tend to involve pain, aching, stiffness, and swelling in and around one or more joints. The symptoms can develop gradually or suddenly. Certain rheumatic conditions can also involve the immune system and various internal organs of the body.

What Is Arthritis?

The word arthritis is used to describe pain, swelling and stiffness in a joint or joints. Arthritis isn’t a single condition and there are several different types.

Around 10 million people in the UK are thought to have arthritis. It can affect people of all ages – even children and teenagers. Some forms of arthritis are more common in older people.

If you have pain in or around a joint or joints that doesn’t go away after a few days, you should see a doctor. Finding out what’s causing your pain is key to finding the right treatment and self-help options.

Although there’s no cure for arthritis, treatments have improved greatly in recent years and, for many types of arthritis, particularly inflammatory arthritis, there’s a clear benefit in starting treatment at an early stage.

It may be difficult to say what has caused your arthritis. There are several factors that can increase the risk of each type of arthritis. It could be that the genes you inherited from your parents or grandparents made you more likely to get arthritis.

Arthritis can make life tough by causing pain and making it harder to get about. The symptoms of arthritis can vary from week to week, and even from day to day. Many types, such as osteoarthritis and rheumatoid arthritis, are long-term conditions.

However, with the right treatment and approach you can manage your symptoms.

Whatever condition you have, remaining physically active will help you stay mobile and will be good for your general health.

Types of Arthritis

Some of the more common types of arthritis are:

Osteoarthritis. This is the most common type. It causes the cartilage on the ends of your bones to wear away. That makes the bones rub against each other. You might have pain in your fingers, knees, or hips.

The cartilage breakdown, or degeneration, of osteoarthritis often happens with age. This is why osteoarthritis is sometimes called degenerative joint disease. But if there are other causes, it can begin much sooner. For example, an athletic injury like a torn anterior cruciate ligament (ACL) or a fracture near a joint can lead to arthritis. It can happen in any joint but most often affects the hands and weight-bearing joints such as the knee, hip, and facet joints (in the spine).

Rheumatoid arthritis. This long-lasting disease can affect joints in any part of the body but most often involves the hands, wrists, and knees. With rheumatoid arthritis, the immune system — the body’s defense system against disease — mistakenly attacks the joints and causes the joint lining to swell. The inflammation spreads to the nearby tissues and can damage cartilage and bone. In more severe cases, rheumatoid arthritis can affect other areas of the body, such as the skin, eyes, and nerves.

Gout. This is a painful condition that happens when the body can’t get rid of a natural substance called uric acid. The excess uric acid forms needle-like crystals in the joints that cause marked inflammation with swelling and severe pain. Gout most often affects the big toe, knee, and wrist joints.

Spondyloarthritis is a word used to describe a number of conditions that cause pain and swelling, mainly around the joints of the spine.

In these conditions there is inflammation of small pieces of connective tissues, called entheses. These are tough little cords that join either ligaments or tendons to bones.

Ankylosing spondylitis is a type of spondyloarthritis and it causes pain and swelling, mainly around the joints of the spine.

In this condition, in response to inflammation around the spine, the body can create more of the mineral calcium. This mineral is normally used by the body to make bones strong. However, in ankylosing spondylitis the extra calcium can make new bits of bone grow in the spine, and this will cause pain and stiffness.

This condition typically causes pain in the second half of the night, and swelling of your back in the morning that lasts for more than half an hour.

There are drugs that can slow this process down. Keeping active will help to minimise stiffening of the spine, while maintaining a good posture will help prevent increased curving of the spine.

Ankylosing spondylitis usually occurs between the ages of 20 and 30. It is more common among men.

Psoriatic arthritis is an auto-immune condition. It is also a type of spondyloarthritis.

The body’s immune system can cause painful swelling and stiffness within and around joints, as well as a red scaly skin rash called psoriasis. The rash can affect several places in the body, including the elbows, knees, back, buttocks and scalp.

It is also common to have severe tiredness, otherwise known as fatigue.

Disease modifying anti-rheumatic drugs (DMARDs) and biological therapies can treat the cause of the inflammation in joints. There is also a variety of treatments, such as creams and medications, for psoriasis.

Psoriatic arthritis usually affects people who already have psoriasis. However, some people develop the arthritis before the psoriasis. It’s possible to have the arthritis but no psoriasis at all.

This condition can affect people of any age, but tends to affect adults.

If someone is diagnosed with inflammatory arthritis before their sixteenth birthday, it’s called juvenile idiopathic arthritis, or JIA.

There are different types of JIA. They are auto-immune conditions, and the immune system can cause pain and swelling in joints.

The earlier someone is diagnosed with JIA, the better. This is so that effective treatment can be started and limit any damage to the body.

There are drugs that can treat the symptoms, such as painkillers and non-steroidal anti-inflammatory drugs (NSAIDs). Disease-modifying anti-rheumatic drugs (DMARDs) and biological therapies can slow down or stop the arthritis causing the swelling inside the body.

What Are The Symptoms Of Arthritis?

Joint pain, stiffness, and swelling are the most common symptoms of arthritis. Your range of motion may also decrease, and you may experience redness of the skin around the joint. Many people with arthritis notice their symptoms are worse in the morning.

In the case of RA, you may feel tired or experience a loss of appetite due to the inflammation the immune system’s activity causes. You may also become anemic — meaning your red blood cell count decreases — or have a slight fever. Severe RA can cause joint deformity if left untreated.

Causes

Different types of arthritis have different causes. For instance, gout is the result of too much uric acid in your body. But for other types of arthritis, the exact cause is unknown. You may develop arthritis if you:

  • Have a family history of arthritis.
  • Have a job or play a sport that puts repeated stress on your joints.
  • Have certain autoimmune diseases or viral infections.

Diagnosed

A diagnosis of arthritis is the first step toward treatment. Your doctor will:

Consider your complete medical history. This will include a description of your symptoms.

Do a physical exam. Your doctor will check for swollen joints, tenderness, redness, warmth, or loss of motion in the joints.

Use imaging tests like X-rays. These can often tell what kind of arthritis you have. X-rays are used to diagnose osteoarthritis, often showing a loss of cartilage, bone spurs, and in severe cases, bone rubbing against bone.

Test your joint fluid. Sometimes, joint aspiration (using a needle to draw a small sample of fluid from the joint for testing) and blood tests are used to tell osteoarthritis from other types.

If your doctor suspects infectious arthritis as a complication of some other disease, testing a sample of fluid from the affected joint will usually confirm the diagnosis and determine how it will be treated.

Test your blood or urine. These tests can help tell your doctor what type of arthritis you have or rule out other diseases as the cause of your symptoms.

Blood tests for rheumatoid arthritis include one for antibodies called rheumatoid factors (RF), which most people with rheumatoid arthritis have in their blood, though RF may also be present in other disorders.

A newer test for rheumatoid arthritis that measures levels of antibodies in the blood (called the anti-CCP test) is more specific and tends to be higher only in people who have or who are about to get rheumatoid arthritis. The presence of anti-CCP antibodies can also be used to predict which people will get more severe rheumatoid arthritis.

Treatment

Treatment for arthritis aims to control pain, minimize joint damage, and improve or maintain function and quality of life.

A range of medications and lifestyle strategies can help achieve this and protect joints from further damage.

Treatment might involve:

  • medications
  • non-pharmacologic therapies
  • physical or occupational therapy
  • splints or joint assistive aids
  • patient education and support
  • weight loss
  • surgery, including joint replacement

Medication

Non-inflammatory types of arthritis, such as osteoarthritis, are often treated with pain-reducing medications, physical activity, weight loss if the person is overweight, and self-management education.

These treatments are also applied to inflammatory types of arthritis, such as RA, along with anti-inflammatory medications such as corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs), disease-modifying anti-rheumatic drugs (DMARDs), and a relatively new class of drugs known as biologics.

Medications will depend on the type of arthritis. Commonly used drugs include:

  • Analgesics: these reduce pain, but have no effect on inflammation. Examples include acetaminophen (Tylenol), tramadol (Ultram) and narcotics containing oxycodone (Percocet, Oxycontin) or hydrocodone (Vicodin, Lortab). Tylenol is available to purchase online.
  • Non-steroidal anti-inflammatory drugs (NSAIDs): these reduce both pain and inflammation. NSAIDs include available to purchase over-the-counter or online, including ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve). Some NSAIDs are available as creams, gels or patches which can be applied to specific joints.
  • Counterirritants: some creams and ointments contain menthol or capsaicin, the ingredient that makes hot peppers spicy. Rubbing these on the skin over a painful joint can modulate pain signals from the joint and lessen pain. Various creams are available to purchase online.
  • Disease-modifying antirheumatic drugs (DMARDs): used to treat RA, DMARDs slow or stop the immune system from attacking the joints. Examples include methotrexate (Trexall) and hydroxychloroquine (Plaquenil).
  • Biologics: used with DMARDs, biologic response modifiers are genetically engineered drugs that target various protein molecules involved in the immune response. Examples include etanercept (Enbrel) and infliximab (Remicade).
  • Corticosteroids: prednisone and cortisone reduce inflammation and suppress the immune system.

Prevent

Some of the causes of arthritis can’t be prevented, such as your family history, age or sex. But there are some risk factors you can do something about:

  • Eat a healthy diet.
  • Be physically active.
  • Maintain a healthy weight.
  • Don’t drink too much alcohol.
  • Quit smoking.
  • Doing low-impact, non-weight bearing exercise.
  • Maintaining a healthy body weight.
  • Reducing your risk of joint injuries.

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