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Arthritis
Arthritis
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What is arthritis?
The term arthritis literally means inflammation of a joint, but is
generally used to describe any condition in which there is damage to
the cartilage. Inflammation is the body's natural response to injury.
The warning signs that inflammation is present are redness, swelling,
heat and pain.
The cartilage coats the joint surfaces to absorb stress, and allow
smooth joint movement. The proportion of cartilage damage and synovial
inflammation (the lining and fluid in the joint capsule) varies with
the type and stage of arthritis. Usually the early pain is due to
inflammation. Later in the disease, pain is from the irritation of the
worn joint structures
and inability of the joint to move properly.
What are the different types of
arthritis?
There are over 150 different types of
rheumatic diseases.
e.g., Osteoarthritis, Rheumatoid Arthritis
Osteoarthritis is the most common form of
arthritis. It is often referred to as wear and
tear arthritis as it involves the thinning and breakdown of the
cartilage lining, which cushions and protects the joints, where two
bones meet. The bone may lose shape and thicken at the ends or produce
bony spurs. It causes pain in the joints and surrounding
soft tissues and limits the range of movement of a joint.
Osteoarthritis affects many joints including the large, weight bearing
joints of the hips and knees and also the spine, hands, feet and
shoulders. There are several reasons for the development of
osteoarthritis including age, being overweight, heredity factors, and
joint damage from a previous injury or during early development of a
joint. The severe pain of osteoarthritis can be very fatiguing and
disabling.
Rheumatoid arthritis. This is an
auto-immune disease in which the body's immune
system (the body's way of fighting infection) attacks healthy joints,
tissues, and
organs. Occurring most often in women of childbearing age (15-44),
this disease
inflames the lining (or synovium) of joints. It can cause pain,
stiffness, swelling, and
loss of function in joints. When severe, rheumatoid arthritis can
deform, or change, a
joint.
Rheumatoid arthritis affects mostly joints of the hands and feet
and tends to be symmetrical. This means the disease affects the same
joints on both sides of the body
(like both hands or both feet) at the same time and with the same
symptoms. No other
form of arthritis is symmetrical. About two to three times as many
women as men have
this disease.
Fibromyalgia. Fibromyalgia is a condition
associated with generalised muscle pain and fatigue. It is often
described as a form of "soft tissue rheumatism", which means it is a
condition that causes pain and stiffness around the joints and in
muscles and bones. It does not cause inflammation.
Gout is a form of arthritis. The joints
appear painful, tight and swollen. The pain is caused by
needle shaped microcrystals which can destroy the joint cartilage.
When a person has gout,
they have higher than normal levels of uric acid in the blood. The
body makes uric acid from the foods we eat. Too much uric acid causes
deposits, called uric acid crystals, which form in the fluid and
lining of the joints. If the kidneys don't work properly then you
can't get rid of the uric acid in the urine as you should. The result
is an extremely painful attack of arthritis. People often inherit gout
and although we don't know why, Maori and Pacific island peoples are
more likely to get gout. The joint most commonly affected is the big
toe.
Infectious arthritis. Arthritis can be
caused by an infection, either bacterial or viral. When this disease
is caused by bacteria, early treatment with antibiotics can ease
symptoms and cure the disease.
Reactive arthritis. This is arthritis
that develops after a person has an infection in the urinary
tract, bowel, or other organs. People who have this disease often have
eye problems, skin
rashes, and mouth sores.
Systemic lupus erythematosus. Also called
lupus or SLE is a form of arthritis which affects
joints, muscles and other parts of the body. It is one of the
autoimmune rheumatic diseases. In people with autoimmune diseases,
antibodies are produced which act against certain body tissues and
cause inflammation.
There are two main form of Lupus: Discoid Lupus which affects only
skin, and Systemic Lupus which involves the joints and sometimes the
internal organs as well. Lupus (Latin for wolf) takes its name from
the fact that it can cause serious rashes across the cheeks and nose
(rather fancifully resembling the face of the wolf) (Arthritis NZ)
Ankylosing spondylitis is a term used to
describe a form of arthritis that mainly affects the
joints of the spine. However it may affect other parts of the body,
e.g. hips, shoulders, knees or ankles. It causes inflammation outside
the joint where the ligaments and tendons are attached to the bone,
whereas in most forms of arthritis the inside of the joint is
inflamed. It usually affects the little joints between the vertebrae
of the spine and tends to diminish the movement which takes place at
these joints. It affects younger people, teenagers to mid thirties and
more men then women.
Juvenile rheumatoid arthritis. The most
common type of arthritis in children, this disease
causes pain, stiffness, swelling, and loss of function in the joints.
A young person can
also have rashes and fevers with this disease.
Polymyalgia rheumatica which means
rheumatic pain in many muscles, results in severe
stiffness and pain in the muscles of the neck, shoulders, lower back,
buttocks and thighs.
Other symptoms may be fatigue, loss of weight, night sweats and fever.
Visual disturbance may indicate temporal arteritis or Giant cell
Arteritis.
Polymyositis. Causing inflammation and
weakness in the muscles, this disease can
affect the whole body and cause disability.
Psoriatic arthritis. Is an inflammatory
arthritis associated with psoriasis, a chronic skin and nail disease.
Psoriatic arthritis affects about 10% of people with psoriasis. It can
affect single joints, usually of the fingers or toes, as well as
wrists, knees, ankles and sacro iliac joints of the spine.
Bursitis. This condition involves
inflammation of the bursa, small, fluid-filled sacs that help
reduce friction between bones and other moving structures in the
joints. The inflammation
may result from arthritis in the joint or injury or infection of the
bursa. Bursitis produces pain
and tenderness and may limit the movement of nearby joints.
Tendinitis. Also called tendonitis, this
condition refers to inflammation of tendons (tough
cords of tissue that connect muscle to bone) caused by overuse,
injury, or a rheumatic
condition. Tendinitis produces pain and tenderness and may restrict
movement of nearby
joints.
What causes osteoarthritis?
Osteoarthritis is caused by the wearing out of the cartilage
covering the bone ends in a joint. This may be due to excessive strain
over prolonged periods of time, or due to other joint diseases, injury
or deformity. Primary osteoarthritis is commonly associated with
ageing and general degeneration of joints.
Secondary osteoarthritis is generally the consequence of another
disease or condition, such
as repeated trauma or surgery to the affected joint, or abnormal joint
structures from birth.
Some people may have developmental or congenital abnormalities of
the joints that may cause early degeneration and subsequently cause
arthritis.
Predisposing factors to Osteoarthritis
Unalterable
Potentially Preventable
- Obesity
- Injury and joint trauma- in the knee from fractures and torn
ligaments and
cartilage (menisci)
- Mechanical stress
- Deformity and malalignment in the hip, growth abnormalities or
childhood hip problems
- Prior inflammatory disorders
- Endocrine and metabolic disorders
What are the symptoms of arthritis?
There are more than 150 different forms of arthritis. Symptoms vary
according to the form
of arthritis. Each form affects the body differently.
Arthritic symptoms generally include swelling and pain or tenderness
in one or more
joints for more than two weeks, redness or heat in a joint, limitation
of motion of a joint,
early morning stiffness, and skin changes, including rashes.
How can a doctor diagnose
arthritis?
Doctors diagnose arthritis with a medical history, physical exam,
x-rays and blood tests.
There is no blood test for osteoarthritis.
What you can do?
- Consult a doctor to determine the type of arthritis you have.
Treatment will depend
on a correct diagnosis.
- Take medication as recommended by your doctor
- Rest/ and or exercise. A balance as advised by your doctor or
health professional.
- Protect your joint/s from further damage.
- Pain relief such as heat or cold therapy
- Weight control to prevent extra stress on weight bearing joints
- Maintain your general health and well being.
What your doctor can do for you?
There is no cure for arthritis, so beware of 'miracle cures'. Your
doctor may prescribe
anti-inflammatory medicine. They may recommend occupational therapy or
physiotherapy,
which includes exercises and heat treatment. In severe cases, surgery
may be suggested,
such as a hip or knee replacement. The type of surgery will depend on
your age and severity
of the disease. In the elderly with severe arthritis, joint
replacement can give good results.
Treatment Options
Initial treatment for osteoarthritis is conservative with a balance
of rest and exercise, avoiding vigorous weight bearing activities,
education in arthritis management, support,
and joint protection such as walking aids or braces, and non invasive
pain relief techniques. Pharmacy measures include analgesic and anti-
inflammatory medication, complementary medication, possibly injections
into the joint of cortisone/ corticosteroids.
OA should be managed with combined non pharmacological and
pharmacological approaches.
Treatment of osteoarthritis focuses on decreasing pain and
improving joint movement,
and may include:
- Education and understanding,
- Exercises to keep joints flexible and improve muscle strength
- support, from health professionals and family
- Joint protection, to prevent stress or strain on painful joints
e.g. suitable foot wear
- Weight control to prevent extra stress on weight bearing joints
- Physiotherapy and/ or heat or cold treatments.
- Medication approaches i.e. anti inflammatory gels/rub ons, the
use of non steroidal
anti inflammatory medication, non narcotic analgesics such as
paracetamol and
complementary and alternative medications such as glucosamine with
or without
chondroitin and injections of glucocorticoids into the joint if
needed
- Surgery to relieve chronic pain in damaged joints.
Does exercise really help those who have arthritis?
Exercise is very important because it increases lubrication of the
joints and strengthens
the surrounding muscles, putting less stress on joints. Exercise in
heated swimming
pools-hydrotherapy-can bring enormous relief from pain and stiffness.
Also studies have shown that exercise helps people with arthritis by
reducing joint pain
and stiffness and increasing flexibility, muscle strength and energy.
It also helps with
weight reduction and offers an improved sense of well-being.
Can special diets treat arthritis?
But what if you have arthritis - are diet and nutrition still such
a simple matter?
Can what you eat cure your arthritis? Can food prevent it from
occurring?
Are there foods that can cause your arthritis to 'flare' or go into
remission?
What role do vitamins and nutritional supplements play in the
treatment of arthritis?
Will losing (or gaining) weight help ease your symptoms?
Will taking powerful anti-arthritic medications affect your appetite
or your ability to eat
certain foods?
These are the sorts of questions that people with arthritis often
ask, and they're valid
questions. Some questions "Can what you eat cure your arthritis?" have
simple
answers "No". Some questions "Are there foods that can cause your
arthritis to
'flare' or go into remission?" aren't so straightforward. "Perhaps..."
Most of what you need to know about diet and nutrition is common
sense; healthy
eating is pretty much the same for anyone, whether you have arthritis
or not. But there
are exceptions.
Summary
From learning about the importance of exercising regularly to fully
understanding your arthritis medications, the information contained in
this section is meant to provide you with insights, information and
tips that can be used by you to help make living with arthritis a
little bit more manageable.
For people with arthritis, learning to make it part of your life
can be difficult. But learning as
much as you can about your particular type of arthritis and actively
working with your arthritis treatment team are two very effective ways
of regaining control over your life. There is plenty of information,
some specific to arthritis and some not, that can be very helpful to
someone facing the challenges associated with having a chronic or
lifelong disease.
Our suggestion is - don't let arthritis beat you. Take control.
How? Arm yourself with as much information as possible. Learn from the
experiences of others in similar circumstances. What we're presenting
here is a virtual toolbox of tips for living well with arthritis. Some
may work for you one day and not the other. Some may work for you but
not others. That's why we've tried to cover several topics. There are
plenty of tools or tips here. Use them or refer to them when you need
them. Call upon them when you require help.
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