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Arthritis

Arthritis

Arthritis means joint inflammation, but the term is used to describe around 200 conditions that affect joints, the tissues that surround the joint, and other connective tissue. It is a rheumatic condition.

Overview

The most common form of arthritis is osteoarthritis. Other common rheumatic conditions related to arthritis include gout, fibromyalgia, and rheumatoid arthritis (RA).

Rheumatic conditions tend to involve pain, aching, stiffness, and swelling in and around one or more joints. The symptoms can develop gradually or suddenly. Certain rheumatic conditions can also involve the immune system and various internal organs of the body. Some forms of arthritis, such as rheumatoid arthritis and lupus (SLE), can affect multiple organs. Arthritis is more common among adults aged 65 years or older, but it can affect people of all ages, including children.

Symptoms

Arthritis:

  • Joint pain.
  • Stiffness when you wake up or after you’ve been sitting for a while.
  • Tenderness - the area is sore when touched.
  • Lack of movement - the joint won’t complete its full range of motion.
  • Grating - the patient might feel things rubbing together inside the joint.
  • Bone spurs - lumps of bone form around the joint.

Rheumatoid Arthritis:

  • Joint pain, swelling and tenderness for 6 weeks or longer.
  • More than one joint affected, especially small joints in the hands, wrists, and feet.
  • The same joints on both sides of the body are affected.

Causes

  • Cartilage degradation: Cartilage is a firm but flexible connective tissue in a human being’s joints. It protects the joints by absorbing the pressure and shock created when one moves and puts stress on them. A reduction in the normal amount of this cartilage tissue cause arthritis.
  • Osteoarthritis: Normal wear and tear causes OA, one of the most common forms of arthritis. An infection or injury to the joints can exacerbate this natural breakdown of cartilage tissue. Your risk of developing OA may be higher if you have a family history of the disease.
  • Rheumatoid Arthritis: Another common form of arthritis, RA, is an autoimmune disorder. It occurs when the body’s immune system attacks the tissues of the body. These attacks affect the synovium, a soft tissue in the joints that produces a fluid that nourishes the cartilage and lubricates the joints. The exact cause of the immune system’s attacks is unknown. But scientists have discovered genetic markers that increase your risk of developing RA fivefold.

Diagnosis

  • Reviewing the medical history and current symptoms of a patient.
  • A doctor can perform arthrocentesis (the procedure of removing fluid from a joint) and analyze it for inflammation levels in the blood and joint fluids, which can help determine what kind of arthritis one has. Blood tests that check for specific types of antibodies like anti-CCP (anti-cyclic citrullinated peptide), RF (rheumatoid factor), and ANA (antinuclear antibody) are also common diagnostic tests.
  • Imaging scans such as X-ray, MRI, and CT scans, produce an image of bones and cartilage. This gives a clear picture and can rule out other causes of symptoms, such as bone spurs.

Treatment

Treatment for arthritis aims to control pain, minimize joint damage, and improve or maintain function and quality of life. A range of medications and lifestyle strategies can help achieve this and protect joints from further damage. Treatment might involve:

  • Medications.
  • Non-pharmacologic therapies.
  • Physical or occupational therapy.
  • Splints or joint assistive aids.
  • Patient education and support.
  • Weight loss.
  • Surgery, including joint replacement.

Medication

Non-inflammatory types of arthritis, such as osteoarthritis, are often treated with pain-reducing medications, physical activity, weight loss if the person is overweight, and self-management education. Medications will depend on the type of arthritis. Commonly used drugs include:

  • Analgesics: These reduce pain, but have no effect on inflammation. Examples include acetaminophen (Tylenol), tramadol (Ultram) and narcotics containing oxycodone (Percocet, Oxycontin) or hydrocodone (Vicodin, Lortab). Tylenol is available to purchase online.
  • Non-steroidal anti-inflammatory drugs (NSAIDs): These reduce both pain and inflammation. NSAIDs include available to purchase over-the-counter or online, including ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve). Some NSAIDs are available as creams, gels or patches which can be applied to specific joints.
  • Counterirritants: Some creams and ointments contain menthol or capsaicin, the ingredient that makes hot peppers spicy. Rubbing these on the skin over a painful joint can modulate pain signals from the joint and lessen pain. Various creams are available to purchase online.
  • Disease-modifying antirheumatic drugs (DMARDs): Used to treat RA, DMARDs slow or stop the immune system from attacking the joints. Examples include methotrexate (Trexall) and hydroxychloroquine (Plaquenil).
  • Biologics: Used with DMARDs, biologic response modifiers are genetically engineered drugs that target various protein molecules involved in the immune response. Examples include etanercept (Enbrel) and infliximab (Remicade).
  • Corticosteroids: Prednisone and cortisone reduce inflammation and suppress the immune system.
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