Arthritis — the most common cause of disability in the US — is common and frequently talked about, but not that well-understood. This can be explained by the fact that arthritis isn't just one disease, but many. Over one hundred subtypes exist, and though they all have slightly different characteristics, most kinds of arthritis come with common symptoms. These are joint paint, stiffness, decreased range of motion, and inflammation; all things that interfere with patients' ability to live the way they want to.
Though most people will immediately think of the elderly when they hear the word "arthritis" and it is true that age increases the risk, the fact is that arthritis can strike people of any age, from children to senior citizens. Consider, for instance, that:
- An estimated 54 million adults in the United States have been formally diagnosed with some form of arthritis. Because this estimate is a conservative one, the true number could be much higher.
- Did you believe that arthritis only affects older people? Think again! Around 300,000 babies (yes, babies!) and children in the US have arthritis.
- Approximately two thirds of arthritis patients in the US are aged 18 to 64, in other words of working age.
What should you know about arthritis — whether you're newly diagnosed, suspect you could have it, or are just a curious citizen? This article serves as a "launch pad" that contains the basic facts our team here at SteadyHealth thinks everyone should be aware of. We'll share links that allow you to explore different aspects of arthritis throughout.
What are the most common types of arthritis? What are their symptoms and risk factors?
With over one hundreds known kinds of arthritis, we can't share them all! Instead, here's an overview of the most frequent types.
Osteoarthritis is the most prevalent kind of arthritis. Also called "wear and tear arthritis", it develops when the cartilage — a strong but elastic kind of tissue — breaks down, causing damage to the surrounding bone. Over 30 million people in the US alone have osteoarthritis, which is most likely to affect the hands, hips, and knees, though it can also impact other joints.
The most common symptoms of osteoarthritis are:
- Pain or aching in the affected joint(s).
- "Decreased range of motion", a medical term you'll hear often arthritis is discussed and that basically means you can't move the affected joints as well as you used to be able to.
- Inflammation, or swelling.
Risk factors for osteoarthritis include, but aren't limited to:
- A history of injury to the joint in question.
- Overuse — repetitive stress can increase your risk of developing this form of arthritis.
- Sex. Biological women are more likely to suffer from osteoarthritis.
- Obesity. If you are obese, your joints are under extra stress that increases your risk of osteoarthritis.
- Age. It is really no surprise that older people will have had more time to wear out their joints, and are thus more likely to develop osteoarthritis.
Rheumatoid arthritis is among the most well-known kinds of arthritis out there. It is an inflammatory autoimmune disease, in which your own immune system mistakes healthy tissues for a threat and attacks them, leading to inflammation. Affecting around one percent of the population, it is most likely to affect the joints of the hands, wrists, and knees — though rheumatoid arthritis often strikes multiple joints at once. Rheumatoid arthritis features periods during which the disease is more active, known as flare-ups, as well as periods of remission during which symptoms improve.
The symptoms of rheumatoid arthritis include:
- Pain, aching, feelings of stiffness, soreness, and swelling, in multiple joints.
- Losing weight without trying.
- Fatigue, physical weakness, or loss of energy.
- In some cases, fever.
- Symptoms tend to be bilateral. This means, for instance, that if one knee is affected, the other is likely to be, too.
While the causes of this autoimmune disease are not yet understood, we do know what the risk factors are. Rheumatoid arthritis becomes more common with age, and people in their sixties are most likely to develop it. Women have a higher risk of ending up with RA than men, especially if they never gave birth to any children. Smokers are both more likely to develop rheumatoid arthritis and to suffer more severe symptoms, and, again, being obese increases the risk.
Children, too, can develop arthritis — in this case, it's called juvenile arthritis. The most common subtype is juvenile idiopathic arthritis, also called juvenile rheumatoid arthritis. "Idiopathic" means that there is no known cause, both some kind of immune-system dysfunction is likely to be implicated.
Symptoms of arthritis in children can include:
- Joint pain (aching), swelling, and stiffness.
- A rash.
- A low appetite.
- Eye inflammation.
These symptoms tend to result in an inability to engage in the kinds of activities other children will have no trouble with, like playing, getting dressed, and participating in sports.
Other conditions that fall under the arthritis umbrella include:
- Ankylosing spondylitis
- Psoriatic arthritis
- Infectious arthritis
- Enteropathic arthritis
How is arthritis diagnosed?
Your ability to receive the best possible treatment for your arthritis depends on having the correct diagnosis — so your medical team will want to be thorough as they determine what could be causing your symptoms.
The diagnostic process starts with:
- A chat about your symptoms — exactly what are they, how long have you had them for, when do they usually occur?
- A discussion about your personal and family medical history.
- A physical exam in which your doctor looks at inflammation and the range of motion of the joints you are experiencing issues with.
- X-rays — these can determine whether you have osteoarthritis, since the damage this "wear and tear" arthritis causes will show up on them.
Blood tests are used in the diagnosis of arthritis, both to rule particular types and other conditions in and out. They can include:
- Erythrocyte sedimentation rate (ESR). This test investigates the levels of inflammation in your body, although it does not reveal the source of the inflammation.
- C-Reactive protein (CRP) is another blood test used to look at inflammation, that is frequently used in the diagnostic process for arthritis, but that won't give your medical team all the information they need.
- Anti-cyclic citrullinated peptide antibody (AntiCCP). Testing positive for these antibodies will show that you either already have rheumatoid arthritis or will almost certainly develop it, though not all patients with rheumatoid arthritis will have these antibodies.
- Rheumatoid factor (RF). This blood tests looks for an antibody strongly associated with rheumatoid arthritis.
- Antinuclear antibody (ANA) looks for markers that indicate an autoimmune disease. It will help your doctor determine whether you have rheumatoid arthritis, lupus, and some other conditions that fall under the arthritis umbrella.
- Genetic tests that look for genes associated with specific kinds of arthritis can also be conducted. The HLA-B27 gene, for instance, indicates you have a higher risk of psoriatic arthritis, ankylosing spondylitis, and reactive arthritis.
Though the science behind these blood tests is complicated, all the patient being diagnosed has to do is offer up their blood.
How is arthritis treated?
The way in which arthritis should be managed depends on the kind of arthritis you have. In general, however, your treatment plan may encompass:
- Lifestyle changes
- Physical and occupational therapy
- Some people with arthritis also turn to alternative medicine as they seek symptom relief
Lifestyle changes for arthritis patients
Lifestyle changes that make your life easier by reducing your symptoms represent one of the 5 ways arthritis can be treated.
- Losing weight is a big one for overweight and obese arthritis patients, as extra weight will add significant strain to already suffering joints.
- Exercising regularly will also help, as being physically active increases your strength and stamina, boosts energy levels, and helps strengthen the muscles around your arthritis joints. Working out can also increase your range of motion. It is, however, important to consult your doctor so you know the kinds of exercises you are doing are safe for you.
- Assistive devices, which range from a walking stick to a mobility scooter, and from automatic can openers to special devices that allow you to pull your zips up more easily, aren't a "treatment", as such, but they can certainly make your life a lot easier and less painful.
Medications used in the treatment of arthritis
The kinds of medications a patient will be prescribed for arthritis will vary from one subtype to another. The most common medications for arthritis include:
- Disease modifying anti-rheumatic drugs (DMARDs) reduce inflammation and slow the progression of some kinds of arthritis — including rheumatoid arthritis, juvenile arthritis, ankylosing spondylitis, lupus, and psoriatic arthritis. Some examples of DMARDs are hydroxychloroquine, leflunomide, and minocycline.
- Biologics, which work by blocking the pathways that create inflammation, are injected. Several different kinds exist, with TNF-alpha inhibitors being among the most frequently prescribed. Examples of biologics include rituximab, adalimumab, and infliximab.
- Janus associated kinase (JAK) inhibitors are a less commonly prescribed class of medication that also interferes with inflammation and modifies the immune system. It is most likely to be offered to patients with rheumatoid arthritis and some other subtypes of arthritis who have not benefited from DMARDs and biologics.
- Corticosteroids, which can be taken orally or be injected, can help people with arthritis both by decreasing inflammation and suppressing the immune system (which is useful in people with autoimmune forms of arthritis).
- Non-steroidal anti-inflammatory medications do two things as well — they reduce inflammation and fight pain at the same time.
Physical and occupational therapy for arthritis
Physical therapy can play an important role in improving the quality of life in arthritis patients. It encompasses exercises specifically designed to increase your muscle strength, range of motion, flexibility, and stamina — and has been shown to not only improve arthritis patients' ability to get around and be active, but also their mood.
Occupational therapy, on the other hand, focuses on educating patients to help them live their best lives with arthritis. This can include advice about assistive devices and ways to complete tasks that are easier on the body.
Surgery for arthritis: What are your options?
Your doctor may advise surgery for your arthritis if you live with intense pain despite having tried other treatments, your joint function is extremely limited, and your doctor believes that the benefits or surgery outweigh the risks that always come with an operation. The different kinds of surgery sometimes performed on arthritic joints include:
- Arthroscopy (keyhole surgery) can be used to get a closer look at the joints, and for actual treatment — to repair damaged cartilage and remove portions of cartilage that have broken off.
- Arthrodesis (fusion) surgery uses pins, plates, or rods to join two bones in a joint together, allowing for pain relief. It is typically carried out on the joints of the fingers, thumbs, wrists, or ankles.
- Osteotomy involves removing portions of bone and sometimes adding artificial portions. It can be performed on the knee and hip joints.
- Synovectomy removes the synovium that lines the joints, leading to relief from swelling and pain, and limiting further joint damage. This kind of operation can be suitable for patients with inflammatory arthritis, including rheumatoid arthritis. The synovium may reappear over time, though.
- Total joint replacement or total joint arthroplasty replaces an entire joint with artificial materials such as metal, platsic, or ceramic.
- Resurfacing is another kind of surgery that often has benefits over a total joint replacement surgery. For instance, in hip resurfacing, the femoral head isn't completely removed and replaced, but it's reshaped to allow a metal cap to be placed. Knee resurfacing replaces one of the three portions of the knee with an implant. It can be performed on many joints, such as the hip, shoulder, and wrist joints. Patients should be aware that their replaced joints can wear out, too, however.
What should you know about alternative treatments for arthritis?
The natural ways to cope with arthritis inflammation and pain are many and varied. Some of these ways to cope are supported by science — using hot and cold packs to relieve pain and inflammation, for instance, exercising regularly, and practicing breathing techniques to get through the pain. Others, however, would fall into the category of alternative and complementary treatments.
- Acupuncture for arthritis.
- Using magnets and copper bracelets for arthritis pain relief.
- Using herbal remedies such as turmeric, capsaicin, and thunder god vine.
- Aromatherapy, which has been shown to have the capacity to boost your mood but which some arthritis patients also use in an attempt to alleviate pain and inflammation.
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Never ignore the early signs of arthritis. If your symptoms of pain, stiffness, swelling, heat radiating from a joint, and a noticeable decline in your ability to get around have led you to suspect that you may be suffering from one of the numerous kinds of arthritis, you are absolutely right to seek medical attention. The diagnostic process can uncover exactly what is behind your symptoms. Should you turn out to have arthritis, your treatment plan will likely include lifestyle modifications and medications, but surgery is also sometimes an option.