Arthritis is a broad term that covers a group of over 100 diseases
. It has everything to do with your joints -the places where your bones connect – such as your wrists, knees, hips, or fingers. But some types of arthritis can also affect other connective tissues and organs, including your skin.
About 1 out of 5 adults have some form of the condition. It can happen to anyone, but it becomes more common as you age.
With many forms of arthritis, the cause is unknown. But some things can raise your chances of getting it.
• Age: As you get older, your joints tend to get worn down.
• Gender: Most types of arthritis are more common among women, except for gout.
• Genes: Conditions like rheumatoid arthritis, lupus, and ankylosing spondylitis are linked to certain genes.
• Excess weight: Carrying extra pounds makes arthritis in the knee start sooner and get worse faster.
• Injuries: They can cause joint damage that can bring on some types of the condition.
• Infection: Bacteria, viruses, or fungi can infect joints and trigger inflammation.
• Work: If you go hard on your knees at work — knee bends and squats — you might be more likely to get osteoarthritis.
The most common signs and symptoms of arthritis involve the joints. Depending on the type of arthritis you have, your signs and symptoms may include:
• One or more joints that are swollen or stiff
• Joints that look red or feel warm to the touch
• Trouble moving
• Problems doing everyday tasks
The symptoms can be constant, or they may come and go. They can range from mild to severe.
More-severe cases may lead to permanent joint damage.
The two main types of arthritis — osteoarthritis and rheumatoid arthritis — damage joints in different ways.
The most common type of arthritis, osteoarthritis involves wear-and-tear damage to your joint’s cartilage — the hard, slick coating on the ends of bones where they form a joint. Cartilage cushions the ends of the bones and allows nearly friction less joint motion, but enough damage can result in bone grinding directly on bone, which causes pain and restricted movement. This wear and tear can occur over many years, or it can be hastened by a joint injury or infection.
Osteoarthritis also affects the entire joint. It causes changes in the bones and deterioration of the connective tissues that attach muscle to bone and hold the joint together. It also causes inflammation of the joint lining.
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 (synovial membrane) becomes inflamed and swollen. The disease process can eventually destroy cartilage and bone within the joint.
Gout is another form of arthritis that can be very painful. Uric acid buildup in the body causes needle-like crystal deposits to form in your joints. You might notice lumps under your skin called tophi.
A lot of people see the first symptoms of gout in their big toe, which can get swollen, sore, red, and warm.
Other areas that gout can attack include:
• Foot instep
Bouts of gout can come and go. The pain might become constant if you don’t get the condition treated.
You can treat it with medication, but you’ll also need to control your weight, limit alcohol, and cut down on meats and fish that have chemicals called purines.
Risk factors for arthritis include:
• Family history: Some types of arthritis run in families, so you may be more likely to develop arthritis if your parents or siblings have the disorder. Your genes can make you more susceptible to environmental factors that may trigger arthritis.
• 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 most 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 eventually develop arthritis in that joint.
• Obesity: Carrying excess pounds puts stress on joints, particularly your knees, hips and spine. People with obesity have a higher risk of developing arthritis.
During the physical exam, your doctor will check your joints for swelling, redness and warmth. He or she will also want to see how well you can move your joints.
Depending on the type of arthritis suspected, your doctor may suggest some of the following tests.
The analysis of different types of body fluids can help pinpoint the type of arthritis you may have. Fluids commonly analyzed include blood, urine and joint fluid. To obtain a sample of your joint fluid, your doctor will cleanse and numb the area before inserting a needle in your joint space to withdraw some fluid.
These types of tests can detect problems within your joint that may be causing your symptoms. Examples include:
• X-rays: Using low levels of radiation to visualize bone, X-rays can show cartilage loss, bone damage and bone spurs. X-rays may not reveal early arthritic damage, but they are often used to track progression of the disease.
• Computerized tomography (CT): CT scanners take X-rays from many different angles and combine the information to create cross-sectional views of internal structures. CTs can visualize both bone and the surrounding soft tissues.
• Magnetic resonance imaging (MRI): Combining radio waves with a strong magnetic field, MRI 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 (bursae). Ultrasound is also used to guide needle placement for joint aspirations and injections.
You doctor can help you manage your pain, prevent damage to the affected joint, and keep inflammation at bay.
She might recommend:
• Physical therapy
• Splints or other aids
• Weight loss
• In rare cases, surgery
The types of medicines your doctor might suggest are:
• Painkillers: over-the-counter or prescription
• Non steroidal anti-inflammatory drugs ( NSAIDs )
• Biologics medications that are designed to counteract inflammatory signals in the body and are made by complex methods involving genetically-modified bacteria
• Steroids to cut down on inflammation
• Disease-modifying anti-rheumatic drugs (DMARDs) : meds that slow or stop inflammation
Physical therapy can be helpful for some types of arthritis. Exercises can improve range of motion and strengthen the muscles surrounding joints. In some cases, splints or braces may be warranted.
If conservative measures don’t help, your doctor may suggest surgery, such as:
• Joint repair: In some instances, joint surfaces can be smoothed or realigned to reduce pain and improve function. These types of procedures can often be performed arthroscopically — through small incisions over the joint.
• Joint replacement: This procedure removes your damaged joint and replaces it with an artificial one. Joints most commonly replaced are hips and knees.
• Joint fusion: This procedure is more often used for smaller joints, such as those in the wrist, ankle and fingers. It removes the ends of the two bones in the joint and then locks those ends together until they heal into one rigid unit.
Alternative treatments such as acupuncture, massage, yoga, and physical therapy may help ease your symptoms, too. Talk to your doctor before you try them or any supplements or herbal remedies.