Arthritis Treatment

What is Arthritis?

Arthritis is the pain and inflammation of one or more joints. It is not a single disease but refers to joint pain or joint disease, with over 100 types of arthritis and related conditions. Arthritis is very common, especially in people older than the age of 50. An orthopaedic doctor helps determine the type of arthritis, its causes and the treatment plan needed. Understanding arthritis can help manage it better.

Arthritis can affect any joint however, it is most common in:

• Hands and wrists

• Hips

• Knees

• Ankles and feet

• Lower back (lumbar spine)

• Shoulders

Note: Consult a doctor if you’re experiencing joint pain that is severe enough to hamper daily life activities and movement.

Arthritis Disease Types

There are over 100 different types of arthritis. However, it can be categorised into the following major types:

Inflammatory Arthritis

Inflammation occurs as a defence against virus and bacteria or as response to certain injuries. Inflammatory arthritis affects different joints and the inflammation damages the surface of the joint and the underlying bone.

Some of the examples of inflammatory arthritis include:

• Rheumatoid arthritis

• Reactive arthritis

• Ankylosing spondylitis

• Psoriatic arthritis

Mechanical or Degenerative Arthritis

Mechanical or degenerative arthritis refers to a group of conditions that mainly involves cartilage damage. To compensate for the loss of cartilage and alterations in joint function, the body remodels the bone as an attempt to restore normal stability. This leads to the development of undesirable bony growths, called osteophytes. This causes pain, stiffness, swelling and other symptoms in the joint. This condition is commonly referred to as osteoarthritis (OA).

Connective Tissue Disease

Connective Tissue Disease (CTD) involves pain and inflammation in the joints. Some examples of CTD are:

• Dermatomyositis

• Systemic sclerosis or scleroderma

• Lupus arthritis

• Sjögren disease

Infectious Arthritis

A bacterium, fungus or virus that enters a joint can sometimes cause inflammation. A doctor can treat this type of joint infection with antibiotics. However, if the infection persists for some time, the arthritis can become chronic.

Metabolic Arthritis

Accumulation or build-up of uric acid in some individuals leads to formation of needle-like crystals in the joint. This results in sudden episodes of extreme joint pain or gout flare-up.

-Gout may come and go in episodes and can also become chronic if the uric acid levels do not reduce.

Childhood Arthritis

Childhood arthritis encompasses different types of arthritis in children. Juvenile rheumatoid arthritis (JRA) also known as Juvenile idiopathic arthritis (JIA) is the most common type. Childhood arthritis causes permanent damage to the joints. While the cure has not been found yet, remission is possible.

Septic Arthritis

Septic arthritis is joint inflammation caused by a fungal or bacterial infection. It most commonly affects the knee and hip area. The following conditions may increase the risk of septic arthritis:

• Existing joint damage or disease

• Bacterial infection in the body

• Artificial joint implants

• Chronic illness such as diabetes

• Recent joint injury

• Medications that suppress the immune system

• Conditions affecting the immune system, such as HIV

• Old age

Arthritis Symptoms

Common arthritis symptoms include:

• Pain in the joints

• Reduced range of motion or stiffness

• Inflammation or swelling

• Skin discolouration

• Tenderness to touch around the joint

• A feeling of warmth or heat near the joints

Note: Some types of arthritis can cause signs and symptoms in waves that come and go (flare-ups), while others may cause persistent pain and stiffness.

Causes of Arthritis Disease

The causes of arthritis disease depend on its type.

• Osteoarthritis happens naturally due to ageing- a lifetime of using the joints can eventually wear down the cartilage cushioning.

• Hyperuricemia or too much uric acid in the blood can cause gout.

• Scleroderma, lupus, and rheumatoid arthritis are caused by the body’s immune system attacking the body itself.

• Some types of arthritis can be genetic. For instance, people with the genetic marker HLA-B27 are at a greater risk of ankylosing spondylitis.

Arthritis Risk Factors

Arthritis risk factors can be categorised as modifiable and non-modifiable.

Non-modifiable Risk Factors 

1. Age: The older an individual gets, the more are the chances of having arthritis

2. Gender: Woman are more likely to have arthritis as compared to men

3. Family history: Some types of arthritis such as rheumatoid arthritis are linked to certain genes.

Modifiable Risk Factors 

1. Weight: Being obese or overweight can damage the knee joints. This increases the risk of osteoarthritis.

2. Injury: An individual with a joint that has been damaged due to an injury is more likely to develop arthritis.

3. Infection: Reactive arthritis can impact joints after an infection.

4. Occupation: Work that involves repeated squatting or bending can lead to knee arthritis.

How Do Doctors Diagnose Arthritis?

For the diagnosis of arthritis, a doctor will examine the medical history and recommend physical examination. Some blood tests may also be done including:

• ANA (antinuclear antibody) test: This type of test assesses the antibody levels in the blood.

• CBC (complete blood count): This test checks if the white blood cell, red blood cell and platelet count is normal.

• Creatinine: This test detects kidney disease.

• Hematocrit: This test measures the percentage of red blood cells in the blood.

• CCP (cyclic citrullinated peptide) and RF (rheumatoid factor) antibody tests: These tests help diagnose rheumatoid arthritis and also assess the severity of the disease.

• Uric acid tests: This helps diagnose gout.

• X-rays and other imaging tests: These imaging tests help determine how damaged a joint is.

• Arthrocentesis (joint aspiration): A sample of synovial fluid is taken from a joint. It is tested to check for the presence of viruses, bacteria or crystals.

Arthritis Treatment

Treatment of arthritis depends on the symptoms, age and general health of an individual. It will also depend on the type of arthritis and the severity of the condition. There is no cure for arthritis, however, the goal of treatment is to limit pain, inflammation and ensure optimum joint function. Arthritis treatment includes both short-term and long-term methods.

• Short-term treatments
  
  

1. Medications

Short-term relief from pain and inflammation may include administering pain relievers.

2. Physical Therapy

Heat and cold: Pain may be eased by using moist heat (warm showers) or dry heat (heating pad) on the joint. Pain and swelling may be eased by applying an ice pack wrapped in a towel on the joint.

Joint immobilisation: The use of brace or splint can help protect the joint from further damage or injury.

Acupuncture: This involves the use of thin needles inserted at specific points in the body. This stimulates the release of pain-relieving chemicals made by the nervous system.

• Long-term treatments

Disease modifying antirheumatic drugs (DMARDs): This type of prescription medicines slow down the disease and treat immune system problems linked to the disease.

Corticosteroids: Corticosteroids help reduce inflammation. These medicines can be taken orally or as an injection.

Surgery:

There are different types of surgery, depending on the joints affected. The two most common surgical options for arthritis are:

1. Spinal fusion or ankle fusion

2. Arthroplasty (partial or total joint replacement)

Note: Complete recovery after surgery for arthritis takes up to 6 months.

How to Prevent Arthritis

Working on lifestyle changes help improve the quality of life and prevent arthritis, including:

• Do low-impact aerobics and range-of-motion exercises

• Following a healthy and balanced diet plan

• Avoiding use of tobacco products and smoking

• Wearing proper protective equipment to protect the joints from any damage.

FAQs

What is the fastest way to treat arthritis?

Being overweight increases the risk of osteoarthritis or makes it worse. Staying active is the best way to relieve symptoms of arthritis. Low-impact exercises can help reduce pain and stiffness in the joint, and when paired with a balanced diet can also manage weight.

How will arthritis affect my life?

Arthritis causes joint pain and inflammation, leading to reduced mobility and weakness. Trouble sleeping, tiredness and exhaustion are common symptoms of arthritis that can greatly affect daily life activities and wellbeing.

Is arthritis hereditary?

Some types of arthritis are linked to genetic factors. The inheritance pattern of rheumatoid arthritis, for instance, involves both genetic and environmental factors. Having a close relative with rheumatoid arthritis increases an individual’s risk of developing the condition.

Can arthritis be cured?

Even though there is no cure for arthritis, treatment started at an early stage can help relieve symptoms. Also, working on lifestyle changes such as following a low-impact exercise routine can help improve the quality of life.

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