Bones, joints, and muscles

What is arthritis?

Arthritis is an illness characterized by pain and swelling in the joints. The origin of the word arthitis is Greek, from arth- meaning "joint" and -itis, meaning "inflammation." This is sometimes a misnomer, however, since not all types of arthritis involve inflammation. Specifically, arthritis is a broad term used to refer to more than 100 conditions that can cause pain in the body's joints. Arthritis can also lead to health complications affecting other organs in the body such as the eyes or skin.

It is sometimes thought that arthritis affects only older adults. This is a common misconception. Arthritis affects millions of people—men, women, and children of all ages.

Types of arthritis

There are five types of arthritis, as outlined below.

Osteoarthritis

Also known as degenerative joint disease, osteoarthritis is the most common form of arthritis and usually develops later in life. It commonly affects only a few joints, namely the fingers, knees, and hips. It's believed osteoarthritis is caused by wear and tear on the joints over time. It's also believed chemical and genetic factors may play a role in the development of osteoarthritis.¹ Osteoarthritis can sometimes develop following an injury. For example, hockey players or football players who suffer a debilitating knee injury may, years later, develop osteoarthritis in their knees.²

Rheumatoid arthritis

Rheumatoid arthritis is considered an auto-immune disease; it occurs because the body's immune system does not function properly. Rheumatoid arthritis affects the entire body. Because rheumatoid arthritis is an autoimmune disease, it can also affect internal organs—the body's own immune system attacks tissues and joints. Over time, such attacks on the joints' tissues can lead to tissue and joint damage. Rheumatoid arthritis primarily affects the hands, wrists, and feet and occurs in a much younger age group. It is also more common in women than in men. Children too can be affected by the disease. Those suffering from rheumatoid arthritis experience stiffness, pain, deformity, and occasionally fever. In most cases, pain and stiffness can be relieved with medication. Deformity can be prevented through a combination of medication, rest, exercise and joint protection.³

Gout

Gout is a type of arthritis resulting from a disorder of the body's metabolism. Gout occurs because of a build up of uric acid in the body. Crystals develop in the joints, causing pain, redness, and swelling. Gout commonly affects only one joint at a time, most commonly the big toe, although it can also affect the foot, ankles, knees, and hands. Gout is ten times more common in men than in women. Fortunately, many people never suffer more than one attack of gout, and there is minimal or no damage to the joint as a result. Repeated attacks, however, can lead to joint damage. Treatment of gout involves the use of medications to reduce the inflammation and to lower the level of uric acid in the body. Another recommended treatment is to reduce the intake of foods such as organ meats, legumes, and poultry which are known to be high in a substance called purine. High levels of purine can increase uric acid levels in the body. Alcohol consumption can also trigger gout in some people.⁴

Pseudo-gout

Similar to gout, pseudo-gout involves the buildup of calcium crystals, rather than uric acid crystals. Treatment of both gout and pseudo-gout involves anti-inflammatory medications.

Ankylosing spondylitis

Ankylosing spondylitis is an inflammatory disease affecting the spine and the joints between the spine and pelvis. It isn't clear at this time what causes ankylosing spondylitis. People suffering from ankylosing spondylitis begin to develop symptoms between age 20 and 40. The condition is more common in males than in females. Ankylosing spondylitis is characterized by pain and stiffness in the lower back and hips, particularly after resting. Pain can also occur in the chest, knees, and ankles. Pain has been known to improve with activity and exercise. As a person gets older, progression of the disease slows or stops, and the inflammatory process in ankylosing spondylitis becomes less. Treatment of ankylosing spondylitis involves the use of anti-inflammatory medication (to prevent or reduce joint damage and relieve inflammation and pain) and regular exercise (to maintain the mobility of the joints).⁵

Causes of arthritis

As mentioned, rheumatoid arthritis is an auto-immune disease and sports-related injuries can sometimes lead to osteoarthritis. Other medical conditions may also lead to arthritis. These include:⁶

• lupus, in which the body's defense system can harm the joints, heart, kidneys, and other organs
• scleroderma
• viral hepatitis, in which an infection of the liver can cause arthritis
• nerve impairment
• increased or decreased function of the endocrine glands
• infections such as tuberculosis, gonorrhea, Lyme disease, or rheumatic fever

Other risk factors include age, gender, and obesity. Repetitive injuries such as those incurred by typists, for example, and physical trauma can sometimes lead to osteoarthritis.

Symptoms of arthritis

• joint pain
• joint swelling
• stiffness, particularly in the early morning
• warmth around joints
• redness of the skin around joints
• unexplained weight loss
• weakness accompanying joint pain

Treatment of arthritis

The inflammation common in arthritis can by accompanied by redness or pain. Mild symptoms of arthritis can be controlled with proper care and treatment. Other, more severe symptoms of arthritis, if left untreated, can lead to severe disability. Treatment depends on the type of arthritis. Common to all types of arthritis, however, is the importance of early diagnosis. The earlier a diagnosis is made, the sooner treatment can begin and the sooner treatment can help avoid disability and permanent damage.⁷

Symptomatic treatment of arthritis may include heat, physical therapy, and aspirin, corticosteroids, or nonsteroidal anti-inflammatory medications such as acetominophen, ibuprofen, or naproxen. Remission can sometimes be achieved through penicillamine, gold salts or steroids, but these medications can often have undesirable side effects including gastrointestinal bleeding, hypertension, cataracts, thinning of bones, upset stomach, and increased infections. In severe cases of arthritis, orthopedic surgery, including artificial joint implants, may be necessary.⁸

A common feature in arthritis is the underproduction of synovial fluid, a fluid produced by the body to lubricate joints. A recent development in the treatment of arthritis involves injecting arthritic joints with a manmade version of synovial fluid known as Hylan G-F. This type of treatment may postpone the need for orthopedic surgery—at least temporarily — in more severe cases of arthritis.⁹

If you have any symptoms of arthritis and you suspect you may have the disease, consult your physician or other health care provider. Early diagnosis and treatment may mean less disability in the long run. Your doctor can diagnose arthritis through physical examination, x-rays, and bloodwork. Once a firm diagnosis of arthritis has been made, your doctor can then set up a treatment program to reduce the pain and disability associated with arthritis.

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