Arthritis: Symptoms, Causes, and Treatment

Arthritis is the inflammation of either one or more joints in your body. The main symptoms of arthritis are joint pain and stiffness, which typically aggravate with age. Arthritis has been the leading cause of disability among US adults for more than 15 years. Adults with arthritis were 2.5 times more likely to have two or more falls or suffer an injury in the past 12 months than individuals who don’t have arthritis.

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Types of Arthritis

The most common types of arthritis are osteoarthritis and rheumatoid arthritis.

Osteoarthritis causes cartilage to break down Cartilage is a firm, but flexible connective tissue in joints and its purpose is to protect your joints by absorbing the pressure and shock created when you move and form stress on them.

Rheumatoid arthritis is an autoimmune disorder that first targets the lining of joints (synovium).

Uric acid crystals, infections or underlying disease, such as psoriasis or lupus, can cause other types of arthritis.

Symptoms of Arthritis

The most common signs and symptoms of arthritis involve the joints. Depending on the type of arthritis you have, your signs and symptoms may include:

  • Swollen or stiff joint(s)
  • Difficulty moving
  • Tenderness
  • Joints look red and are warm to the touch
  • Difficulty performing everyday tasks
  • Decreased flexibility and range of motion
  • Symptoms tend to be worse in the morning
  • Pain either constant or comes and goes

Causes of Arthritis

The two main types of arthritis — osteoarthritis and rheumatoid arthritis — damage joints in different ways.

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Osteoarthritis

The most common type of arthritis, osteoarthritis involves wear-and-tear damage to cartilage in your joint. Enough damage can result in bone grinding directly on bone, which causes pain and restricted movement. This wear and tear can occur over many years, or it can be hastened by a joint injury or infection.

Rheumatoid arthritis

The immune system of the body attacks the lining of the joint capsule, a tough membrane that encloses all the joint parts, in rheumatoid arthritis. This lining, known as the synovial membrane, becomes inflamed and swollen. The disease can eventually destroy cartilage and bone inside the joint.

The general causes of arthritis include:

  • Abnormal metabolism
  • Heredity
  • Infections – like in the arthritis of Lyme disease, or infections that speed up breakdown of cartilage tissue
  • Injury – leads to degenerative forms of arthritis
  • Problems with immune system – like in rheumatoid arthritis

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Risk factors

Risk factors for arthritis include:

  • Age:The risk of many types of arthritis increases with age.
  • Family history:Some types of arthritis run in families, so you may be more likely to develop arthritis if your parents or siblings have the disorder.
  • Your sex:Women are more likely to develop rheumatoid arthritis than men. However, most of the people who are affected by gout – another type of arthritis, are men.
  • Previous joint injury:People who have injured a joint, perhaps while playing a sport, are more likely to in due course develop arthritis in that joint.
  • Obesity:Carrying excess pounds mounts pressure on joints, particularly your knees, hips and spine. Obese people have a higher risk of developing arthritis.

Complications

Severe arthritis, particularly if it affects your hands or arms, can make it difficult for you to carry out daily tasks. Arthritis of weight-bearing joints can keep you from walking comfortably or sitting up straight. In some cases, joints may become twisted and deformed.

Diagnosis

Your doctor will check your joints for swelling, redness and warmth during physical examination. Your doctor will also want to see how well you can move your joints. Depending on the type of arthritis suspected, your doctor may suggest some of the following tests.

Laboratory tests

The analysis of different types of body fluids can help identify the type of arthritis you may have. Fluids usually examined include urine, blood, and joint fluid. Your doctor will cleanse and numb your joint before inserting a needle in your joint space to withdraw some fluid (aspiration).

Imaging

These types of tests can detect problems within your joint that may be causing your symptoms. Examples include:

  • X-rays: X-rays can display cartilage loss, bone damage and bone spurs. X-rays may not reveal early arthritic damage, but they are often used to track progression of the disease.
  • Computerized tomography (CT):This process involves using CT scanners to take X-rays from many different angles and combining the information to create cross-sectional views of internal structures.
  • Magnetic resonance imaging (MRI): MRI can produce detailed cross-sectional images of soft tissues such as cartilage, tendons and ligaments, by combining radio waves with a strong magnetic field.
  • Ultrasound:This technology uses high-frequency sound waves to image soft tissues, cartilage and fluid-containing structures such as bursae. Ultrasound also is used to guide needle placement for joint aspirations and injections.

Treatment

Arthritis treatment focuses on getting rid of symptoms and improving function of your joint. You may need to try several different treatments, or combinations of treatments, before you determine the best treatment for you.

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Medications

The medications used to treat arthritis differ depending on the type of arthritis. Commonly used arthritis medications include:

  • Analgesics:These medications have no effect on inflammation, but helps to reduce pain. Examples include acetaminophen (Tylenol, others), tramadol (Ultram, Ultracet, others) and narcotics containing oxycodone (Percocet, Oxycontin, others) or hydrocodone (Norco, Vicoprofen, others).
  • Nonsteroidal anti-inflammatory drugs (NSAIDs).NSAIDs reduce both pain and inflammation. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve).
  • Counterirritants:Some creams and ointments contain menthol or capsaicin, the ingredient that makes hot peppers spicy. Rubbing these preparations on the skin over your aching joint may restrict with the transmission of pain signals from the joint itself.
  • Disease-modifying antirheumatic drugs (DMARDs).Often used to treat rheumatoid arthritis, DMARDs slow or stop your immune system from attacking your joints. Examples include methotrexate (Trexall) and hydroxychloroquine (Plaquenil).
  • Biologic response modifiers.Typically used in conjunction with DMARDs, biologic response modifiers are genetically engineered drugs that target various protein molecules that are involved in the immune response. Examples include etanercept (Enbrel) and infliximab (Remicade).
  • This class of drug, which includes prednisone and cortisone, reduces inflammation and suppresses the immune system. Corticosteroids can be taken orally or be injected directly into the painful joint.

Surgery

If the above treatments is unsuccessful in relieving symptoms, your doctor may suggest surgery, such as:

  • Joint repair.In some instances, joint surfaces can be smoothed or realigned to reduce pain and improve function. These types of procedures can often be performed arthroscopically — through small cuts over the joint.
  • Joint replacement.This involves removing your damaged joint and replacing it with an artificial one. Joints most commonly replaced are hips and knees.
  • Joint fusion.This procedure is more often used for smaller joints, such as those in the wrist, ankle and fingers.

 

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