Arthritis

Contents

1. What is arthritis?
2. Most common types of arthritis
3. Symptoms
4. Causes
5. Diagnosis
6. Treatment

What is arthritis?

Arthritis is a common condition that causes pain and inflammation in a joint. There are over ten million people in the UK suffering from arthritis or other joint-related conditions.[1] It can affect people of all ages, and there are various degrees of severity and types of arthritis. The common symptoms usually include pain and stiffness around the affected joint, with some types of arthritis also affecting the immune system and internal organs.

Most common types of arthritis

There are more than 100 different types of arthritis so it’s important to see a doctor if you are concerned about your symptoms.[2] However, there are two that are far more common. Osteoarthritis and rheumatoid arthritis are the two most common types of arthritis.

Osteoarthritis

Osteoarthritis is the most common type of arthritis, affecting nearly nine million people in the UK.[3] It can occur at any age and is usually a result of an injury or associated with other joint related conditions like gout or rheumatoid arthritis. It generally develops after the age of 50-60 years old, but some studies suggest that is can occur in women in their 40s too.

Osteoarthritis affects the smooth cartilage lining of the joint making it painful and stiff. Once the cartilage lining starts to thin out, the tendons and ligaments have to work harder. This often leads to inflammation and pain.  If a large amount of cartilage is lost, it can cause bone to rub against bone altering the shape of the joint and forcing the bones out of their normal structure. This is most common in hands, spine, knees and hips.

Rheumatoid arthritis

Rheumatoid arthritis affects more than 400,000 people in the UK.[4] It occurs when the body’s immune system targets affected joints causing pain and swelling. The outer covering of the joint, called the synovium, is the first place affected. This often spreads across the joint creating more inflammation and changing the joints shape. The bone and cartilage may also break down. The typical age for developing rheumatoid arthritis is between 30-50 years old. Rheumatoid arthritis patients are also at risk of developing problems with other tissues and organs in their bodies.

Other types of arthritis

While osteoarthritis and rheumatoid arthritis are the most common types of arthritis, there are many other types too. Here are some of them:

• Ankylosing Spondylitis: This is a long term inflammatory condition that affects the bones, muscles and ligaments of the spine. It first occurs in the sacroiliac joints and progresses up the vertebral column causing symptoms including back pain and swelling of tendons and joints.
• Cervical Spondylosis: Affects the joints and bones in the neck causing pain and stiffness.
• Fibromyalgia: Caused by a dysfunction of the central nervous system including the brain and spinal cord. It causes pain in the body’s ligaments, muscles and tendons.
• Psoriatic arthritis: An inflammatory joint condition typically affecting people with psoriasis. It is an autoimmune inflammatory disease whereby the immune system attacks the body, particularly the skin and joints, causing a skin rash and pain.
• Gout: A type of inflammatory arthritis where high levels of uric acid cause pain. If your body produces too much uric acid or you are unable to remove excess quickly enough, it can build up in blood while excess uric acid can cause crystals in joints.
• Lupus: A complex autoimmune inflammatory disease affecting many parts of the body including joints, skin, brain and other organs. It can cause joint pain, headaches and chest pain among other symptoms.

Symptoms

As like most things, symptoms vary depending on the individual and the type of arthritis you have. Symptoms of arthritis usually develop over time, but they can also appear suddenly.  Here are some of the most common symptoms of arthritis:

Symptoms of osteoarthritis:

• Pain and stiffness around one or more joints
• Limited range of movement
• Clicking and popping
• Buckling joints
• Muscle weakness 

Symptoms of rheumatoid arthritis:

• Morning stiffness
• More than one affected joint
• Fatigue
• Low fever
• Inflammation of the heart muscle, blood vessels, eyes and mouth.
• Low red blood cell count

If you suffer with any of these symptoms then it’s important to seek medical advice to get a thorough diagnosis and treatment.

Causes

Experts are unsure what specifically causes many types of arthritis, but they do know that it is generally caused by injury, wear and tear, and age. We also know that Gout is caused by too much uric acid in the body and sometimes infections can cause arthritis too.

Some studies suggest that arthritis may also be caused by genes and family history, muscle weakness, autoimmune disorders and obesity.[5]

Risk factors

But you can decrease your risk of getting arthritis or making it worse by changing the factors that you can control. Here’s a few things you can do to minimise your risk:

• Weight – Try to maintain a healthy weight and exercise regularly. Excess weight can put stress on joints and osteoarthritis is more prevalent in those who are overweight.
• Joint Injuries – Injuries and repetitive stress can contribute to the potential risk of osteoarthritis. Protect your joints from injuries and do physio to target healing joints when medically advised.
• Infection – Bacteria and viruses can infect joints, potentially causing arthritis. See a doctor in your joints are swollen, warm or red as it may be an infection.
• Smoking – Smoking increases a person’s risk of developing rheumatoid arthritis along with other medical conditions too. If you smoke, try stopping to help avoid this.

Diagnosis

Arthritis is usually diagnosed by analysing a patients medical history and doing a physical examination including questionnaires, x-rays, MRI scans and blood tests.

Physical examination

The physical examination will check for fluids, warmth and redness around the joints. It will also document the range of motion. You may be referred to a specialist, or you can see a rheumatologist who manages and rehabilitates patients with disorders of the musculoskeletal system.

Blood tests

Doctors can determine what type of arthritis you have by measuring inflammation levels in your blood and aspirating and analysing fluids.

Blood tests for specific types of antibodies, such as anti-cyclic citrullinated peptide (CCP), rheumatoid factor (RF), and antinuclear antibody (ANA), are also common diagnostic procedures.[6]

If you are diagnosed with arthritis then there is plenty of support and treatment to help you cope with it. The sooner you understand your arthritis, the quicker you can begin managing it, reducing pain, and implementing healthy lifestyle changes.

Treatment

Treating arthritis can be categorised three ways: controlling the pain, minimising the joint damage and improving or maintaining physical function and quality of life.[7] There are multiple medications you can try to ease the pain of your diagnosis too.

Types of medication

• Analgesics like hydrocodone or acetaminophen are effective for pain management, but do not reduce inflammation.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and salicylates help manage both pain and inflammation.
• Steroids like prednisone help reduce inflammation but should be taken cautiously and only when medically prescribed.
• Menthol or capsaicin creams ease the pain by blocking the transmission of pain signal from your joints.

Seek medical advice and discuss these treatments with your doctor before trying any of these medications.

Lifestyle changes

If you would rather try treating your arthritis naturally before taking medication then there are many lifestyle changes you can make, depending on your diagnosis. Some of these include:

Physiotherapy

Physical therapy helps to strengthen the weaker muscles surrounding the affected joint. Your physical therapist will likely create an exercise plan for you to follow, which will include daily movement exercises that you can do in your own time to build strength. This will help build strength, flexibility, balance and mobility.

Regular exercise

Regular exercise can give you more energy and help relieve arthritis pain and stiffness. Exercise also improves your mood making you feel more positive and happy. Make sure you modify your physical activity program to suit your capabilities to ensure that you don’t push yourself too hard and to avoid injuring yourself.

Cold compresses

Cold ice packs numb the sore area and reduce inflammation and swelling so are good to use when suffering with arthritis.

Hot compresses

Heat therapy is an easy, medication-free way to relieve some types of arthritis stiffness and pain. It encourages the healing of damaged tissue. The warmth dilates the blood vessels of the muscles, increasing the flow of oxygen and nutrients to the muscles. However it is not recommended to do heat therapy for over 30 minutes.

If you are diagnosed with arthritis then there are plenty of ways to treat it and ease the pain through either medication or treatment. With a few lifestyle changes you’ll be able to manage the pain and live a healthy lifestyle.

Sources:

1. Arthritis Foundation. How Arthritis Hurts - https://www.arthritis.org/health-wellness/healthy-living/managing-pain/understanding-pain/sources-of-arthritis-pain 
2. Britannica, Arthritis disease - https://www.britannica.com/science/arthritis
3. Centres for Disease Control and Prevention, Arthritis - https://www.cdc.gov/arthritis/basics/risk-factors.htm
4. Centres for Disease Control and Prevention, Arthritis, FAQs about Arthritis - https://www.cdc.gov/arthritis/basics/faqs.htm 
5. Centres for Disease Control and Prevention, Arthritis, Arthritis Types - https://www.cdc.gov/arthritis/basics/types.html
6. NHS, Arthritis Overview - https://www.nhs.uk/conditions/arthritis/