Arthritis

ARTHRITIS comes from the Greek arthron meaning "joint" and the Latin itis meaning "inflammation".  Arthritis affects the musculo-skeletal system, specifically the joints. It is the main cause of disability among people over fifty-five years of age in industrialized countries.

There are over 100 types of arthritis.  Here is a description of some common ones, together with the causes:

 

·                        Osteoarthritis. Cartilage loses its elasticity. If the cartilage is stiff it becomes damaged more easily. The cartilage, which acts as a shock absorber, will gradually wear away in some areas. As the cartilage becomes damaged tendons and ligaments become stretched, causing pain. Eventually the bones may rub against each other causing very severe pain.

·                        Rheumatoid arthritis.  This is an inflammatory form of arthritis. The synovial membrane (synovium) is attacked, resulting in swelling and pain. If left untreated, the arthritis can lead to deformity. Rheumatoid arthritis is significantly more common in women than men and generally strikes when the patient is aged between 40 and 60. However, children and much older people may also be affected.

·                        Infectious arthritis (septic arthritic) - an infection in the synovial fluid and tissues of a joint. It is usually caused by bacteria, but could also be caused by fungi or viruses. Bacteria, fungi or viruses may spread through the bloodstream from infected tissue nearby, and infect a joint. Most susceptible people are those who already have some form of arthritis and develop an infection that travels in the bloodstream.

·                        Juvenile rheumatoid arthritis (JRA) - means arthritis that affects a person aged 16 or less. JRA can be various forms of arthritis; it basically means that a child has it. 

 SIGNS and SYMPTOMS OF ARTHRITIS

The symptoms of arthritis depend on the type of arthritis, for example:

·                        Osteoarthritis. The symptoms develop slowly and get worse as time goes by. There is pain in a joint, either during or after use, or after a period of inactivity. There will be tenderness when pressure is applied to the joint. The joint will be stiff, especially first thing in the morning. The patient may find it harder to use the joint - it loses its flexibility. Some patients experience a grating sensation when they use the joint. Hard lumps, or bone spurs may appear around the joint. In some cases the joint might swell. The most common affected joints are in the hips, hands, knees and spine.

·                        Rheumatoid arthritis.  The patient often finds the same joints in each side of the body are painfully swollen, inflamed, and stiff. The fingers, arms, legs and wrists are most commonly affected. Symptoms are usually worst on waking up in the morning and the stiffness can last for 30 minutes at this time. The joint is tender when touched. Hands may be red and puffy. There may be rheumatoid nodules (bumps of tissue under the skin of the patient's arms). Many patients with rheumatoid arthritis feel tired most of the time. Weight loss is common. 

The smaller joints are usually noticeably affected first. Experts say patients with rheumatoid arthritis have problems with several joints at the same time. As the arthritis progresses it spreads from the smaller joints in your hands, wrists, ankles and feet to your elbows, knees, hips, neck, shoulders and jaw.

·                        Infectious arthritis.  The patient has a fever, joint inflammation and swelling. He will feel tenderness and/or a sharp pain. Often these symptoms are linked to an injury or another illness. Most commonly affected areas are the knee, shoulder, elbow, wrist and finger. In the majority of cases, just one joint is affected.

        Juvenile rheumatoid arthritis.  The patient is a child. He will experience intermittent fevers which tend to peak in the evening and then suddenly disappear. His appetite will be poor and he will lose weight. There may be blotchy rashes on his arms and legs. Anemia is also common. The child may limp or have a sore wrist, finger, or knee. A joint may suddenly swell and stay larger than it usually is. The child may experience a stiff neck, hips or some other joint.

Physical therapy and occupational therapy for arthritis

Physical therapy and occupational therapy help maintain joint mobility and range of motion. How much therapy you need, and what kind of therapy you get will depend on many factors such as the severity and type of arthritis you have, your age, and your general state of health. This has to be decided by you with your physician and physical or occupational therapist. 

Medications for Arthritis

NSAIDs NSAIDs (nonsteroidal anti-inflammatory drugs) are the most commonly prescribed drugs for arthritis patients.

Traditional NSAIDs - these are the largest subset of NSAIDs. As is the case with most drugs, they do carry a risk of side-effects, such as stomach upset and gastrointestinal bleeding.

Glucocorticoids are anti-inflammatory steroids and are very effective at combating inflammation and can be extremely helpful when used properly. The patient needs to consider the potential for undesirable side-effects with this type of drug.

Diet and bodyweight impact on arthritis

Experts say that eating a well-balanced diet is vital when you have arthritis. Not only will you be receiving critical nutrients, you will also be either maintaining or arriving more quickly at a healthy bodyweight. If you are overweight you will be adding extra pressure on weight-bearing joints. Many patients have found that losing just a few pounds made a significant difference to their quality of life. 

For free e-books on arthritis, you may visit Rheumatoid Arthritis.

R. Y. MANABAT, R.N.