Joint diseases
Sometimes the joints in the body (e.g., knees, elbows, spine, fingers) are affected by inflammation and other issues, resulting in pain that either goes away (acute) or is persistent and frequently recurring (chronic). There are several joint diseases that can be the source of these problems.
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Definition & Facts
Affecting more than 50 million adults in the United States, arthritis is, by far, the most common disease primarily affecting joints. There are more than a hundred different types of arthritis alone, with the most common forms being osteoarthritis (OA), also known as degenerative joint disease, and rheumatoid arthritis (RA).
Pseudogout is a specific form of gout that may affect wrist and knee joints. Gout can also result in the accumulation of crystals around joints, primarily near the base of the big toe. If a fluid-filled sac meant to counteract friction between joints (bursa) and adjacent structures becomes inflamed, it's a condition called bursitis.
Symptoms & Complaints
The pain experienced can be fairly regular if joints are severely affected or more intermittent when only certain muscles, tendons, and ligaments are affected. Such conditions are typically progressive in nature, with symptoms becoming increasingly noticeable and problematic if the condition isn't diagnosed and treated.
When nerve compression is a major factor, symptoms may be triggered by different positions or aggravated by prolonged periods of sitting or standing. Joint disorders are frequently characterized by some degree of inflammation usually accompanied by swelling and pain at the location of the affected joint. Additional symptoms and complaints may include:
- Joint stiffness
- Muscle weakness
- Limited range of motion
- Grating sensation in the joints
- Noticeable tenderness
Causes
Many joint diseases are caused by age-related wear and tear to cartilage and other supporting tissues. Being within a certain age group sometimes increases the odds of developing a joint disease. This is the case with osteoarthritis with about half of all people 65 and older having some degree of osteoarthritis affecting one or more joints. Rheumatoid arthritis tends to be more prevalent in women.
Genetic factors may play a role in various types of joint diseases. Rheumatoid arthritis is an autoimmune disease caused by an overactive immune system. Smoking may increase one's risk for this condition. Some joint-released conditions like Adult Still's disease have no clear cause, although a viral infection or bacterial infection may be a contributing factor.
A preexisting condition such as diabetes or high blood pressure may contribute to the development of some joint conditions. Dietary abnormalities and stress are associated with gout.
Diagnosis & Tests
Diagnosis of a joint disease often starts with a physical examination and a review of a patient's medical history and family history, including all prescription and over-the-counter medications currently being taken. Patients are usually asked to describe their symptoms, the location of the pain experienced and discuss how it impacts their daily life.
Blood tests may be conducted. With RA, in particular, a blood test can show elevated levels of certain antibodies and proteins that indicate inflammation is affecting some part of the body. Imaging studies such as X-rays, magnetic resonance imaging (MRI) scans, and computed tomography (CT) scans can show changes to joints and tissues that often point to a more specific condition. Ultrasound tests can determine the severity of a joint disease to help fine-tune treatment options.
Joint aspiration is a test involving the insertion of a needle into an affected joint to withdraw fluid. The fluid is then checked for crystals that deposit around joints and nearby tissues affected by a joint disease and other indicators.
Treatment & Therapy
There is no complete cure for most joint diseases and conditions. Symptoms can be managed with a combination of medication and physical therapy. Common medications prescribed to ease related discomfort as much as possible include nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation, corticosteroids to ease pain and slow the progression of joint damage, and disease-modifying antirheumatic drugs (DMARDs).
Biologics work on specific parts of the immune system likely to be affected by inflammation and are derived from genes as opposed to chemically synthesized. Opiate pain medications aren't recommended for long-term use to manage joint-related pain due to the risk of addiction.
Water therapy in the form of water aerobics, swimming, or warm water therapy is often recommended since it's less stressful on joints. Surgery is a last resort and rarely recommended when joint diseases can be sufficiently managed with traditional or conservative methods. Joint fusion to stop motion in the affected area, tendon repair, and joint replacement are the most common procedures performed. Treatment may also involve:
- Modification of activities likely to trigger pain
- Appropriate exercise to strengthen supporting muscles
- Transcutaneous electrical nerve stimulation (TENS)
- Chiropractic manipulation though doctors warn that chiropractic may worsen certain conditions
Prevention & Prophylaxis
The best approach to prevention, in general, is to maintain optimal bone health. According to the Centers for Disease Control and Prevention, bone health can be further maintained with foods rich in calcium, including green, leafy vegetables, low-fat dairy products, nuts and fish. The World Health Organization recommends that healthy adults get approximately two hours of light to moderate exercise per week to maintain good overall health.
Other lifestyle factors can also contribute to the develop of certain joint conditions. Drinking plenty of water throughout the day helps to keep the tissues that support joints hydrated. The standard recommendation is eight 8-ounce glasses per day. Maintaining a healthy body weight reduces stress on bones and joints. Wearing proper equipment and taking other steps to avoid sports injuries can also be beneficial.