Arthritis is a complex family of musculoskeletal disorders. It consists of more than 100 different diseases or conditions that destroy joints, as well as the bones, muscles, cartilage, and connective tissue around the joint, hampering physical movement and causing pain.
The most common of these are Rheumatoid Arthritis (RA), Osteo Arthritis (OA), and Juvenile Arthritis (JA). Most of us do not understand that these are all distinctly different disorders falling into the category of arthritis, and I shall strive to differentiate between RA and OA, the two that most commonly affect seniors. Patients across the spectrum experience pain, stiffness, inflammation, and soreness, and this may be why we tend to lump all forms of arthritis together.
RA is an autoimmune disease where the body makes antibodies that attack its own tissues and joints. The exact causes of RA are unknown but the important factors are:
• It affects predominantly females.
• Can occur at any age, from children to the elderly, peaking around 50 to 55.
• There is some evidence of genetic predisposition but environmental factors are very important in triggering onset (causes unknown, though definite increase with cigarette smoking has been evidenced). The majority of patients have no family history.
This disease causes inflammation of the synovial membrane that lines the joints. Symptoms that are specific to RA are fatigue, lack of appetite, low-grade fevers, body aches, and stiffness. It affects several joints at once in a symmetrical pattern and the most common joints affected are the small joints of the hands and feet. The pain experienced with RA is typically worse at the start of the day and eases as the body warms up over the day.
OA, on the other hand, is a symptom of degeneration of the joint as a result of external factors such as traumatic physical injury, excessive sports or physical activities over the course of decades causing wear and tear of the joints. This results in degeneration of the cartilage that cushions the area where two bones meet to form a joint. When that cushion wears out or cracks, the bones rub together, resulting in intense pain. Calcium can build up on the bones and in the soft tissues making them stiff and painful to move. The pain of OA builds up gradually with use as the day progresses. Age, weight, and physical stress are related to the development of OA and weight loss and exercise play an important part in reducing pain and improving function, especially in the knee.
A third form of arthritis that tends to be neglected and often incorrectly treated is gout. This is a very specific form of arthritis caused by uric acid crystal deposits in joints and soft-tissue. It is eminently treatable in this day and age by reducing the uric acid.
But of course not all joint pain is arthritis, which is why diagnosis begins with a comprehensive history. Blood tests may be helpful in confirming the presence of an autoimmune disease and x-rays will demonstrate the extent of the damage to cartilage and bones.
Though a specialty area has evolved around the treatment of arthritis called rheumatology, and treatment will ideally involve a team of professionals, your general practitioner should be consulted in the early stages for a diagnosis and maybe referral to the specialist team. The rheumatologist with whom I consulted stressed the importance of early diagnosis especially in RA, in order to slow the process and resultant deformities, so instead of waiting to see a rheumatologist she advocated a visit to the GP as soon as possible.
The rheumatologist will head up a team including physiotherapists, occupational therapists with an orthopaedic surgeon, and neurologist being brought in as needed. The team may also include a hand therapist, orthotist, and podiatrist as required.
There is no known cure for arthritis, so treatment focuses on the alleviation of symptoms.
Drugs are used to slow the progress of the disease, ease the symptoms of inflammation and stiffness, and manage the pain. This will involve varying combinations to find the best fit for the patient. The rheumatologist who heads the team will be responsible for the drug regime.
Occupational therapy will focus on helping you manage your daily life around the pain, assisting you in making adjustments where necessary. It may also involve making splints to rest or support the joints.
The physiotherapist will devise a programme of exercise and advise on how to increase activity and avoid further injury. They may also draw on an array of treatments that ease pain such as heat or ice packs, massage, acupuncture, to mention a few. They will also guide you in the use of walking aids such as sticks or crutches to keep you mobile.
The orthopaedic surgeon will be involved should the replacement of a joint be considered necessary. With the development of medical science, the replacement of a joint that has collapsed due to OA has become the treatment of choice in recent years.
These days many are drawn to complementary and alternative forms of medicine to ease their pain. There is a wide array available, from various cultural and historical backgrounds. If you want to take supplements, discuss it with your medical team. Evidence supporting the use of glucosamine and chondroitin supplements is not conclusive and some studies have found them to be no better than a placebo.
But diet is probably the most important aspect of complementary medicine. There are plenty of myths around the foods that increase inflammation and a visit to this website will be useful if you think you can cure your arthritis by diet. The ideal diet involves plenty of fish rich in Omega 3, fruit, vegetables, nuts and seeds, beans, and olive oil. Being overweight aggravates all joint pain, so a healthy diet with moderate intake of alcohol and no processed foods is ideal.
The Arthritis Foundation have been a valuable resource for me in writing this article. They perform a valuable role in providing education around the management of the disease. You can visit them by clicking here.
Article by: Hilary Henderson
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