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Understanding Arthritis

Arthritis and inflammatory conditions are some of the most common chronic health conditions. Arthritis impacts one out of four American adults, some 58.5 million people.  As our population grows and ages, the number of people affected by arthritis will only continue to increase: by 2040, 78.4 million U.S.  adults are projected to have arthritis.

Because arthritis affects so many people, causing pain and limiting mobility, it is important to understand this condition, its different forms and how they can be treated.   Arthritis includes more than 100 different diseases and conditions affecting the joints, as well as the skin and organs in some cases. 

Certain physicians – including many who are part of Privia Medical Group North Texas – specialize in treatment of various types of arthritis, including orthopedic and sports medicine physicians, rheumatologists, pain management specialists and physical medicine and rehabilitation specialists/physiatrists.   Here’s a look at some of the more common types of arthritis.  

Osteoarthritis

The most common form of arthritis is osteoarthritis, affecting more than 32.5 million adults in the United States. 

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. 

Common risk factors for osteoarthritis include:

  • Age
  • Injury to a joint
  • Overuse of joints; repetitive stress
  • Gender: women are more likely to develop osteoarthritis
  • Obesity: extra weight causes added stress to joints, especially the knees, hips and spine

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. 

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:

  • Exercise: while it may seem counter-intuitive to exercise as a way of treating pain, it can really help! By strengthening the muscles that support the joints, you’ll help relieve some of the stress on them.  Aerobic exercise improves blood flow, which is also beneficial to the joints.  Both forms of exercise burn calories, which in turn helps us lose weight. 
  • Losing weight:  If you are overweight, losing a few pounds can help improve arthritis, especially if it’s your hips or knees that are bothering you.  Excess pounds mean extra work for your joints – so any time you can lighten the load they are carrying, that’s a good thing!
  • Rest:  Resting affected joints helps them to recover, reducing pain and swelling. It’s important to balance rest with exercise. 

“While there is no cure for osteoarthritis, there are multiple treatment options that can lessen the pain and stiffness,” explains Dr. Ade Adedokun, a physiatrist in Fort Worth.  “Getting exercise, losing weight if needed and knowing when to rest your body are all steps that will help most people suffering from osteoarthritis.  Additional measures may also be helpful, depending on the specific situation.” 

Your doctor may recommend medication to treat osteoarthritis.  This could include over-the-counter drugs such as acetaminophen, ibuprofen and naproxen.  These may all help with pain while reducing inflammation.  With any of these treatments, follow your doctor’s guidance – there can be side effects to taking these medications long-term.  Your doctor may also decide a prescription drug is appropriate. 

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. 

Regenerative stem cell therapy is sometimes used to regrow cartilage in the joints.  The Privia Medical Group North Texas Bone and Joint Clinic has successfully provided stem cell treatments to patients with joint conditions for nearly a decade. 

Rheumatoid Arthritis

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 in the hands, wrists and knees.  Unlike osteoarthritis, rheumatoid arthritis frequently affects joints in a symmetrical pattern – for example, if the right knee is affected, the left knee 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. 

Old man holding knee from pain

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)
  • Fever
  • 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. 

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 key to successfully treating rheumatoid arthritis is catching it early,” explains Dr. Rajni Kalagate, a Fort Worth rheumatologist.  “We often see the best success when a diagnosis occurs within six months of the onset of symptoms – so, if you begin experiencing any unexplained changes in your body, it’s best to get in and see your health care provider right away.” 

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.  At the same time, 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

Fibromyalgia causes pain throughout the body and symptoms such as 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

Another autoimmune disease, Lupus causes the body to attack healthy tissue, creating 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, 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. 

While it can be challenging to accurately diagnose lupus, 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. 

Gout

Unlike many other forms of arthritis, 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.  The condition 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 liver, anchovies, dried beans and peas. 

“The onset of gout can be treated effectively with medications that help lower uric acid level in the body.  Dietary improvements, avoiding alcohol and losing weight will help reduce the frequency and severity of gout,” says Dr. Beth Valashinas, a rheumatologist in Fort Worth.           

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, 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.  Patients affected by rheumatoid arthritis, fibromyalgia, lupus or gout must undergo treatment to manage the disease’s impact on quality of life and daily activity. 

“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. William Moore, a pain management specialist in Fort Worth.  “Our goal is always to manage arthritis and inflammation in a way that protects the patient’s quality of life.”     

This article has been reviewed and approved by a panel of Privia Medical Group North Texas physicians. 

This article contains information sourced from:

The National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health

The U.S. Centers for Disease Control and Prevention

The Mayo Clinic

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