Tuesday, November 4, 2014

What is arthritis?







What is arthritis?

The US National Library of Medicine1 says that if you have trouble moving around or feel pain and stiffness in your body, you could have arthritis. In the majority of cases arthritis causes pain and swelling in the joints.
Eventually a swollen joint can suffer severe damage. In some cases, arthritis can cause problems in the patient's eye, skin or other organs.
According to the Centers for Disease Control and Prevention (CDC)2, about 1 in every 5 American adults, i.e. 50 million people, have doctor-diagnosed arthritis. As the country's population ages, it is estimated that this number will increase to at least 67% by 2030.
Arthritis is not a single disease - it is a term that covers over 100 medical conditions. Osteoarthritis (OA) is the most common form of arthritis and generally affects elderly patients. Some forms of arthritis can affect people at a very early age.

What causes arthritis?

In order to better understand what is going on when a person suffers from some form of arthritis, let us look at how a joint works.
Diagram of a Joint
Basically, a joint is where one bone moves on another bone. Ligaments hold the two bones together. The ligaments are like elastic bands, while they keep the bones in place your muscles relax or contract to make the joint move.
Cartilage covers the bone surface to stop the two bones from rubbing directly against each other. The covering of cartilage allows the joint to work smoothly and painlessly.
A capsule surrounds the joint. The space within the joint - the joint cavity - has synovial fluid. Synovial fluid nourishes the joint and the cartilage. The synovial fluid is produced by the synovium (synovial membrane) which lines the joint cavity.
If you have arthritis something goes wrong with the joint(s). What goes wrong depends on what type of arthritis you have. It could be that the cartilage is wearing away, a lack of fluid, autoimmunity (your body attacking itself), infection, or a combination of many factors.
Arthritis Research UK3 says that most types of arthritis are caused by a combination of several factors working together. The following factors may contribute towards a higher arthritis risk:
  • Your genetic makeup
  • A physically demanding job, especially one with repetitive movements
  • A previous injury
  • Some infections or allergic reactions may cause short-term arthritis. When it is caused by an infection it is known as "reactive arthritis"
  • For a number of people certain foods can either bring on arthritis symptoms, or make existing ones worse
  • Obesity, which places extra strain on joints4
  • Arthritis may also be caused by autoimmune disease5.
Recent developments on arthritis causes from MNT news
Does cracking knuckles cause arthritis? - Cracking one's knuckles, also known as "popping", is a kind of joint manipulation that produces a cracking sound. It is a deliberate action.
In fact, humans are able to crack several joints, including the ankles, shoulders, feet, jaws, toes, neck and back vertebrae, elbows, wrists and hips.
Two studies showed that chronic knuckle cracking does not appear to increase the risk of hand osteoarthritis, but may reduce the strength of your grip.
Dr. Donald Unger won the Ig Nobel Prize in Medicine after spending 60 years cracking the knuckles on his left hand but not his right. He reported that neither hand had arthritis after all that time, or other problems.

Types of arthritis

There are over 100 types of arthritis. Here is a description of some common ones, together with the causes:

Osteoarthritis

With osteoarthritis, the cartilage loses its elasticity. If the cartilage is stiff it becomes damaged more easily. The cartilage, which acts as a shock absorber, will gradually wear away in some areas. As the cartilage becomes damaged tendons and ligaments become stretched, causing pain. Eventually the bones may rub against each other causing very severe pain.

Rheumatoid arthritis

This is an inflammatory form of arthritis. The synovial membrane (synovium) is attacked, resulting in swelling and pain. If left untreated the arthritis can lead to deformity.
Rheumatoid arthritis is significantly more common in women than men and generally strikes when the patient is aged between 40 and 60. However, children and much older people may also be affected.
During the first ten years after diagnosis, patients with rheumatoid arthritis have a higher risk of blood clots.

Infectious arthritis (septic arthritic)

Infectious arthritis is an infection in the synovial fluid and tissues of a joint. It is usually caused by bacteria, but could also be caused by fungi or viruses.
Bacteria, fungi or viruses may spread through the bloodstream from infected tissue nearby, and infect a joint.
Most susceptible people are those who already have some form of arthritis and develop an infection that travels in the bloodstream.

Juvenile rheumatoid arthritis (JRA)

Juvenile rheumatoid arthritis is a type of arthritis that affects a person aged 16 or less. JRA can be various forms of arthritis; it basically means that a child has it.
There are three main types:
  1. Pauciarticular JRA, the most common and mildest. The child experiences pain in up to 4 joints.
  2. Polyarticular JRA affects more joints and is more severe. As time goes by it tends to get worse.
  3. Systemic JRA is the least common. Pain is experienced in many joints. It can spread to organs. This can be the most serious JRA.



Signs and symptoms

Osteoarthritis of the knee
The most commonly affected joints with osteoarthritis are in the hips, hands, knees and spine.
The symptoms of arthritis depend on the type, for example:

Osteoarthritis

The symptoms of osteoarthritis develop slowly and get worse as time goes by. There is pain in a joint, either during or after use, or after a period of inactivity. There will be tenderness when pressure is applied to the joint. The joint will be stiff, especially first thing in the morning.
The patient may find it harder to use the joint - it loses its flexibility. Some patients experience a grating sensation when they use the joint. Hard lumps, or bone spurs may appear around the joint. In some cases the joint might swell.
The most commonly affected joints are in the hips, hands, knees and spine.

Rheumatoid arthritis

The patient often finds the same joints in each side of the body are painfully swollen, inflamed, and stiff. The fingers, arms, legs and wrists are most commonly affected.
Symptoms are usually worst on waking up in the morning and the stiffness can last for 30 minutes at this time. The joint is tender when touched. Hands may be red and puffy. There may be rheumatoid nodules (bumps of tissue under the skin of the patient's arms).
Many patients with rheumatoid arthritis feel tired most of the time. Weight loss is common.
The smaller joints are usually noticeably affected first. Experts say patients with rheumatoid arthritis have problems with several joints at the same time.
As the arthritis progresses it spreads from the smaller joints in your hands, wrists, ankles and feet to your elbows, knees, hips, neck, shoulders and jaw.

Infectious arthritis

The patient commonly has a fever, joint inflammation and swelling with infectious arthritis. They will feel tenderness and/or a sharp pain. Often these symptoms are linked to an injury or another illness.
Most commonly affected areas are the knee, shoulder, elbow, wrist and finger. In the majority of cases just one joint is affected.

Juvenile rheumatoid arthritis

The patient is a child and will experience intermittent fevers which tend to peak in the evening and then suddenly disappear. Appetite will be poor and weight may be lost.
There may be blotchy rashes on arms and legs. Anemia is also common. The child may limp or have a sore wrist, finger, or knee. A joint may suddenly swell and stay larger than it usually is. The child may experience a stiff neck, hips or some other joint.

How will it affect me?

Arthritis affects people in many different ways. How long the patient is affected and how severely it is depends on the type of arthritis. Arthritis sufferers will find there are good and bad days. Most patients with arthritis will suffer from discomfort, pain, stiffness and/or fatigue.
You may also feel frustrated that you are no longer able to grip things so well or get around like you used to. It is important to remember that if you suffer from arthritis this does not mean you have to give up having an active lifestyle. With some changes to your way of life there is no reason why you cannot continue being active.

Physical therapy and occupational therapy

Physical therapy and occupational therapy help maintain joint mobility and range of motion. How much therapy you need, and what kind of therapy will depend on many factors, such as the severity and type of arthritis you have, your age, and your general state of health. This has to be decided by you with your physician and physical or occupational therapist.
People with arthritis will often avoid moving the affected joint because of the pain. A physical therapist can help the patient work out the joint stiffness without damaging it. In order to perform your daily activity the physical therapist will help you achieve a good range of motion. This may involve building strength in the muscles that surround the affected joint - stronger muscles help stabilize a weakened joint. You will also be taught the best way to move from one position to another, as well as learning how to use such walking aids as crutches, a cane or a walker, if you need one.
Physical therapy, apart from significantly improving function and reducing pain, has been shown to delay the need for surgical intervention in advanced cases8.
Occupational therapy can teach you how to reduce the strain on your joints as you go about your daily activities. The occupational therapist can help you modify your home and workplace so that your movements do not aggravate your arthritis. You may need a splint for your hands or wrists, as well as aids for dressing, housekeeping, work activities, driving and washing/bathing yourself.
An occupational and/or physical therapist can make an enormous difference to your quality of life if you suffer from arthritis. He/she will help you learn more about your arthritis, devise a dietary plan if you are overweight and over-stressing the joints as a result, help you make better decisions about what shoes to buy if that part of the body is affected.
You will learn how and when to rest - rest is crucial for treating inflammation and pain, especially when many joints are affected and you feel tired. Resting individual joints is very helpful too - custom splints can be made to rest and support affected joints.
Local pain can be relieved with ice packs or heating pads. Ultrasound and hot packs provide deep heat which relieves localized pain and relaxes muscle spasm around the affected joint. You may find that a warm bath/shower makes it easier for you to exercise afterwards.
Physical activity can improve arthritis symptoms - doctors warn that inactivity could harm the health of most patients with arthritis or some kind of rheumatic disease. Inactivity raises the risk of cardiovascular disease and diabetes type 2. Muscles become weaker with no exercise, joints become stiffer, and the patient's tolerance for pain decreases. Balance problems may also become worse.
Arthritis patients who are physically active generally enjoy better health, are happier, live longer, experience improvements in pain, sleep, day-to-day functioning and general energy levels.
David Borenstein, MD, American College of Rheumatology President and practicing rheumatologist says:
"Many people with arthritis and rheumatic diseases suffer from joint pain and stiffness, which can cause a person to avoid exercise out of the fear of increasing their pain or causing injury. However, exercise, when properly planned and safely executed, can do just the opposite."
The American College of Rheumatology offers the following tips for those wishing to embark on an exercise plan:
  • Check with your rheumatologist first
  • Ask your physical therapist for advice
  • Set realistic goals, both short- and long-term ones. Include rewards for each achievement
  • Plan ahead, so that you can identify pitfalls, obstacles or problems for your exercise program, and how to overcome them
  • For variety, create a range of physical activities and do them in different locations
  • Try starting off with friends or family members
  • Keep a log of what you do so that you are aware of your progress.

 

No comments:

Post a Comment