Arthritis

Arthritis is caused by inflamed joints

Arthritis is a very common medical condition, estimated to affect around seven million people in the UK.

However, it is not a single disease, but comes in around 200 different forms.

The term essentially means an inflammation of the joints. This inflammation makes the joints painful, stiff, and swollen, and in severe cases can significantly restrict movement.

The two most common forms are osteoarthritis and rheumatoid arthritis.

---

Osteoarthritis:

What is it?

Osteoarthritis is caused by the breakdown of protective tissue called cartilage in the joints. Inflammation results when the unprotected bones of the joint begin to rub together.

It most commonly affects the joints of the fingers, knees, hips, and spine.

However, it may also affect the wrists, elbows, shoulders, and ankles.

The condition often affects joints which have been injured, or which have been over-used.

What causes osteoarthritis?

The exact cause is unknown.

One theory is that mechanical stress on the joint stimulates the release of natural chemicals in abnormally high levels.

This disturbs the delicate balance required to ensure that cartilage builds up, breaks down and is replaced.

Instead, cartilage breaks down too quickly and cannot be properly replaced.

As cartilage breaks down, the body tries to repair the damage by making new bone.

The ends of the bones in the joint thicken, and the new bone can result in obvious lumps, most often on the hands and feet.

Each step in this cycle of damage and inadequate repair produces pain.

What are the symptoms?

Osteoarthritis usually comes on slowly. Early in the disease, joints may ache after physical work or exercise, but by no means everybody with the condition feels pain.

However, over time the disease can lead to steady or intermittent pain in a joint accompanied by swelling or tenderness.

Periods of inactivity may lead to stiffness.

At times, use of the affected joint can be accompanied by a crunching sound or feeling of bone rubbing on bone.

---

Rheumatoid arthritis:

What is it?

This is a condition caused by inflammation of the lining (synovium) of the joints.

In some people, it can also affect other parts of the body, including the blood, the lungs, and the heart.

The affected joint may also lose its shape, resulting in loss of normal movement.

What causes rheumatoid arthritis?

Rheumatoid arthritis is an auto-immune disease. This means that the immune system, which acts to repel infections and other foreign invaders, malfunctions, and attacks the tissues of the body itself.

The reason why this happens is unclear. Genetic factors play a role, but not in every case.

Research also suggests that in some cases the condition may be triggered by an infection.

What are the symptoms?

Rheumatoid arthritis causes affected joints to feel tender, stiff and swollen.

The symptoms can last for an extended period of time, or they may suddenly flare up, and then recede again.

In severe cases the condition can cause serious joint damage and disability.

---

Treatment for arthritis:

It is widely thought that eating a varied and balanced diet can help to reduce the symptoms of arthritis. Exercise, too, is thought to be beneficial.

Physical therapy is widely used, as are alternative therapies such as acupuncture.

Are drugs available?

Many medicines are available for relief of the pain and inflammation of arthritis.

Each class of medicines works in a different way. Some are used only for the treatment of rheumatoid arthritis, while others help patients with both rheumatoid arthritis and osteoarthritis.

The main categories of treatment are:

Traditional nonsteroidal anti-inflammatory drugs (NSAIDs)

COX-2 specific inhibitors

Combination therapies

Pain relievers (analgesics)

Steroids

Disease-modifying antirheumatic drugs (DMARDs)

Biologic response modifiers

What about surgery?

Various types of surgery are used to treat arthritis, but usually only in serious cases where other treatments have proved ineffective.

These include:

Arthrodesis: A procedure to fuse the bones in an arhritic joint together by removing the cartilage and placing a bone graft in the joint. The aim is to create a solid, and hopefully painfree, structure.

Arthroplasty: The rebuilding or replacement of an entire joint.

Arthroscopy: The use of tiny instruments to trim and wash out abnormal cartilage fragments, and/or bony overgrowths.

Osteotomy: A correction of hip or knee deformities in younger patients

Synovectomy: The removal of diseased lining of the joints.