OVERVIEW
Arthritis is a disease that affects your joints (areas where your bones meet and move). Arthritis usually involves inflammation or degeneration (breakdown) of your joints. These changes can cause pain when you use the joint.
Arthritis is most common in the following areas of the body:
- Feet.
- Hands.
- Hips.
- Knees.
- Lower back.
What are the parts of a joint?
Joints get cushioned and supported by soft tissues that prevent your bones from rubbing against each other. A connective tissue called articular cartilage plays a key role. It helps your joints move smoothly without friction or pain.
Some joints have a synovial membrane, a padded pocket of fluid that lubricates the joints. Many joints, such as your knees, get supported by tendons and ligaments. Tendons connect muscles to your bones, while ligaments connect bones to other bones.
Types
Arthritis is a broad term that describes more than 100 different joint conditions. The most common types of arthritis include:
- Osteoarthritis, or “wear and tear” arthritis, which develops when joint cartilage breaks down from repeated stress. It’s the most common form of arthritis.
- Ankylosing spondylitis, or arthritis of the spine (usually your lower back).
- Juvenile arthritis (JA), a disorder where the immune system attacks the tissue around joints. JA typically affects children 16 or younger.
- Gout, a disease that causes hard crystals of uric acid to form in your joints.
- Psoriatic arthritis, joint inflammation that develops in people with psoriasis (autoimmune disorder that causes skin irritation).
- Rheumatoid arthritis, a disease that causes the immune system to attack synovial membranes in your joints.
Differential Features of the Hand in Rheumatoid Arthritis and Osteoarthritis
| Criteria | Rheumatoid Arthritis | Osteoarthritis |
|---|---|---|
| Joint swelling | CommonSynovial, capsular, soft tissue | UncommonPossibly mild swelling |
| Bony hypertrophy | Only in late stages | Common, often with irregular spurs |
| DIP involvement | Rare | Frequent |
| MCP involvement | Frequent | Unusual, usually mildPossibly significant MCP involvement in hemochromatosis |
| PIP involvement | Frequent | Frequent |
| Wrist involvement | Frequent | Rare, however involvement of first CMC joint (common) sometimes perceived as wrist pain |
| CMC = carpometacarpal; DIP = distal interphalangeal; MCP = metacarpophalangeal; PIP = proximal interphalangeal. |
Symptoms
The symptoms of arthritis that appear and how they appear vary widely, depending on the type.
They can develop gradually or suddenly. As arthritis is most often a chronic disease, symptoms may come and go, or persist over time.
However, anyone who experiences any of the following four key warning signs should see a doctor.
- Pain: Pain from arthritis can be constant, or it may come and go. It may affect only one part or be felt in many parts of the body.
- Swelling: In some types of arthritis, the skin over the affected joint becomes red and swollen and feels warm to the touch.
- Stiffness: Stiffness is a typical symptom. With some types, this is most likely upon waking up in the morning, after sitting at a desk, or after sitting in a car for a long time. With other types, stiffness may occur after exercise, or it may be persistent.
- Difficulty moving a joint: If moving a joint or getting up from a chair is hard or painful, this could indicate arthritis or another joint problem.
In addition to these general signs, certain types of arthritis may cause their own unique symptoms. For example, Juvenile RA can cause eye problems, including uveitis, iridocyclitis, or iritis.
Septic arthritis often causes fever and intense joint pain. It can become an emergency if it progresses to sepsis.
Causes
There is no single cause of all types of arthritis. The cause or causes vary according to the type or form of arthritis.
Possible causes may include:
- an injury, which can lead to degenerative arthritis
- an abnormal metabolism, which can cause gout and calcium pyrophosphate deposition disease (CPPD)
- a genetic inheritance, which can lead to developing osteoarthritis
- an infection such as Lyme disease, which can trigger arthritis symptoms
- an immune system dysfunction, such as the type that causes RA and lupus
Most types of arthritis are linked to a combination of factors. However, some have no obvious cause and appear to be unpredictable in their emergence.
Treatment
Treatment for arthritis aims to control pain, minimize joint damage, and improve or maintain function and quality of life. A range of medications and lifestyle strategies can help achieve this and protect joints from further damage.
The exact treatment depends on the type of arthritis a person develops. It may involveTrusted Source:
Medication
Medications will depend on the type of arthritis. Commonly used drugs include:
- Analgesics: These reduce pain. However, they have no effect on inflammation. Examples include acetaminophen (Tylenol) and tramadol (Ultram).
- Nonsteroidal anti-inflammatory drugs (NSAIDs): These reduce both pain and inflammation. NSAIDs include available to purchase over-the-counter or online, including ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve). Some NSAIDs are available as creams, gels, or patches, which can be applied to specific joints.
- Counterirritants: Some creams and ointments contain menthol or capsaicin, the ingredient that makes hot peppers spicy. Rubbing these on the skin over a painful joint can modulate pain signals from the joint and lessen pain.
- Disease-modifying antirheumatic drugs (DMARDs): These are used to treat RA. DMARDs slow or stop the immune system from attacking the joints. Examples include methotrexate (Trexall) and hydroxychloroquine (Plaquenil).
- Biologics: These are genetically engineered drugs that target various protein molecules involved in the immune response. Examples include etanercept (Enbrel) and infliximab (Remicade).
- Corticosteroids: prednisone and cortisone reduce inflammation and suppress the immune system.
Diet
Eating some types of food may help reduce inflammation.
The following foods, found in a Mediterranean diet, can provide many nutrients that are good for joint health and can help relieve joint inflammation.
- fish
- nuts and seeds
- fruits and vegetables
- beans
- olive oil
- whole grains
On the other hand, people living with arthritis should avoid or limit eating processed foods, foods that contain added sugar, and refined carbohydrates. These foods may actually make arthritis inflammation worse.
Surgery
Depending on the type of arthritis a person has, different surgical treatments on the affected joints may be necessary. It may depend on the degree of a person’s symptoms and whether other treatments have been successful.
Surgery options for arthritis includeTrusted Source:
- synovectomy
- total joint replacement (TJR)
- osteotomy
- joint fusion