Arthritis

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Arthritis

Alternative names

Osteoarthritis, Rheumatoid arthritis

Description

Your joints ache and you’ve recently noticed some swelling in your fingers. Is this a normal part of the aging process or something more serious?

Arthritis is the term used to describe a number of conditions that cause pain and swelling in the joints. While aches and pains are common as people age, arthritis causes specific symptoms and damage to the joints and is not necessarily a “normal” part of aging.

While arthritis is more common in older people, osteoarthritis, rheumatoid arthritis and other types of arthritis can occur in younger people as well and may lead to deformities in the joints and even disability. There’s even a type of arthritis called juvenile arthritis that strikes children under the age of 16.

There is no cure for arthritis, but the condition can be managed with appropriate therapies, which can include hot and cold therapy, physical therapy and medication.

Causes

Osteoarthritis is the most common type of arthritis, and it is typically the result of years of wear and tear on the joints and the cartilage. When the cartilage becomes damaged, the bones grind against each other, creating pain and swelling. Injuries and infections to the joint may cause osteoarthritis to occur earlier than it would otherwise.

Rheumatoid arthritis is an autoimmune disease. The body’s immune system does not recognize the lining of the joint capsule as a part of the body and instead treats it as a foreign invader, attacking it. This causes the lining to become inflamed, swollen and painful. In time, rheumatoid arthritis can destroy the cartilage and bone tissue of the joint.

Risk Factors

Most of the risk factors for developing arthritis are unavoidable. These include:

  • A family history of the condition
  • Increased age
  • Being female
  • Previous injury or infection in the joints

One common risk factor for developing osteoarthritis is mostly within the patient’s control. Carrying a great deal of extra weight puts more strain on the joints and is often implicated in developing osteoarthritis. Losing weight can also lessen the symptoms of arthritis if the condition is already present.

Symptoms

The symptoms of arthritis are well known, limited to the joints, and are usually what drives a patient to seek medical help. These are:

  • Pain
  • Swelling
  • Stiffness
  • Inflammation and warmth
  • Decreased range of motion
  • Redness

These symptoms increase as time goes by, especially if left untreated.

Tests and Examinations

The doctor will perform a physical examination of the joint and may also take x-rays to determine the full extent of the damage the arthritis has caused. Range-of-motion tests will also be performed.

If there’s a question about the type of arthritis you have, laboratory tests may be performed. These require blood, urine or a small amount of the synovial fluid from your joints. A blood test will also confirm the presence of antibodies called rheumatoid factors if rheumatoid arthritis is suspected.

Other tests that are effective for diagnosing and understanding the type of arthritis that is present are CT scans, MRIs and ultrasounds. The doctor may also order an arthroscopy. In this test, a small tube is inserted near your joint and transmits images of your joints to the doctor.

Diagnosis

A diagnosis is made based on the results of the physical examination, the patient’s description of symptoms and the results of various tests. If x-rays show a loss of cartilage, then arthritis will be the diagnosis. The presence of rheumatoid factors in a blood test will confirm a diagnosis of rheumatoid arthritis.

Treatment

Physical therapy combined with medication therapy is typical in the treatment of arthritis. Physical therapy may include hot and cold therapy, range of motion exercises and splinting.

A range of medications are used to treat arthritis:

  • Pain relievers, or analgesics, include both over-the-counter medications such as acetaminophen and prescription medications such as tramadol. In more severe cases, narcotic analgesics may be used including hydrocodone and oxycodone.
  • Nonsteroidal anti-inflammatories including ibuprofen and naproxen are used to control both pain and swelling.
  • Cox-2 inhibitors reduce pain and swelling by blocking the production of a specific enzyme. Celecoxib is a Cox-2 inhibitor.
  • Corticosteroids such as prednisone reduce inflammation and can be taken as a pill or injected into the joint.
  • Disease modifying antirheumatic drugs (DMARDS) are used to treat rheumatoid arthritis. They work by lowering the immune system. Methotrexate and hydroxychloroquine are examples of these.
  • Genetically engineered medications known as biologic response modifiers include etanercept and infliximab. These are also used to alter the immune response to treat rheumatoid arthritis.

In some cases, surgery may be a solution. Joint replacement and joint fusion surgeries are both used to treat arthritis. Joint replacement surgeries are performed on the larger joints such as the shoulders, knees and hips, and joint fusion surgeries are done in the smaller joints such as the fingers and toes.

Prognosis

With early diagnosis and treatment as well as a commitment to therapy, caring for the joints and following the provider’s instructions, the long-term prognosis can be good with minimal pain and swelling. Without treatment, inflammation and pain will increase, limiting motion in the affected joints.

Rheumatoid arthritis is a progressive disease that causes severe damage to the affected joints. The goal is to cause the disease to go into remission, which is defined as no active inflammation and no further progress of damage or functional deterioration. So far, this can be achieved in 10 to 50 percent of patients who are diagnosed early.

Complications

The pain and swelling of osteoarthritis and rheumatoid arthritis can severely affect a person’s quality of life and their ability to manage self-care. In advanced stages, disability is likely. Joints may become deformed as the condition progresses. Rheumatoid arthritis is linked to early death.

When to Contact a Health Professional

Any patients experiencing pain, swelling or redness in the joints should contact a doctor for an assessment and early treatment to keep the symptoms and deterioration of arthritis at bay. It’s also important to determine which type of disease is present for proper treatment.

Prevention

While some cases of arthritis can’t be prevented, there are steps that people can take to reduce their risk:

  • Stay physically active with low-impact exercises.
  • Maintain an appropriate weight.
  • Care for joints properly when exercising, playing sports or even sitting at a desk.

To prevent the flare-ups and pain associated with arthritis, follow your doctor’s therapy and self-care instructions and take your medications as prescribed.