Arthritis

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Arthritis is a joint disorder featuring inflammation. A joint is an area of the body where two different bones meet.  The function of our human joints is to move our body’s connected bones. Arthritis is essentially an inflammation of one or more joints.

Arthritis is constantly associated with joint pain – joint pain is referred to as arthralgia, however, when four or more joints are involved, the arthritis is referred to as polyarthritis. There are many types of arthritis; the types of arthritis range from those related to wear and tear of cartilage to those associated with inflammation resulting from a misdirected immune system. While osteoarthritis and rheumatoid arthritis are common types of arthritis, there are many other common and uncommon types of arthritis. Other types of inflammatory arthritis include:

Types of Arthritis

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Psoriatic Arthritis

Psoriatic Arthritis (PsA) is a chronic, inflammatory disease of the joints and where tendons and ligaments connect to bone. Like psoriasis, PsA is associated with related health conditions. It can start at any age and may affect children. The disease often appears between ages 30 and 50 years. For many patients, it begins about 10 years after psoriasis develops, but some develop PsA first or without ever developing or noticing psoriasis.

 

Lupus

This condition can affect the joints, nervous system, skin, kidneys, lungs, heart, and other organs of the body. Lupus can be difficult to diagnose, as it sometimes mimics other types of arthritis and rheumatic diseases. A butterfly-shaped rash appearing on the cheeks and over the bridge of the nose is one of the characteristics of lupus.

 

Ankylosing Spondylitis

Ankylosing Spondylitis (AS) is a form of arthritis that causes chronic spine inflammation. Ankylosing Spondylitis inflames the sacroiliac joints located between the base of the spine and pelvis. This inflammation, called sacroiliitis, is one of the first signs of AS. Inflammation often spreads to joints between the vertebrae, the bones that make up the spinal column. This condition is known as spondylitis. Some patients with AS experience severe, persistent back and hip pain and stiffness. Others have milder symptoms that come and go. Over time, new bone formations may fuse vertebrae sections together, making the spine grid. This condition is known as ankylosis.

 

Reactive Arthritis

Reactive Arthritis, formerly referred to as “Reiter’s syndrome”, is a form of arthritis that affects the joints, eyes, and skin. The disease is recognized by various symptoms in different organs of the body that may or may not appear at the same time. It may come on quickly and severely or more slowly, with sudden remissions or recurrences.

 

Gout

A disease that causes hard crystals of uric acid to form in your joints.

 

Osteoarthritis

Also know as “wear and tear” arthritis, which develops when joint cartilage breaks down from repeated stress. It is the most common form of arthritis.

Some serious types of infectious arthritis include Septic Arthritis and Lyme Arthritis, as described below:

 

Septic Arthritis

Septic Arthritis is also known as “infectious arthritis”, and is typically caused by bacteria. It can also be caused by a virus or fungus. The condition is an inflammation of a joint that is caused by infection. Typically, Septic Arthritis affects one large joint in the body, such as the knee or hip. Less frequently, Septic Arthritis can affect multiple joints.

 

Lyme Arthritis

Lyme Arthritis is a chronic condition that occurs when the bacteria that cause Lyme disease lead to inflammation of joint tissues. If the infection is not treated, permanent joint damage can occur.

Causes & Symptoms

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Cartilage is a firm but flexible connective tissue in your joints – it protects the joints by absorbing the pressure and shock created when you move and put stress on them. A reduction in the normal amount of this cartilage tissue causes some forms of arthritis. Normal wear and tear cause osteoarthritis, one of the most common forms of arthritis.

An infection or injury to the joints can exacerbate this natural breakdown of cartilage tissue. Your risk of developing osteoarthritis may be higher if you have a family history of the disease. Another common form of arthritis called rheumatoid arthritis is an autoimmune disorder.

It occurs when your body’s immune system attacks the tissues of the body. These attacks affect the synovium, a soft tissue in your joints that produces a fluid that nourishes the cartilage and lubricates the joints. Rheumatoid arthritis is a disease of the synovium that will invade and destroy a joint. Therefore, it can eventually lead to the destruction of both bone and cartilage inside the joint.

Overall, different types of arthritis have different symptoms. They can be mild in some patients and severe in others. Joint discomfort might come and go, or it could stay constant. Common symptoms of arthritis include:

 

  • Redness

 

  • Pain

 

  • Stiffness

 

  • Tenderness

 

  • Swelling

Who gets Arthritis?

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Each form of arthritis has its own particular risk factors, some of which we cannot change and others that can manage. Some of the most common risk factors for the development of arthritis include the following:

 

  • Gender – Most types of arthritis are more common in women; nearly 60% of all patients with arthritis are women. Ankylosing spondylitis and gout are more common in men.

 

  • Age – The risk of developing most types of arthritis increases with age.

 

  • Obesity – Excess weight can contribute to both the onset and progression of knee and hip osteoarthritis.

 

  • Genetic – Specific genes are associated with a higher risk of certain types of arthritis, such as rheumatoid arthritis, and ankylosing spondylitis.

 

  • Joint injuries – Damage to a joint can contribute to the development of osteoarthritis in that joint.

 

  • Physical inactivity – Is associated with increased severity and progression of many types of arthritis.

 

  • Smoking – This is linked to the progression and severity of rheumatoid arthritis.

 

  • Occupation – Certain occupations involving repetitive knee bending and squatting are associated with osteoarthritis of the knee and hip.

 

  • Diet – Diet plays an important role in healthy weight maintenance, which is a key factor in the prevention / reduction of disease progression. It is also an identified risk factor for the development and management of gout.

How Does it Affect You? How Serious is it?

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Complications of arthritis vary depending on the type of arthritis. These types of arthritis include:

 

Juvenile arthritis

About 1 in 1,000 children under the age of 16 have one of the forms of arthritis. The symptoms are similar to the symptoms seen in adults.

 

Rheumatoid arthritis

With rheumatoid arthritis, the disease progression can destroy joints, leading to deformity in the fingers and wrist. Obesity and smoking can exacerbate the lung and heart complications of rheumatoid arthritis. Cardiovascular disease is the leading cause of death with this condition. Women with rheumatoid arthritis also have more difficulty conceiving. It’s recommended that the condition be well-controlled for 3-6 months before attempting to get pregnant.

 

Ankylosing spondylitis

Patients with ankylosing spondylitis have an increased risk of vertebral fracture, which could injure the spinal cord and lead to a variety of neurological symptoms like weakness, numbness, or even paralysis. Severe misalignment of the spine from ankylosing spondylitis can also cause spinal cord compression.

 

Lupus

Complications from the inflammation lupus causes can affect any number of areas in your body, including your skin, heart, lungs, kidneys, blood, and brain. If you get pregnant while you have lupus, you are more likely to have a miscarriage, high blood pressure during pregnancy, and preterm birth.

 

Gout

The high uric acid levels in long-term, untreated gout can lead to kidney stones. If you have poor kidney function, you are also at risk of acute uric acid nephropathy.

Recommended Treatment & Rehabilitation

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If you think you may have arthritis, it is recommended to see a healthcare provider. The provider will begin by asking about your symptoms and explain how joint pain can affect your life. He / she will then perform a physical exam, which may include:

 

  • Evaluating your health overall to determine if a different condition could be causing your symptoms.

 

  • Checking for areas of tenderness or swelling around your joints.

 

  • Assessing mobility and range of motion in your joints.

 

Imaging tests may help your healthcare provider get a better image of your bones, joints, and soft tissues. An X-ray, MRI, or ultrasound can reveal bone fractures or dislocations that can be causing joint pain, muscle, ligament, or tendon injuries near your joints, and soft tissue inflammation.

If you have been diagnosed with osteoarthritis in your knee, hip, shoulder, or other joint, you may want to know how to relieve your joint pain and slow down the disease’s process. Physiotherapy can help you resolve both problems. To reach a solution, a physiotherapist may design a combination of treatments to reduce most symptoms associated with arthritis. Here are a few strategies a physiotherapist may work with you, such as:

 

Maintain your range of motion

Osteoarthritis can make a joint stiff. Physiotherapy can improve your ability to bend and straighten a joint. Even incremental improvements in a joint’s range of motion can make a significant difference in joint function. For example, getting an arthritic knee to bend just 10 degrees more may allow you to comfortably get in and out of low chairs.

 

Strengthen muscles that support an arthritic joint

When osteoarthritis causes protective cartilage to wear away in a joint, there can be painful friction between the joint’s bones. You can decrease this friction by strengthening the surrounding muscles that support the joint. Your physiotherapist can identify areas of impairments and teach you how to address these impairments with functional strengthening to help you improve strength and stability in your joints.

 

Improve your balance

Individuals with osteoarthritis often have impaired balance resulting from muscle weakness, decreased joint function, decreased mobility, and other factors. Additionally, to functional strengthening, your physiotherapist may also incorporate balance components into your treatment plan that include changes in terrain / surface, walking distances, and elevation to help stimulate daily functional tasks in an effort to improve balance and reduce your risk of falling.

 

Supporting equipment

Walkers, canes, crutches, splints, and shoe inserts may be recommended to help take pressure off certain arthritic joints depending on the severity of the condition. Understanding when and how to use these assistive devices can help decrease the risk of injury and / or further impairment. Your physiotherapist can teach you how to properly fit and use certain assistive devices while also fostering an environment for you to work toward your functional independence.

 

Postural adjustments

A good posture can take the stress off arthritic joints. Your physiotherapist can educate you about ways to adjust your posture and put less stress on joints as you sit, stand, and walk. This may include suggestions to modify your environment at home and work and even in your car. Some simple changes, such as adjusting the position of your car seat, can put less stress on your arthritic joints to make your daily activities easier.

A healthcare provider typically only recommends surgery for certain severe cases of arthritis – these surgical treatments include:

 

Joint replacement

A damaged, arthritic joint gets replaced with an artificial joint. Joint replacement preserves joint function and movement. Examples include ankle replacement, hip replacement, knee replacement, and shoulder replacement.

 

Fusion

Two or more bones are permanently fused together. Fusion immobilizes a joint and reduces pain caused by movement.

Unfortunately, there is no cure for arthritis, however, there are treatments that can help you manage the condition. Your treatment plan will depend on the severity of arthritis, its symptoms, and your overall health. Conservative treatments include the following:

 

Medication

Anti-inflammatory and pain medications can help relieve your arthritis symptoms. Another medication called biologics can target your immune systems and inflammatory response. A healthcare provider may recommend biologics for your rheumatoid or psoriatic arthritis.

 

Therapeutic injections

Cortisone shots may help temporarily relieve pain and inflammation in your joints. Arthritis in certain joints, such as your knee, may improve with a treatment called ‘viscosupplementation’. This injects lubricant to help joints move smoothly.

Alternative & Homeopathic Treatment

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The following types of exercise and homeopathic treatment may help relieve the pain, joint stiffness, and other symptoms that can cause arthritis:

 

Stretching

Stretching can help improve flexibility, reduce stiffness, and increase range of motion. Stretching daily is important for relieving arthritis symptoms. The ideal stretching routine will be different for each person and depend on which joints are affected and what symptoms occur.

 

Walking

Walking is a low-impact form of exercise that can help with aerobic conditioning, heart and joint health, and mood. It is essential to wear proper shoes and stay hydrated, even if the walking is not as strenuous.

 

Strength training

Strengthening the muscles around the affected joints can help increase strength while reducing pain and other arthritic symptoms. Using a resistance band is a way to challenge the body and build muscle over time.

 

Hot and cold application

Heat therapy boosts circulation and can soothe stiff joints and aching muscles, while cold therapy restricts blood vessels, which shows circulation, reduces swelling, and numbs the pain.

 

Massage

Some studies show that regularly massaging the muscles and joints can help soothe pain resulting from arthritis. Experts believe that massage lowers the body’s production of the stress hormone cortisol and helps improve mood by boosting serotonin levels.