Arthritis: There's More to it Than You Might Think!

You have probably heard the word ‘arthritis’ commonly used and thrown around, but it surprisingly refers not to a single disease but rather a reference to joint pain and inflammation. Arthritis is diverse in that it not only affects people of all ages, sexes, and ethnicities, but its symptoms vary in its severity, location, and duration. Common symptoms include swelling, pain, stiffness, and decreased range in motion. This can result in chronic or permanent joint changes, both physically visible (i.e. knobby finger joints) and invisible (can only be seen with X-rays).

The most common type of arthritis is osteoarthritis, which usually comes with age and the overuse of joints, although obesity and frequent joint injuries are also factors. The joints particularly affected are the knees, hips, feet, and spine-- the parts of the body that bear the most weight. What happens is that the body’s shock absorber is lost, as cartilage, which covers the bones and acts as a slippery cushion, gradually breaks down. This results in bone rubbing against bone, making movement painful; when the cartilage becomes rough and rubs against each other, it is possible to hear a grating sound. This results in painful bumps on the ends of bones, especially fingers and feet. Symptoms include feeling pain after walking, stiffness after resting, and swollen and warm joints. Joint replacement is necessary for severe cases, but mild or moderate cases of osteoarthritis can be managed by maintaining a healthy weight, exercising, using therapy, and avoiding excessive repetitive movements. 

Another common form is rheumatoid arthritis, an autoimmune disease. The immune system attacks its own joints, causing inflammation and rheumatoid nodules (bumps on the skin) to form over the knuckles, elbows, and heels. The symptoms are often more severe than those of osteoarthritis, as it usually affects multiple joints at once and has a symmetrical pattern-- for example, if the knuckles on the left hand swell, those on the right hand will start to as well. This leads to constant fatigue throughout the day and weight loss, symptoms not associated with osteoarthritis. Scientists believe that the immune system is triggered by two chemical factors-- tumor necrosis factor (TNF) and interleukin-1, although genetics and environmental factors such as smoking also play a role. This can be treated with disease-modifying antirheumatic drugs (DMARDs) that will reduce pain, improve function, and prevent further joint damage. 
Psoriatic arthritis is also another common form of arthritis and is a type of inflammatory arthritis. It is the inflammation of the skin, leading to patchy red areas of inflamed skin. It usually affects the fingers and toes, although other affected areas can include elbows, knees, the scalp, and genital areas. The skin disease, psoriasis, usually appears first; about 20% of people with psoriasis will develop psoriatic arthritis. 

Diagnosis of arthritis often begins with a primary care physician, who can perform a physical exam, blood tests, and scans to determine what type of arthritis is present. If the arthritis is inflammatory or if the physician is uncertain, a rheumatologist (arthritis specialist) should be referred to, as they are better suited for more complicated cases. When other body parts are affected, other doctors may come in, such as orthopedic surgeons for joint surgery, ophthalmologists, dermatologists, and dentists. 

Although arthritis can sometimes be inevitable and not prevented, there are definitely ways to reduce the risk for arthritis. Avoiding overuse or strain on a body part, exercising with proper form, staying physically active, not smoking, and maintaining a healthy weight are all ways to decrease risk factors. There is not a cure for arthritis, but that does not mean that there aren’t medications, therapies, and lifestyle modifications that can be taken. Self-care is an important aspect of treating arthritis, including using hot and cold packs. Medications are constantly used for the pain, such as non-steroidal anti-inflammatory drugs and immunosuppressive drugs. Forms of therapy include hydrotherapy, stretching, massages, and acupuncture. Hip, knee and joint replacement are the common forms of surgery that is performed for those with severe arthritis. It is a common stereotype that arthritis affects only the elderly, but it is not true! In fact, about 300,000 infants, children, and teenagers experience arthritis, which is even more of a reason why we should all be aware of ways to lead a healthy lifestyle and protect our joints from unnecessary damage.

Stephanie ChanComment