ARTHRITIS

Arthritis, simply put, means joint inflammation. Usually joint inflammation is a sign or a symptom rather than a specific diagnosis. The term arthritis refers to any disorder that affects the joints. Joints are where two bones meet, such as your wrists, knees or hips.

There are many types of arthritis. The two most common forms are osteoarthritis and rheumatoid arthritis.

Osteoarthritis is also known as degenerative joint disease and may occur with aging, or after sustaining trauma to a joint. Rheumatoid arthritis is an autoimmune disease common in young adults in which the body’s immune system attacks the joint lining. Other common forms of arthritis include psoriatic arthritis, gout and fibromyalgia. Nearly 1 in 5 adults have some form of arthritis. It’s more common with older age, but can happen to anyone.

Arthritis causes pain in and around your joints. These symptoms might be constant, or they could come and go. The pain and discomfort could range from mild to severe.

Pain from rheumatoid arthritis tends to be in the hands, wrists, elbows, shoulders, knees, feet and ankles.

For people with gout, one of the first symptoms is usually pain and swelling in their big toes. It may also turn red and feel warm. Gout comes from uric acid buildup in the body which causes sharp crystal-like deposits to form in your joints. You may also find lumps underneath your skin called tophi. 

In many forms of arthritis, the cause is unknown. There are some factors that may increase your chances of getting it. This includes: age, genetics, work, cigarettes, gender, weight, injuries and infection

Your doctor will ask you about your symptoms, family history, and lifestyle. He or she will perform a physical exam on you. This will include feeling for swollen glands, checking your blood pressure, and looking in your eyes and down your throat. Your doctor will examine at the joints causing you pain to check for redness and swelling. If your pain is in your back, your doctor will look for abnormalities in the curvature of your spine. You might need to stand and walk so your doctor can see if pain affects your movement.

There are some tests that might be necessary for a more conclusive diagnosis. Tests could include x-rays, MRIs, ultrasounds, nerve tests, and blood tests, among others.

Treatment for arthritis centers around relieving symptoms and improving joint function and mobility. Most people need various forms of treatments. Treatments fall into four different categories: medication, lifestyle change, physical therapy, and surgery.

Medication

Nearly all pain medications come with side effects. 

• Painkillers 
  • Over the counter painkillers such as Tylenol will help reduce pain. However, they do not reduce inflammation, the underlying cause of arthritic pain.
  • Your doctor may prescribe opioids if you have severe pain. This is not an ideal option as long term opioid use might result in dependency.

• Anti-inflammatories
  • Non steroidal anti-inflammatory drugs (NSAIDs) reduce pain and inflammation. Some NSAIDs are available over the counter, while others require a doctor’s prescription. NSAIDs can cause stomach irritation and might increase the risk of stroke or heart attack. Some forms of NSAIDs are available as creams or gels which you apply topically.

• Counterirritants
  • Capsaicin, a chemical found in hot peppers can be added to a cream or ointment that can alleviate joint pain. 

• Disease-modifying antirheumatic drugs (DMARDs)
  • These are for rheumatoid arthritis to prevent your immune system from attacking your joints

• Biologic response modifiers
  • This class of drugs includes genetically engineered to target specific immune response molecules.

• Corticosteroids
  • This class of drugs can be taken orally or injected into painful joints.

Lifestyle

• Weight
  • Permanent lifestyle changes that result in gradual weight loss are the most effective methods of weight loss.
• Smoking
  • Cigarette and cigar smoking causes stress to connective tissue. This increases arthritis pain.

Physical Therapy and Exercise

A physical therapist can help develop a program for you to improve your strength without putting stress on your joints. Pay attention to the following:

• Your Everyday Routine
  • Use good posture. Physical and occupational therapists can evaluate your posture. They make recommendations on the best ways to sit, stand, and walk.
• Exercise
  • While it’s important to exercise regularly, it’s also important to choose the right types of exercises. You should avoid high-impact activities and repetitive motions. These could include running, jumping, tennis and high-impact aerobics.
• Heat and Cold
  • Your physical therapist might recommend the use of heating pads or ice packs to relieve arthritis pain
• Assistive Devices
  • Canes, shoe inserts, walkers, raised toilet seats, tub rails, jar openers and other assistive devices can help you perform everyday tasks without pain.

Surgery

If non-invasive measures don’t alleviate your pain, your doctor may recommend surgery. These surgeries could include:

• Repair
  • Joint repair entails smoothing or realigning joint surfaces. This is the least invasive form of joint surgery
• Replacement
  • Joint replacement removes a damaged joint and replaces it with an artificial one.
• Fusion
  • Joint fusion is for smaller joints. It removes the ends of the bones in a joint and locks them together until they heal together into one unit.