Arthritis Overview

Knowing Arthritis and Its Cause

The medical definition of arthritis comes from the Greek and the Latin.  Anthron, the Greek part, means joint. Itis, the Latin, means inflammation.  Inflammation of a joint which is usually accompanied by swelling, pain, and, frequently, changes in structure.  Joints, which is what arthritis affects, are part of the musculoskeletal system.

Arthritis is the main cause of disabilities in people over fifty-five in industrialized countries.

Arthritis is a term used to cover a disease.  There are over 100 different types of arthritis. Being mainly associated with the elderly, arthritis is known to affect a person of any age. In order to understand the affects arthritis has, one must first understand what a joint is made of and how it works. So let’s take a look at that.

A joint is the point of structure between two bones.  The components of the joint are cartilage, ligaments, and synovial fluid. The cartilage covers the bone surfaces to keep them from rubbing together.  The ligaments surround the joint allowing the joint to move.  The synovial fluid which is made from the synovial membrane that lines the joint cavity nourishes the cartilage and joint.

Arthritis can be caused from a lack of fluid or the wearing away of cartilage.  It can also be caused from trauma, an infection, or the body attacking itself, which is known as autoimmunity, as well as, other factors.  No matter what the cause the joints are targeted.

Let’s discuss a few of the more common types of arthritis:

  • Osteoarthritis – is a degenerative disease.  It affects mostly the weight bearing joints and is characterized by the destruction of cartilage.  The loss or destruction of cartilage can create spurs on the bones, the bones to overgrow or lip.  This condition develops slowly.
  • Rheumatoid Arthritis – is a chronic systemic disease.  It affects the synovial membrane and is characterized by the inflammatory changes in joints and related structures.  This disease causes crippling deformities.
  • Infectious arthritis (septic arthritis) – It affects the synovial fluid and surrounding tissue of the joint.  It is an infection that is caused primarily by bacteria but can be caused from a virus or fungi.  The germs can be carried through the bloodstream and infect the joint.
  • Juvenile rheumatoid arthritis – rheumatoid arthritis affecting juveniles.  Onset for this type of arthritis is usually before the age of 16.

What to look for:

Osteoarthritis – Being the slow developer it starts out with mild pain when the joint is put under pressure, over worked, or not used for a long period of time.  There may be tenderness.  As the cartilage wears the joint starts to stiffen, losing its elasticity making it more difficult to use, especially in the morning.  Eventually it causes the bones to rub against each other which causes severe pain.

Rheumatoid arthritis – The same joints become inflamed, stiff, and painfully swollen on both sides of the body.  The most commonly affected joints are the wrists, legs, arms and fingers.  The symptoms usually last 30 minutes after waking up when the stiffness is at its worst.  There may be puffiness and redness in the hands.  The patient may also find rheumatoid nodules in the arms.  Tiredness and weight loss are common in people who suffer from rheumatoid arthritis.  Sufferers usually notice the small joints being affected first, but as the disease progresses it moves to the larger joints.

  • Infectious arthritis – In most of the patients suffering from infectious arthritis only one joint is affected.  The joint becomes red and swollen.  The patient might complain of a sharp pain or tenderness.  The patient will have a fever.  Most likely these symptoms are related to another illness or injury.
  • Juvenile rheumatoid arthritis - The child may shows signs of blotchy rashes on his legs or arms.  The child might experience a fever on and off.  The fevers may be worse in the evening.  The child may show signs of poor appetite and most likely have some weight loss.  Nearly 75% of patients suffering from this type of arthritis have complete remission.

The Affects Arthritis has on Me

Arthritis affects each person differently.  Although sufferers may share the same symptoms not all sufferers deal with those symptoms the same way.  The severity, length of time, and type of arthritis one suffers from would also play a part in determining what the affects are.

There are some common complaints among arthritis sufferers.  Fatigue, pain, stiffness and discomfort to name a few.  Most people who suffer with arthritis will tell you there are good days and there are bad days.    Most sufferers will admit it gets frustrating but the important part is to remember with some changes in lifestyle there is no reason you can’t be an active participant in life.

Advantages of Physical and Occupational Therapies

Physical and occupational therapies help in keeping the joint(s) flexible and mobile.  The type of therapy one requires depends on which joint(s) are affected, the type of arthritis one suffers from, and the severity of the disease, as well as, age and overall state of health.  You, your physician and a physical or occupational therapist will need to take all these factors into consideration before therapy is started.

Joint pain can cause a person suffering with arthritis to avoid using it.  A physical therapist will provide exercises to improve your range of motion.  They can aid in working out the stiffness in the joint without causing any damage to it.  Part of improving you range of motion might consist of muscle strengthening.  Strong muscles can provide support to a weak joint.  In the event you require walking aids such as a cane, walker, or even crutches the physical therapist will teach you the proper usage.  The physical therapists may also teach you the best way to move from one position to another.

Where as a physical therapist helps in using the joint an occupational therapist trains you on how to reduce straining the joint.  Occupational therapists help teach you how your movements can aggravate your arthritis.  They can suggest how to modify your workplace and/or home to reduce the strain.

The quality of life a arthritis sufferer has can be enormously improved by a physical and/or occupational therapist.  They can teach you the best ways to handle your type of arthritis to keep you pain free and active.  Whether it’s a dietary plan, what type of shoes you should wear, or to learn more about your arthritis the therapist will help you make better decisions to improve your active lifestyle.  Rest and exercise are both important factors in maintaining an active lifestyle and a therapist can help you decide what is best for you.

A warm bath or shower can loosen the muscles making it easier to exercise.  Heating pads and ice packs are used to relieve local pain.  To relieve localized pain around the affected joint the use of hot packs and ultrasound therapy provides a deep heat that also relaxes muscles spasms.

Arthritis Medications

NSAIDs – (nonsteroidal anti-inflammatory drug) are prescribed more often for arthritis patients than any other.  These can be purchased over-the-counter or prescribed by your doctor.  NSAIDs aren’t just for arthritis sufferers.  They help reduce fever, minor pain, muscle aches and headaches when given at low doses which can be purchased over-the-counter.  A prescribed dose – higher dosage – reduces joint inflammation. Some NSAIDs block the hormone like substances called prostaglandins.  Prostaglandins trigger pain, fever, muscle cramps and inflammation.  The three main types of these NSAIDs are:

Traditional NSAIDs - These NSAIDs are the largest subset.  The side-effects of these drugs is gastrointenstinal bleeding and upset stomach.  A patient shouldn’t take high doses of this drug without physician supervision.  There is a significantly higher risk of side-effects for patients over the age of 60.

COX-2 inhibitors - these drugs reduce inflammation and pain.  In 2004/2005 certain NSAIDs were taken off the market even though they had fewer gastrointestinal and upset stomach side-effects.  Bextra caused serious skin reactions and Vioxx had cardiovascular risks.  Makers of NSAIDs were asked by the FDA to highlight warnings in a black box on their labels.

Salicylates - there are two types of salicylates, ones that contain acetylate, like aspirin, and nonacetylated salicylates.  Aspirin, however, remains the medication of choice by many doctors and patients alike, for aiding arthritis pain.  But for aspirin to have an effective control on arthritis pain high doses are needed frequently.  High doses of aspirin have serious side effects so arthritis sufferers should consult their doctor before using it on a regular basis.  Nonacetylated salicylate has less side effects than aspirin so many doctors will prescribe them. Nonacetylated salicylate doesn’t protect against cardiovascular disease like aspirin, so some doctors will prescribe for their patients who they feel need this protection, aspirin in a low dose.

  • Glucocorticoids - an anti-inflammatory steroid when used properly can be very effective at fighting inflammation.  This type of drug has undesirable side-effects which the patient will need to consider.
  • Anti-malarials – these drugs are used in mild inflammatory arthritis.  Hydroxychloroquine and chloroquine are anti-malarial drugs.
  • Minocycline – is an antibiotic whose use is controversial in treating patients with rheumatoid arthritis.
  • Sulfasalizine - is a sulfa derivative and is commonly used for many types of inflammatory arthritis.
  • Methotrexate - is commonly used in treating more serious types of inflammatory arthritis.  It works by blocking the metabolism of rapidly dividing cells
  • Azathioprine - is also used in treating more serious types of inflammatory arthritis and like methotrexate it blocks the metabolism of rapidly dividing cells
  • Gout medications - some doctors may use gout medications to treat some types of arthritis
  • Leflunomide - is used to block cell metabolism in treating rheumatoid and psoriatic arthritis
  • Cyclosporine - is usually used with methotrexate in arthritis patients.  It is a immunosuppressant drug used mainly by transplant patients so they don’t reject their new organs. It makes the immune system less aggressive.

The Impact of Bodyweight and Diet

Bodyweight can have quite an impact on arthritis.  Overweight people are adding stress to the weight bearing joints which can aggravate arthritis.  Losing a few pounds by following a healthy diet can make a difference to a arthritis sufferers quality of life.  Just by cutting back on the portions placed on your plate can help.  Eating more fruits and vegetables and less sugary and/or fatty foods is also helpful.

Arthritis experts say eating a well balanced diet is crucial in arthritis patients.  Keeping red meats, cream and cheeses to a minimum and adding more whole grains is a step in the right direction.  Sardines, trout, and salmon contain Omega 3’s which are believed to relieve arthritis symptoms.

Family life

Arthritis can be frustrating.  It can upset your daily routine and make the simplest thing seem impossible.  It can be exhausting.  And, although there is no cure for arthritis there are treatments to minimize the impact it has on your everyday activities.  For these reasons it is so important for arthritis sufferers to seek medical help and treatment.

Whether you have a job or want a job, have a family to take care of or just taking care of yourself, there are treatments available that help give you a better quality of life, compared to no treatment at all.

You should also talk with your family and friends about the type of arthritis you have and the impact it has on you.  When you make them aware of how it affects you they will better understand and may be able to help you.

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