Description

Arthritis is the swelling and tenderness of one or more joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. The most common types of arthritis are osteoarthritis and rheumatoid arthritis.

Osteoarthritis causes cartilage — the hard, slippery tissue that covers the ends of bones where they form a joint-to break down. Rheumatoid arthritis is a disease in which the immune system attacks the joints, beginning with the lining of the joints.

Uric acid crystals are formed when there is too much uric acid in the blood, can cause gout. Infections or underlying disease, such as psoriasis or lupus, can cause other types of arthritis.

Treatments vary depending on the type of arthritis. The main goals of arthritis treatments are to reduce symptoms and improve quality of life.

Symptoms

The most common signs and symptoms of arthritis involve the joints. Depending on the type of arthritis, the signs and symptoms may include:

  • The pain
  • Stiffness
  • Swelling
  • Redness
  • Decreased range of motion

Causes

The two main types of arthritis — osteoarthritis and rheumatoid arthritis — damage joints in different ways.

Osteoarthritis

The most common type of arthritis, osteoarthritis is characterized by the wear of the damage to the joint cartilage of the hard, slick coating on the ends of bones where they form a joint. Cartilage that protects the ends of bones and allows nearly frictionless movement of the joint, but as damage can result in bone grinding directly on bone, which causes pain and restriction of movement. This wear and tear can occur over many years, or may be driven by a joint injury or infection.

Osteoarthritis can also cause changes in the bones and deterioration of the connective tissues that join muscle to bone and hold the joint together. If the cartilage in a joint is severely damaged, the lining of the joint may become inflamed and swollen.

Rheumatoid arthritis

In rheumatoid arthritis, the body's immune system attacks the lining of the joint capsule, a tough membrane that encloses all the joint parts. This lining (synovium) becomes inflamed and swollen. The disease process can eventually destroy cartilage and bone within the joint.

Risk factors

Risk factors for arthritis include:

  • The history of the family. Some types of arthritis in families, so that they may be more likely to develop arthritis if your parents or siblings have the disorder.
  • Age. The risk of many types of arthritis, including osteoarthritis, rheumatoid arthritis, and gout — increases with age.
  • Your sex. Women are more likely than men to develop rheumatoid arthritis, while the majority of the people who have gout, another type of arthritis, are men.
  • Previous joint injury. People who have injured a joint, perhaps while playing a sport, are more likely to develop arthritis in the joint.
  • Obesity. The excess pounds puts stress on the joints, especially the knees, hips, and spine. People with obesity have a higher risk of developing arthritis.

Complications

Severe arthritis, particularly if it affects your hands or arms, can make it difficult for you to do everyday tasks. Arthritis of weight-bearing joints can keep you from walking comfortably or sitting right. In some cases, joints may gradually lose their alignment and form.

Diagnosis

During the physical exam, doctors will check their joints, swelling, redness and heat. They also want to see how well you can move your joints.

Laboratory tests

The analysis of the different types of body fluids can help to identify the type of arthritis you may have. Fluids commonly analyzed include blood, urine, and joint fluid. To obtain a sample of fluid from the joint, the doctors clean and numb the area prior to the insertion of a needle into the joint space to remove some of the liquid.

Images

These types of tests can detect problems within the joint, which may be the cause of your symptoms. Examples include:

  • The x-ray. The use of low levels of radiation to visualize the bone, the X-rays can show cartilage loss, bone damage and bone spurs. X-rays may not reveal early arthritis damage, but they are often used for monitoring the progression of the disease.
  • The computed tomography (CT). The CT scanners take X-rays from different angles and combine the information to create cross-sectional views of the internal structures. CTs can view both the bone and the surrounding soft tissue.
  • Magnetic resonance imaging (MRI). The combination of radio waves with a strong magnetic field, the magnetic Resonance can produce more detailed cross-sectional images of soft tissues, such as cartilage, tendons, and ligaments.
  • Ultrasound. This technology uses high-frequency sound waves to image soft tissues, cartilage, and fluid-containing structures near the joints (the bags). Ultrasound is also used to guide the placement of the needle to remove fluid from the joint, or the injection of medications into the joint.

Treatment

Arthritis treatment focuses on relieving symptoms and improving joint function. You may need to try various treatments or combinations of treatments, before you determine what works best for you.

Drugs

The medications used to treat arthritis vary depending on the type of arthritis. Commonly used arthritis medications include:

  • Nsaids. Nonsteroidal anti-inflammatory drugs (Nsaids) can relieve pain and reduce inflammation. Examples include ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve). Stronger Nsaids can cause stomach irritation and may increase your risk of heart attack or stroke. Nsaids are also available in the form of creams or gels, which can be rubbed into the joints.
  • Counterirritants. Some varieties of creams and ointments that contain menthol or capsaicin, the ingredient that makes peppers spicy. Rub these preparations on the skin above the pain in your joints can interfere with the transmission of pain signals from the joint itself.
  • Steroids. Corticosteroids, such as prednisone, reduce inflammation and pain and slow joint damage. Corticosteroids may be given as a pill or an injection into the painful joint. Side effects may include thinning of bones, weight gain and diabetes.
  • Disease-modifying antirheumatic drugs (DMARDs). These medications can slow the progression of rheumatoid arthritis and save the joints and other tissues from permanent damage. In addition to traditional Dmards , there are also biological agents and targeted synthetic Dmards . The side effects vary, but the majority of Dmards increase the risk of infections.

Therapy

Physical therapy can be useful for some types of arthritis. The exercises can improve the range of motion and strengthen the muscles that surround the joints. In some cases, the use of splints or braces may be warranted.

Surgery

If conservative measures do not help, doctors may suggest surgery, such as:

  • Set of repair. In some cases, the surfaces of the joints can be smoothed or adjusted to reduce pain and improve function. These types of procedures can often be performed arthroscopically through small incisions in the joint.
  • The replacement of the joint. This procedure removes the damaged joint and replaces it with an artificial one. The joints most commonly replaced hips and knees.
  • The articulation of the merger. This procedure is most frequently used for the smallest, such as the wrist, the ankle and the toes. Remove the ends of the two bones of the joint, and then hang the ends together until they heal into a rigid unit.

Lifestyle and home remedies

In many cases, the symptoms of arthritis can be reduced with the following actions:

  • The loss of weight. Excess weight puts more stress on weight-bearing joints. Losing weight can increase your mobility and reduce future injuries in the joint.
  • Exercise. Regular exercise can help keep joints flexible. Swimming and water aerobics may be a good choice due to the buoyancy of the water reduces stress on weight-bearing joints.
  • The heat and the cold. Compresses or ice packs can help relieve the pain of arthritis.
  • Assistive devices. The use of walking sticks, insoles for shoes, walkers, raised toilet seats, and other assistive devices may help to protect the joints and improve your ability to perform daily tasks.

Alternative medicine

Many people use alternative remedies for arthritis, but there is little reliable evidence to support the use of many of these products. The most promising alternative remedies for arthritis include:

  • Acupuncture. This therapy uses fine needles into specific points on the skin to reduce many types of pain, including that caused by some types of arthritis.
  • The glucosamine. Although study results have been mixed, some studies have found that glucosamine does not work better than placebo. However, the glucosamine and placebo relieved the pain of osteoarthritis better than to take anything, especially in people who have moderate to severe pain from osteoarthritis of the knee.
  • Chondroitin. Chondroitin may provide modest relief of the pain of osteoarthritis, although the results of the study are mixed.
  • The fish oil. Some preliminary studies have found that fish oil supplements can reduce the symptoms of some types of arthritis. The fish oil can interfere with medications, so check with your doctor first.
  • Yoga and tai chi. The slow, stretching the movements that are associated with yoga and tai chi can help to improve joint flexibility and range of motion.
  • The massage. The light stroking and kneading of the muscles can increase blood flow and warm the affected joints, temporarily alleviate the pain. Make sure your massage therapist knows which joints are affected by arthritis.

Preparing for your appointment

While you can talk about your symptoms with your family doctor, he or she may refer you to a doctor who specializes in the treatment of joint problems (rheumatologist) for further evaluation.

What you can do

Before your appointment, make a list that includes:

  • Detailed descriptions of its symptoms
  • The information about the medical problems you have had in the past
  • Information about the health problems of your parents or siblings
  • All of the medications and supplements you take
  • Questions you want to ask the doctor

What to expect from your doctor

Your doctor may ask some of the following questions:

  • When did the symptoms begin?
  • What activities make the pain better or worse?
  • The kind of painful joints?
  • Do you have a family history of pain in the joints?
Symptoms and treatment of Arthritis