Arthritis

The word ‘Arthritis’ implies joint inflammation that causes pain, and stiffness. If this inflammation remains for a long time, it can cause tissue damage. In arthritis, the region inside or surrounding the joint gets swelled causing pain and difficulty in moving.

Types of Arthritis

There are around 100 different kinds of arthritis. Some of them are:

Osteoarthritis: It is the most widespread kind of arthritis. It crops up when the cartilage that covers the end of the bones progressively erodes. When the cartilage wears away, the bones start rubbing against each other creating friction that results in pain and swelling. Osteoarthritis can arise in any joint but it influences the hands as well as other weight-bearing joints like the knee, hip and joints in the spine. Osteoarthritis is characterized by break down of cartilage breaks or its degeneration and is therefore called degenerative joint disease.

Rheumatoid arthritis: Rheumatoid arthritis is a chronic disease affecting joints in any region of body but the hands, wrists and knees. In rheumatoid arthritis, the immune system of the body attacks itself, leading to swelling of the joint lining. The swelling spreads to the neighboring tissues leading to damage of cartilage and bone. In extreme cases, the rheumatoid arthritis can affect other body parts like skin, eyes, and nerves.

Gout: Gout happens when the body cannot excrete a natural substance called uric acid. The surplus uric acid leads to formation of needle like crystals in the joints causing inflammation and acute pain. Gout affects the knee, toe and wrist joints.

Spinal stenos is: Spinal Stenosis is caused by the contraction of the spinal canal where the spinal cord and spinal nerves are present. It occurs when intervertebral discs lose moisture as well as volume with age that decreases the disc space.

Symptoms of Arthritis

The symptoms of arthritis vary in acuteness from person to person. The common symptoms include lethargy, fever and swelling including:

• Pain
• Inflammation
• Rigidity
• Soreness
• Redness
• Tenderness

Pain in joints and gradual stiffness without obvious inflammation, chills or fever perhaps point out the beginning of symptoms.

Agonizing inflammation along with stiffness in the fingers, arms, legs and wrists that occur in the similar joints on each side of the body are signs of rheumatoid arthritis. The main symptoms are fever, joint swelling, soreness, and severe pain along with chills indicates infectitious arthritis.

Knee Arthritis

Arthritis in knee is most common type of osteoarthritis. It occurs if the cartilage at the end of the knee bones experience degenerative process. As the cartilage gets thin, the ends of the bones join and cause friction leading to inflammation of the joint and pain.
 
The pain is felt in the back and the sides of the knee. The range of motion is limited and the joints become stiff in the mornng. You also hear some cracking sounds when you turn and flatten the knee, you will hear some cracking sounds. The condition tends to get worse if not treated.

X-rays can determine the extent of damage. An ESR test is done to check for rheumatoid arthritis. At times, the doctor takes out fluid from the knee joint and check for gout.

Arthritis in hands

In the hand, osteoarthritis develops in three places:

• The base of the thumb which is the trapezio-metacarpal, or basilar, joint
• The end joint closest to the finger tip that is the distal interphalangeal or DIP joint
• The middle joint of a finger that is the proximal interphalangeal or PIP joint

Pain, stiffness and inflammation are symptoms present in all kinds of arthritis in the hand. With osteoarthritis, bony nodules can crop up at the middle, or PIP, joint of the finger and at the end-joints, or DIP, of the finger. A severe, hurting pain at the thumb base is characteristic of osteoarthritis of the basilar joint.

Bursitis

Bursitis is the swelling or botheration of the bursa. The bursa is a sac filled with lubricating fluid, present between tissues like bone, tendons and muscle which reduces friction, and irritation.
This condition is generally caused by recurring, slight effect on the area or by an abrupt injury. Age is another factor because as tendons age they cannot bear stress. They become less elastic and are simpler to split. An unusual or improper bone or arthritis in a joint can pressurize bursa sac causing bursitis.
Bursitis is widespread in adults particularly those above 40 years of age. It affects base of the thumb, elbow, shoulder, knee and hip joint. The major symptom is pain at the place of the bursa. 
Bursitis can be avoided with a progressive augmentation in activities and discontinuing the activity if pain occurs.

Bursitis can be treated by avoiding activities that exacerbate the problem, taking adequate rest and icing the area.

Hip Problems

Hip problems occurs due to over usage, bone weakening with age, infection or modifications in the blood supply. A person with hip problem feels pain in the knee or thigh.

Hip problems may include pain when resting, pain with movement and pain with weight-bearing.

Diagnosis

X-rays are required to diagnose osteoarthritis and they depict a cartilage loss and withered joints. The doctor also does blood tests as well as joint aspiration in order to exclude the chances of any other arthritis. In case the orthopaedician suspects infectious arthritis, testing of a fluid from the problematic joint will validate the diagnosis.

In case of rheumatoid arthritis, blood tests and X-rays are required to authenticate the diagnosis. In most of the patients, the antibodies known as rheumatoid factors (RF) is present in their blood. Rheumatoid factors are a range of antibodies which are there  in about 80% of people with rheumatoid arthritis (RA). A latest test for rheumatoid arthritis checks the antibodies level which bind citrulline modified proteins (anti-CCP). It is a more particular test and is high in patients with rheumatoid arthritis.  This test can also predict the acuteness of the disease.

The erythrocyte sedimentation rate (sed. rate or ESR) is a sign of the level of inflammation in the body. It is a measure of the speed at which the RBCs fall in a test tube of blood. If the swelling is high, the inflammatory material adhere to red blood cells making the speed high. For healthy persons, this rate is low.

C-reactive protein (CRP) is also a measure of inflammation. In people diagnosed with rheumatoid arthritis, the inflammation is quite high.
Both CRP and ESR levels are used to monitor disease activity and how well someone is responding to treatment.

Causes of Arthritis

The exact cause of arthritis is not known but many factors go together to develop this problem. They are

Genetics : The extent of genes involved in this ailment isn’t known but some studies show that there are genetic deviations that can cause arthritis.

Age: With age the cartilage becomes fragile and has decreased ability to repair itself. As the age increases, the chances of getting arthritis also increases.

Weight: Excessive load on the joint can cause joint damage so excess body weight on a joint causes knee arthritis

Previous Injury: Any major wound can also cause arthritis. For example a tibial plateau fracture  occurs if the broken part of bone moves into the cartilage of the knee joint.

Working  Hazards: People in some particular jobs are likely to have a higher probability of developing arthritis as compared to other jobs. These jobs demand a lot of physical pressure like assembly line workers or heavy construction workers.

Sports :Sometimes sports participation can add to arthritis development. At times, sports participation can cause joint injury and arthritis.

Illness or Infection: Any kind of joint infection, frequent episodes of gout can cause arthritis of the joint

Treatment options

An arthritis specialist will help you know about all the treatment options and discuss advantage and risks of each treatment option

Arthritis Medications

They are used for conventional treatment for arthritis. Depending on the acuteness of the  arthritis symptoms, you can go for the following medications

• Nonsteroidal anti-inflammatory drugs
• COX-2 Inhibitors
• Analgesics
• Corticosteroids
• Disease-modifying anti-rheumatic drugs
• Biologic response modifiers
• Joint Injections

There are different types of injections that can be given into the joint. Viscosupplementation is a process which involves the injection of gel-like hyaluronates into a joint  to complement the gelatinous properties of synovial fluid. The five types are Synvisc, Orthovisc,Supartz, Euflexxa and Hyalgan

Natural Treatments

There are numerous natural treatment options called alternative treatments that are quite popular. They include Acupuncture, Biofeedback, Chiropractic, Magnets, and yoga and massage therapies.

Surgical Options

Joint Surgery is considered when no other option is effective or they have stopped working. If the joint damage is acute and pain is unbearable, joint surgery might be the only option to decrease pain and restore function. The surgery options are

• Arthrodesis (fusion)
• Arthroplasty
• Osteotomy
• Joint replacement
• Revision joint replacement
• Resection
• Synovectomy
• Partial knee replacement