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Arthritis
Arthritis information ::
Patient Info Handouts
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?
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.
What are the different types of arthritis?
There are over 100 different types of arthritis. 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.
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.
Predisposing factors to Osteoarthritis of hip.
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.
How can a doctor diagnose arthritis?
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 severity of 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.
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