Arthritis is very common but not well understood. Actually, “arthritis” is not a single disease; it is an informal way of referring to joint pain or joint disease.
Arthritis is a term often used to mean any disorder that affects joints. A joint is an area of the body where two different bones meet. A joint functions to move the body parts connected by its bones.
A lot of people who think they might have arthritis never discuss it with their doctors for some reason. Many older people accept joint pain as a part of aging that can’t be avoided. They don’t talk to their doctors because they assume nothing can be done about it. Myths, like those, can pass from generation to generation, even though they aren’t true, and younger people with joint pain, swelling or stiffness might not even consider arthritis. They would be surprised to learn that people of any age can get arthritis, even children.
People of all ages, sexes and races can and do have arthritis, but It is most common among women and occurs more frequently as people get older.
Arthritis can cause permanent joint changes. These changes may be visible, such as knobby finger joints, but often the damage can only be seen on X-ray. Some types of arthritis also affect the heart, eyes, lungs, kidneys and skin as well as the joints.
The term arthritis is from the Greek word “arthro” - meaning joint - and “itis” – meaning inflammation. There are more than 100 different types of arthritis and related conditions. The most common include:
Osteoarthritis is the most common type of arthritis. When the cartilage – the slick, cushioning surface on the ends of bones – wears away, bone rubs against bone, causing pain, swelling and stiffness. Over time, joints can lose strength and pain may become chronic. Risk factors include excess weight, family history, age and previous injury (an anterior cruciate ligament, or ACL, tear, for example).
When the joint symptoms of osteoarthritis are mild or moderate, they can be managed by:
balancing activity with rest
using hot and cold therapies
regular physical activity
maintaining a healthy weight
strengthening the muscles around the joint for added support
using assistive devices
taking over-the-counter (OTC) pain relievers or anti-inflammatory medicines
avoiding excessive repetitive movements
If joint symptoms are severe, causing limited mobility and affecting quality of life, some of the above management strategies may be helpful, but joint replacement may be necessary.
Osteoarthritis can be prevented by staying active, maintaining a healthy weight, and avoiding injury and repetitive movements.
A healthy immune system is protective. It generates internal inflammation to get rid of infection and prevent disease. But the immune system can go awry, mistakenly attacking the joints with uncontrolled inflammation, potentially causing joint erosion and may damage internal organs, eyes and other parts of the body.
Rheumatoid arthritis and psoriatic arthritis are examples of inflammatory arthritis. Researchers believe that a combination of genetics and environmental factors can trigger autoimmunity. Smoking is an example of an environmental risk factor that can trigger rheumatoid arthritis in people with certain genes.
With autoimmune and inflammatory types of arthritis, early diagnosis and aggressive treatment is critical. Slowing disease activity can help minimize or even prevent permanent joint damage. Remission is the goal and may be achieved through the use of one or more medications known as disease-modifying antirheumatic drugs (DMARDs). The goal of treatment is to reduce pain, improve function, and prevent further joint damage.
A bacterium, virus or fungus can enter the joint and trigger inflammation. Examples of organisms that can infect joints are salmonella and shigella (food poisoning or contamination), chlamydia and gonorrhea (sexually transmitted diseases) and hepatitis C (a blood-to-blood infection, often through shared needles or transfusions). In many cases, timely treatment with antibiotics may clear the joint infection, but sometimes the arthritis becomes chronic.
Uric acid is formed as the body breaks down purines, a substance found in human cells and in many foods. Some people have high levels of uric acid because they naturally produce more than is needed or the body can’t get rid of the uric acid quickly enough. In some people the uric acid builds up and forms needle-like crystals in the joint, resulting in sudden spikes of extreme joint pain, or a gout attack.
Gout can come and go in episodes or, if uric acid levels aren’t reduced, it can become chronic, causing ongoing pain and disability.
What are the Causes and Risk Factors?
The causes of arthritis depend on the form of arthritis. Possible causes may include:
injury, leading to degenerative arthritis
abnormal metabolism, leading to gout and pseudogout
the direct and indirect effect of infections (bacterial and viral)
and a misdirected immune system with autoimmunity (such as in rheumatoid arthritis and systemic lupus erythematosus)
Most types of arthritis are linked to a combination of factors, but some have no obvious cause and appear to be unpredictable in their emergence.
There are certain risk factors associated with arthritis which include:
Age: the risk of developing most types of arthritis increases with age.
Sex: most types of arthritis are more common in females, and 60 percent of all people with arthritis are female. Gout is more common in males than females.
Genetic factors: specific genes are associated with a higher risk of certain types of arthritis, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and ankylosing spondylitis.
Overweight and obesity: excess weight can contribute to both the onset and progression of knee osteoarthritis.
Additional factors, such as smoking and physically demanding occupations, can interact with genes to further increase the risk of arthritis.
Occupation: certain occupations that involve repetitive knee bending and squatting are associated with osteoarthritis of the knee.
What are Arthritis Signs and Symptoms?
Pain, which can vary in severity, is a common symptom in virtually all types of arthritis. Other symptoms include:
locking of the joint
joint stiffness and
aching around the joint(s).
Arthritic disorders like lupus and rheumatoid arthritis can affect other organs in the body, leading to a variety of symptoms. Symptoms may include:
Inability to use the hand or walk
Stiffness, which may be worse in the morning, or after use
Malaise and fatigue
Muscle aches and pains
Difficulty moving the joint
Symptoms may come and go. They can be mild, moderate or severe. They may stay about the same for years, but may progress or get worse over time. It is common in advanced arthritis for significant secondary changes to occur. For example, severe arthritis can result in chronic pain, inability to do daily activities and make it difficult to walk or climb stairs, which can lead to secondary effects, such as:
Loss of flexibility
Decreased aerobic fitness
These changes, in addition to the primary symptoms, can have a huge impact on quality of life.
Arthritis diagnosis often begins with a primary care physician, who performs a physical exam and may do blood tests and imaging scans to help determine the type of arthritis. An arthritis specialist or rheumatologist should be involved if the diagnosis is uncertain or if the arthritis may be inflammatory. Rheumatologists typically manage ongoing treatment for inflammatory arthritis, gout and other complicated cases. Orthopaedic surgeons do joint surgery, including joint replacements. When the arthritis affects other body systems or parts, other specialists, such as ophthalmologists, dermatologists or dentists, may also be included in the health care team.
The treatment of arthritis is very dependent on the precise type of arthritis present. An accurate diagnosis increases the chances for successful treatment. Though, treatment aims to control pain, minimize joint damage, and improve or maintain quality of life. Treatments available include physical therapy, home remedies, splinting, cold-pack application, paraffin wax dips, anti-inflammatory drugs, pain medications (ranging from acetaminophen [paracetamol] and ibuprofen to narcotics), immune-altering medications, biologic medications, surgical operations and patient education and support. Pain from osteoarthritis of the knee can be relieved by hyaluronic acid injections. Rheumatoid arthritis can require medications that suppress the immune system. Low back arthritis that is irritating nerves of the spine can require surgical repair.
Self-management of arthritis symptoms is also important.
Key strategies include:
staying physically active
achieving and maintaining a healthy weight
getting regular check-ups with the doctor
protecting joints from unnecessary stress
Seven habits that can help a person with arthritis to manage their condition are:
Being organized: keep track of symptoms, pain levels, medications, and possible side effects for consultations with your doctor.
Managing pain and fatigue: a medication regimen can be combined with non-medical pain management. Learning to manage fatigue is key to living comfortably with arthritis.
Staying active: exercise is beneficial for managing arthritis and overall health.
Balancing activity with rest: in addition to remaining active, rest is equally important when your disease is active.
Eating a healthy diet: a balanced diet can help you achieve a healthy weight and control inflammation. Avoid refined, processed foods and pro-inflammatory animal-derived foods and choose whole plant foods that are high in antioxidants and that have anti-inflammatory properties.
Improving sleep: poor sleep can aggravate arthritis pain and fatigue. Take steps to improve sleep hygiene so you find it easier to fall asleep and stay asleep. Avoid caffeine and strenuous exercise in the evenings and restrict screen-time just before sleeping.
Caring for joints: tips for protecting joints include using the stronger, larger joints as levers when opening doors, using several joints to spread the weight of an object such as using a backpack and gripping as loosely as possible by using padded handles.
Do not sit in the same position for long periods. Take regular breaks to keep mobile.
If you invest in yourself and recognize your responsibility to take good care of yourself, you can live well with arthritis. You’ll need to make adjustments, but make sure your goals are realistic, even if they involve only small steps right now.
No one can take care of you better than you can.
Is there an arthritis diet?
For most forms of arthritis, diets play little or no role in precipitating or exacerbating the condition. However, in general, oils of fish have been shown to have anti-inflammatory properties. Some osteoarthritis sufferers benefit from omega-3 fatty acid supplements. Some people with osteoarthritis feel they benefit from the curcumin that is present in curry foods.
With the exception of the unique metabolic form of arthritis in gout and celiac disease, there are no universally accepted foods that must be avoided by people with arthritis.
Gout is a particular type of metabolic arthritis that is clearly diet-related. Foods that are high in purines, especially red meats and shellfish, can worsen the condition. Moreover, certain foods elevate the levels of uric acid, including alcohol (especially beer) and those foods containing high amounts of fructose (such as the corn syrup found in soft drinks). For people with celiac disease, gluten-containing foods (wheat, barley, rye) can worsen joint pains.
The Complications of Arthritis and Prognosis
The outlook for patients with arthritis depends on its severity, complications and whether or not there are non-joint manifestations of the disease. For example, rheumatoid arthritis can affect the lungs, kidneys, eyes, etc. Chronic joint inflammation can lead to permanent damage to the joint and loss of joint function, making movement difficult or impossible.
Is it possible to prevent arthritis?
The fact is that there is no sure way to prevent arthritis. But you can help reduce your risk and delay the potential onset of certain types of arthritis. If you have healthy joints right now, do all you can now to maintain mobility and function and avoid the pain and disability associated with arthritis.
Here are just a few preventive measures:
Maintain a healthy weight
Do not smoke
Eat a healthy diet, low in sugar, alcohol and purines
Arthritis that follows joint injury could be prevented by adhering to safety regulations and trying to avoid becoming injured.
Arthritis related to infection (for examples, septic arthritis, reactive arthritis, Whipple's disease) could be prevented by not becoming infected with the causative organism.
Lifelong joint health is an important part of everyone’s wellness, productivity, quality of life and independence. If you have arthritis, you want to find out early so you can take steps to protect your joints from ongoing pain and permanent damage of uncontrolled inflammation. Early diagnosis and treatment can save more than joints. Some types of arthritis can cause internal damage to the heart and other organs from the start. Prompt treatment can protect your overall health.