Arthritis and inflammatory conditions are some of the most common chronic health conditions. Arthritis impacts one out of every four American adults, some 54.4 million people. That number is expected to explode to 70 million people by the year 2040. Due to the chronic pain it causes, arthritis is one of the leading causes of work disability.
Because arthritis affects so many people, causing pain and limiting mobility for millions, it is important to understand this condition, its different forms and how they can be treated. Arthritis actually includes more than 100 different diseases and conditions affecting the joints. Here’s a look at some of the more common types.
The most common form of arthritis is osteoarthritis, affecting more than 30 million adults in the United States. Osteoarthritis affects joints but does not impact internal organs, as do some other forms of arthritis.
Osteoarthritis occurs when the cartilage, the hard and slippery tissue between our joints, wears down. Cartilage helps our bones to glide over one another when we bend our joints, such as the fingers, knees, elbows, toes and hips. If the cartilage deteriorates completely, the result is bone rubbing against bone. This causes pain, swelling and stiffness. Bone spurs may also result, and if a piece of bone or cartilage breaks off and floats in the joint, more pain and discomfort is possible. The most commonly affected joints are the ones in the fingers closest to the nails, thumbs, lower back, knees, neck and hips.
While age and normal wear and tear are major contributing factors to cartilage loss and the onset of arthritis, there are other risk factors, as well. Women are more likely than men to develop osteoarthritis. An injury to a joint can cause damage to the cartilage, accelerating the development of arthritis, even in younger people. Obesity is also a significant risk factor for arthritis in the knees, spine and hips. The extra weight causes added stress to these joints and can hasten cartilage loss. Finally, some types of arthritis can be hereditary.
When someone has osteoarthritis, motion in the affected joint may become increasingly restricted as the pain, stiffness and swelling worsen. This can impact everything from a golf swing to a mundane household task, such as opening a jar.
“Arthritis can substantially and negatively impact a person’s quality of life if not treated,” says Dr. Tracy Munford, an orthopedic surgeon. “While there is not a cure for osteoarthritis, there are steps we can take to help lessen the impact in our patients.”
There is not one test or exam used to diagnose osteoarthritis. Your physician will ask you about your symptoms in detail, conduct a physical examination of the affected joint and may also order an x-ray or MRI. A blood test may be done in order to rule out other possible causes of symptoms.
While there is no cure, various treatments can ease the severity and frequency of symptoms. One of the best is exercise. Strength exercise – using weights or resistance bands – helps to strengthen the muscles that support the joints. Aerobic exercise improves blood flow and helps to control weight. Low-impact exercises, such as cycling or swimming, provide a range of motion for joints and also promote healthy cartilage.
Managing weight is a key component of arthritis treatment – carrying around extra pounds puts greater strain on the hips and knees, worsening symptoms.
Rest is another important strategy for dealing with arthritis. Properly and frequently resting affected joints helps them to recover, reducing pain and swelling. “Everyone should listen to their body, and this is especially true for someone with arthritis,” says Dr. Stephen Brotherton, an orthopedic surgeon. “If your hips or knees are aching, rest temporarily. Don’t overdo your activity and worsen your discomfort level. Get some rest and use an ice pack to help reduce inflammation.”
Medicine can also help. Over-the-counter drugs such as acetaminophen provide pain relief, while ibuprofen and naproxen help with pain and reduce inflammation. However, there can be side effects to taking these medications, so be sure to consult with your doctor before taking any medication on a regular basis. There are also some prescription drugs your physician may recommend.
In some cases, surgery is an option for patients with osteoarthritis. A surgeon can smooth out the surfaces in the joint or reposition them, if necessary. For severely damaged joints, a total or partial replacement may be an option. Knee replacement is a fairly common surgery in which the surgeon resurfaces the damaged portion of the joint, replacing it with metal and plastic components. This process is similar to capping a tooth.
A relatively new approach to treating osteoarthritis is the use of regenerative stem cell therapy, which can be used to regrow cartilage in the joints. The Privia Medical Group North Texas Bone and Joint Clinic, one of the oldest and most established orthopedic practices in North Texas, has provided stem cell treatments to patients since 2014.
Rheumatoid arthritis is an autoimmune disease, meaning the body’s immune system mistakenly attacks healthy cells in the body. In the case of rheumatoid arthritis, the membrane that surrounds and lubricates the joint is attacked, causing inflammation. Eventually, the cartilage and bone in the joint is damaged or destroyed.
Rheumatoid arthritis generally attacks several joints simultaneously, most often joints in the hands, wrists and knees. Unlike osteoarthritis, rheumatoid arthritis frequently affects joints in a symmetrical pattern – in other words, if the right index finger is affected, the left is likely to be, as well. Fever and fatigue sometimes accompany rheumatoid arthritis and the disease can also harm other parts of the body, including the eyes, lungs and heart.
Symptoms of rheumatoid arthritis include:
- Pain, swelling, stiffness or tenderness in more than one joint at the same time.
- The same symptoms on both sides of the body (symmetrical pattern)
- Unexplained weight loss
- Fatigue and weakness
The risk for rheumatoid arthritis increases with age. The greatest onset of new cases occurs in adults in their sixties. Women are more likely than men to be affected and for some people, there are genetic factors involved, as well. Smoking and obesity are also known risk factors for rheumatoid arthritis.
“Effective treatment of rheumatoid arthritis starts with catching the disease early and beginning treatment quickly,” explains Dr. Beth Valashinas, a rheumatologist. “Early and aggressive treatment has proven to give us the best chance of fighting the disease, reducing symptoms and achieving our target of clinical remission.”
As with osteoarthritis, there is no singular test or exam that will produce a diagnosis. However, lab tests can be helpful in identifying certain antibodies in the blood associated with the disease.
The right mix of exercise and rest is especially important for people with rheumatoid arthritis. As with osteoarthritis, exercise produces benefits that can help reduce pain and improve range of motion, but rest is essential to managing the disease. Rheumatoid arthritis tends to flare up periodically, necessitating more frequent rest at these times. In general, short periods of rest are preferable; long intervals between motion can worsen stiffness and pain.
There are a number of medications used to treat rheumatoid arthritis, including the same over-the-counter drugs that may be taken for osteoarthritis. In addition, there are some prescription medications that can help reduce inflammation and others which have been shown to slow the progression of the disease.
Other Types of Arthritis
Fibromyalgia causes pain throughout the body and a number of other symptoms, including irritable bowel syndrome, restless leg syndrome, painful menstruation and difficulty concentrating. The disease affects roughly four million people in the United States, overwhelmingly women. People with rheumatoid arthritis are more likely to also have fibromyalgia.
Fibromyalgia can be effectively treated with medications that help to alleviate pain and inflammation. Getting adequate sleep is one of the keys to managing the disease, as is eating healthy and getting regular exercise. While it is a chronic disease, fibromyalgia is not fatal and can improve over time.
Lupus is another autoimmune disease, in which the body attacks healthy tissue and causes widespread inflammation. Lupus is also much more likely to impact women than men, especially Hispanic, African American and Native American women.
Lupus adversely affects joints, the skin, blood vessels and organs. It may cause a red rash on the face, pain and swelling in the joints, muscle pain, fever and fatigue. Lupus affects people differently – one patient may experience joint pain while another may be impacted by the inflammation of an internal organ.
It can be challenging to accurately diagnose lupus, and rheumatologists are best able to diagnose the disease. As with other forms of arthritis, there is no cure, but lupus can be managed through a series of lifestyle adjustments and medications.
Unlike rheumatoid arthritis, fibromyalgia and lupus, gout primarily affects men. Obesity is also a risk factor. Gout occurs when the body overproduces and/or under-excretes uric acid, causing uric acid crystals to be deposited in the body’s tissue. Gout usually begins in the big toe and can also attack multiple other joints throughout the body.
Gout causes redness, warmth, stiffness, swelling and extreme pain in the affected joint. A flare-up can last for days or weeks. Over time, flare-ups can become more frequent and last longer. Gout is also associated with a greater risk of kidney stones.
The buildup of uric acid can be caused by alcohol consumption, as well as eating too many foods containing purines. Purines are found in foods such as include liver, anchovies, dried beans and peas.
“Gout can be treated effectively with medications that lower uric acid level in the body, while the frequency and severity of flare-ups can be mitigated through dietary changes, avoiding alcohol and losing weight,” says Dr. Rajni Kalagate, a rheumatologist.
Treatment Makes a Difference
Arthritis and inflammation include many different conditions and are some of the most common health concerns, particularly in older people. For some people, a mild case of osteoarthritis may simply cause periodic, minor discomfort that does not interfere with their daily activity or lifestyle. For others, it can be severely limiting and painful. And for patients affected by rheumatoid arthritis, fibromyalgia, lupus or gout, these are serious conditions that will dramatically affect overall health and daily activity if not treated by a physician.
“While there is no cure for arthritis, your physician can give you the best advice and treatment available to reduce pain and make the condition easier to live with,” says Dr. Kalagate. “Our goal is always to manage arthritis and inflammation in a way that protects the patient’s quality of life.”
Arthritis Awareness Month is in May, and the Arthritis Foundation will hold a Walk to Cure Arthritis to raise money and awareness at Levitt Pavilion in Arlington on April 27, 2019. For more details, visit their website.
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