Arthritis, a disease characterized by inflammation of joints, is a painful and debilitating disease that leads to joint stiffness and pain.
There are more than a 100 different types of arthritis, the major categories of which include degenerative arthritis (osteoarthritis), inflammatory arthritis, infectious arthritis and metabolic arthritis.
These include several different types of inflammatory arthritis — such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, juvenile idiopathic arthritis, systemic lupus erythematosus, and many other others.
Inflammatory arthritis can develop in patients of all ages, and rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis are the most prevalent kinds.
1. Causes of inflammatory arthritis
Inflammatory arthritis develops because your body’s immune system, which is designed to protect you from foreign organisms, starts to attack your own joint tissue instead. This leads to joint pain, stiffness, and damage.
Studies have also shown that genetics can play a role in predisposing patients to the development of inflammatory arthritis. That is, some people are more susceptible to developing inflammatory arthritis due to the genes that they inherit from their parents. Other factors that can potentially increase the risk of developing inflammatory arthritis include:
- Exposure to certain infectious agents (such as certain bacteria, viruses)
- Feeling stressed
- Smoking cigarettes
- High levels of certain hormones
2. Symptoms of inflammatory arthritis
As with other types of arthritis, the characteristic symptoms of inflammatory arthritis are pain and stiffness of the joint, particularly after long periods of rest or inactivity. For patients with inflammatory arthritis, joint stiffness in the morning can last longer than 60 minutes.
Generally, patients will experience swelling, redness and warmth in and around around the joint that is affected. However, not all patients with inflammatory arthritis develop swelling. In fact, some patients with the disease actually just have pain without swelling or swelling without pain. Some patients may also present with limitations in physical movement without developing either pain or swelling.
In the case of inflammatory arthritis, the disease actually goes beyond joints and can also affect other parts of the body such as the skin and internal organs. As the disease is systemic (affects all parts of the body), patients may also develop these other symptoms:
- Skin rash
- Inflammation of the eye
- Hair loss
- Dry mouth
3. Diagnosis of inflammatory arthritis
Inflammatory arthritis can often be difficult to diagnose, especially by a general physician. Therefore, in most cases, the diagnosis is made by a specialist known as a rheumatologist. If you are experiencing joint or back pain, your doctor may suspect that you have arthritis.
The first step in being diagnosed with inflammatory arthritis is full a medical history and physical exam that will be conducted by the doctor.
The doctor will likely perform a test known as the squeeze test, which is a reliable test for diagnosing rheumatoid arthritis and psoriatic arthritis. During this test, the doctor will squeeze your hand or foot across the joints of the knuckle. If the patient feels pain, then they may have inflammatory arthritis.
There is no single blood test or genetic test that can help diagnose inflammatory arthritis. Physicians can test for markers of inflammation, however these markers cannot differentiate between rheumatoid arthritis and other types of inflammatory arthritis.
Certain tests can help determine the exact type of inflammatory arthritis that a patient may have. For example, most patients with rheumatoid arthritis have a substance in their blood known as the rheumatoid factor.
Doctors may also order testing for specific genetic markers such as HLA-B27, which is strongly associated with the development of ankylosing spondylitis.
The doctor can further order other types of tests, such as lab tests, X-rays and imaging tests, to rule out other diseases.
4. Treatment of inflammatory arthritis
Currently, there is no cure for arthritis. However, there are several effective treatments that can help reduce pain and joint damage, lower the need for surgery and prevent further complications.
Generally, treatment for inflammatory arthritis is designed to treat the specific subtypes of inflammatory arthritis. Hence, the treatment for rheumatoid arthritis will differ from that of psoriatic arthritis. Additionally, the treatment design is further tailored to suit the particular symptoms and severity of each patient.
In order to determine the ideal treatment, doctors will administer extra tests including blood tests, x-rays, ultrasound scans and disease activity scores to determine the extent of joint damage and limitation in joint movement.
Some common treatments for inflammatory arthritis include nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, naproxen and celecoxib. These can help reduce pain and inflammation. Though not very common, corticosteroids can also be used to stop inflammation that affects the joints or internal organs.
Additionally, drugs known as disease-modifying antirheumatic drugs (DMARDs) can help slow down the progression of inflammatory arthritis as well as slow down damage to the joints. Often two or more DMARDs are used together in what is called combination therapy. A common DMARD is methotrexate, which is given by an injection.
There are also several other self-management strategies that can help treat the disease:
- Physical activity has been found to very beneficial for patients with inflammatory arthritis.
- Weight loss can help reduce the burden on the joints, thereby reducing pain.
- Physical and occupational therapists can help teach strategies to improve flexibility of joints.
- Assistive devices can help improve mobility and functioning.
- Alternative therapies such as supplements, acupuncture, massage, relaxation techniques, medication and others can help improve overall well-being.
- In some cases, chemotherapy is used to treat some types of inflammatory arthritis.