Arthritis

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at May 7, 2016
StartDiseasesArthritis

Arthritis is an umbrella term for over 100 conditions in which the joints of the body are in pain or inflamed. This pain and inflammation typically worsens with age. Arthritis generally can't be cured, but specific treatment options are available. According to the Centers for Disease Control and Prevention, 1 out of every 5 Americans has been diagnosed with arthritis.

Contents

Definition & Facts

Arthritis is a disease that affects millions of people around the world. The type of pain a person experiences differs depending on the arthritis they are afflicted with. Categories of arthritis include osteoarthritis, inflammatory arthritis (of which rheumatoid arthritis is an example), infectious arthritis (also referred to as septic arthritis), and gout (also referred to as metabolic arthritis).

This condition is so common that it's the number one cause of disability in America. The pain created by arthritis tends to cause those affected by it to be less inclined to practice physical activity on a regular basis, despite the fact that these activities and exercises assist in reducing pain.

Symptoms & Complaints

The most common symptom associated with arthritis is pain which is often severe. Taking place primarily in the joints, pain can be felt in many areas of the body depending on the type of arthritis. These areas include the back, hands, fingers, ankles, neck, wrist or muscles. The pain can be felt sharply on a consistent basis or intermittently; it also tends to flare up when the affected area is moved.

Additional symptoms like swelling and redness may also occur. Stiffness is another common symptom that worsens over time. Eventually, it can create a decreased range of motion for affected joints. Symptoms of rheumatoid arthritis (RA) are usually felt most strongly soon after waking up.

Symptoms of infectious arthritis include most of the aforementioned symptoms as well as chills and a fever. Among children, there are several additional symptoms characteristic of infectious arthritis, such as a loss of appetite, a fever that comes and goes, a blotchy rash, and unexplained weight loss.

Causes

Osteoarthritis can begin due to standard wear and tear within the cartilage of a joint. This cartilage is the hard coating towards the end of a bone. Over time, the wear and tear can be enough to completely erode the protective cartilage, which leads to the grinding of one bone on another. This immediately creates pain and other troublesome symptoms. While the wear and tear usually occurs over many years, a sports injury along the joint can precipitate it. Being overweight also puts more stress on the joints, causing additional pain.

Infections that cause reactive arthritis, a form of inflammatory arthritis can be viral infections, bacterial infections, or fungal infections. They can include sexually transmitted infections such as hepatitis C, and chlamydia as well as foodborne illnesses like salmonella infection. Smoking is a risk factor for many types of arthritis as are family history and a host of environmental factors and genetic factors. Gout is caused by hyperuricemia or the build up of uric acid in the blood.

In patients with inflammatory arthritis such as rheumatoid arthritis, the immune system within the body views the lining of the joint capsule as an invader. A joint capsule encloses joint parts. The lining is attacked by the immune system, which causes it to become swollen and inflamed. As arthritis progresses, the cartilage within the joint can become completely destroyed. Lupus is one autoimmune disease that triggers inflammation throughout the body, including the joints, causing arthritis. 

Diagnosis & Tests

Because there are so many types of arthritis, blood tests will typically be administered by a doctor to identify which type of arthritis is present. When testing for rheumatoid arthritis, the blood is tested for a substance called rheumatoid factor, or RF which is a type of protein that can harm and inflame healthy tissue and is commonly found in individuals with rheumatoid arthritis or other autoimmune diseases.

Blood is also sometimes tested for anti-CCP antibodies, which point towards a more severe form of RA. A person's C-reactive protein (CRP) levels and erythrocyte sedimentation rate (ESR) levels are checked to determine the level of inflammation present, which also helps to identify if treatments are working. These tests will check if muscle enzymes are high, if a genetic marker known as HLA-B27 is present and if anti-neutrophil cytoplasmic antibodies are in the blood. The presence of any of these can point towards the onset of some types of arthritis.

Before any blood is taken, the doctor will ask about symptoms, and will perform a physical examination. Once lab tests are administered, X-rays may also be taken. Many forms of arthritis have a lot in common with other diseases, so people in the early stages of the condition may need to go through numerous tests before a conclusion can be made.

Treatment & Therapy

No matter what type of arthritis a person is affected by, there are many treatments available. No treatment will completely cure the disease, but many can mitigate the symptoms. Lifestyle changes such as exercising and maintaining a healthy weight can mitigate symptoms. Anyone that's been diagnosed with gout should stay away from alcohol in order to reduce the risk of flare ups.

When exercising for pain reduction, one should focus on implementing stretching, aerobic exercise and strength training exercises to alleviate the pain. Physical therapy should be considered. Medications like pain relievers and nonsteroidal anti-inflammatory drugs can assist with the reduction of symptoms. Corticosteroids and antidepressants are additional treatment options.

Surgical treatments are also available and include arthroscopy, osteotomy, and total joint replacement. There are significant drawbacks to surgery and individuals with arthritis must determine with their doctors whether they would be a viable candidate for surgery.

Prevention & Prophylaxis

Some risk factors are unchangeable, such as genetic factors. Others can be reduced. For gout, a diet should be healthy, low in alcohol and low in sugar. For rheumatoid arthritis, smoking should be cut down or eliminated altogether. As for osteoarthritis, maintaining a healthy weight is the best way to avoid the disease. Avoiding injuries, such as sports injuries, can also help prevent arthritis.