Arthritis

If you feel pain and stiffness in your body or have trouble moving around, you might have arthritis.

Most kinds of arthritis cause pain and swelling in your joints. Joints are places where two bones meet, such as your elbow or knee. Over time, a swollen joint can become severely damaged. Some kinds of arthritis can also cause problems in your organs, such as your eyes or skin.

Types of arthritis include:

  • Osteoarthritis is the most common type of arthritis. It's often related to aging or to an injury.
  • Autoimmune arthritis happens when your body's immune system attacks healthy cells in your body by mistake. Rheumatoid arthritis is the most common form of this kind of arthritis.
  • Juvenile arthritis is a type of arthritis that happens in children.
  • Infectious arthritis is an infection that has spread from another part of the body to the joint.
  • Psoriatic arthritis affects people with psoriasis.
  • Gout is a painful type of arthritis, it typically starts in the big toe and occurs when too much uric acid builds up in the body. 

Early diagnosis and treatment can help prevent joint damage. If you have a family history of arthritis, tell your doctor, even if you do not have joint pain.

Avoiding excessive, repeated motions may help protect you against osteoarthritis.

 

Certain factors are associated with a greater risk of arthritis. Some of these risk factors are modifiable while others are not.

NON-MODIFIABLE RISK FACTORS

  • Age: The risk of developing most types of arthritis increases with age.
  • Gender: Most types of arthritis are more common in women; 60% of the people with arthritis are women. Gout is more common in men.
  • Genetic: Specific genes are associated with a higher risk of certain types of arthritis, such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), and ankylosing spondylitis.

MODIFIABLE RISK FACTORS

  • Overweight and Obesity: Excess weight can contribute to both the onset and progression of knee osteoarthritis.
  • Joint Injuries: Damage to a joint can contribute to the development of osteoarthritis in that joint.
  • Infection: Many microbial agents can infect joints and potentially cause the development of specific forms of arthritis.
  • Occupation: Certain occupations involving repetitive knee bending and squatting are associated with osteoarthritis of the knee.

Arthritis involves the breakdown of cartilage. Normal cartilage protects a joint and allows it to move smoothly. Cartilage also absorbs shock when pressure is placed on the joint, such as when you walk. Without the normal amount of cartilage, the bones rub together. This causes, swelling, and stiffness.

Joint inflammation may result from:

  • An autoimmune disease (the body's immune system mistakenly attacks healthy tissue)
  • Broken bone
  • General "wear and tear" on joints
  • Infection, usually by bacteria or virus

In most cases, the joint inflammation goes away after the cause goes away or is treated. Sometimes it does not. When this happens, you have chronic arthritis. Arthritis may occur in men or women. Osteoarthritis is the most common type.

Other, more common types of arthritis include:

  • Ankylosing spondylitis
  • Crystal arthritis, gout, pseudogout
  • Juvenile rheumatoid arthritis (in children)
  • Bacterial infections
  • Psoriatic arthritis
  • Reactive arthritis (Reiter syndrome)
  • Rheumatoid arthritis (in adults)
  • Scleroderma
  • Systemic lupus erythematosus (SLE)

 

Arthritis causes joint pain, swelling, stiffness, and limited movement.

Symptoms can include:

  • Joint pain
  • Joint swelling
  • Reduced ability to move the joint
  • Redness and warmth of the skin around a joint
  • Joint stiffness, especially in the morning

The health care provider will perform a physical exam and ask questions about your medical history.

The physical exam may show:

  • Fluid around a joint
  • Warm, red, tender joints
  • Difficulty moving a joint (called "limited range of motion")

Some types of arthritis may cause joint deformity. This may be a sign of severe, untreated rheumatoid arthritis.

Blood tests and joint x-rays are often done to check for infection and other causes of arthritis.

Your doctor may also remove a sample of joint fluid with a needle and send it to a lab to be checked.

 

The goal of treatment is to reduce pain, improve function, and prevent further joint damage. The underlying cause often cannot be cured.

Lifestyle Changes

Lifestyle changes are the preferred treatment for osteoarthritis and other types of joint swelling. Exercise can help relieve stiffness, reduce pain and fatigue, and improve muscle and bone strength. Your health care team can help you design an exercise program that is best for you.

Exercise programs may include:
  • Low-impact aerobic activity (also called endurance exercise)
  • Range of motion exercises for flexibility
  • Strength training for muscle tone

Your health care provider may suggest physical therapy.

This might include:
  • Heat or ice
  • Splints or orthotics to support joints and help improve their position; this is often needed for rheumatoid arthritis
  • Water therapy
  • Massage
Other things you can do include:
  • Get plenty of sleep. Sleeping 8 to 10 hours a night and taking naps during the day can help you recover from a flare-up more quickly, and may even help prevent flare-ups.
  • Avoid staying in one position for too long.
  • Avoid positions or movements that place extra stress on your sore joints.
  • Change your home to make activities easier. For example, install grab bars in the shower, the tub, and near the toilet.
  • Try stress-reducing activities, such as meditation, yoga, or tai chi.
  • Eat a healthy diet full of fruits and vegetables, which contain important vitamins and minerals, especially vitamin E.
  • Eat foods rich in omega-3 fatty acids, such as cold water fish (salmon, mackerel, and herring), flaxseed, rapeseed (canola) oil, soybeans, soybean oil, pumpkin seeds, and walnuts.
  • Avoid excessive alcohol and smoking.
  • Apply capsaicin cream over your painful joints. You may feel improvement after applying the cream for 3 to 7 days.
  • Lose weight, if you are overweight. Weight loss can greatly improve joint pain in the legs and feet.

Medicines

Medicines may be prescribed along with lifestyle changes. All medicines have some risks. You should be closely followed by a doctor when taking arthritis medicines.

Over-the-counter medicines:
  • Acetaminophen (Tylenol) is often the first medicine tried. 
  • Aspirin, ibuprofen, or naproxen are nonsteroidal anti-inflammatory drugs (NSAIDs) that can relieve arthritis pain. However, they can carry risks when used for a long time. 
Prescription medicines:
  • Biologics are used for the treatment of autoimmune arthritis. These drugs can improve the quality of life for many patients, but can have serious side effects.
  • Corticosteroids ("steroids") help reduce inflammation. They may be injected into painful joints or given by mouth.
  • Disease-modifying anti-rheumatic drugs (DMARDs) are used to treat autoimmune arthritis. 
  • Immunosuppressants are used to treat patients with rheumatoid arthritis when other medications have not worked.
  • For gout, medications may be used to the lower your uric acid levels.

It is very important to take your medicines as directed by your doctor. If you are having problems doing so (for example, because of side effects), you should talk to your doctor. Also make sure your doctor knows about all the medicines you are taking, including vitamins and supplements bought without a prescription.

SURGERY AND OTHER TREATMENTS

In some cases, surgery may be done if other treatments have not worked. This may include:

  • Joint replacement, such as a total knee joint replacement

 

A few arthritis-related disorders can be completely cured with proper treatment.

Most forms of arthritis however are long-term conditions.