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Arthritis:
Symptoms, Causes, Diagnosis & Treatment

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1.What is Arthritis?

The term arthritis is commonly referred to as inflammation of joints. However, this term is commonly used as a synonym for joint pains or any other associated ailments. Arthritis though can be broadly classified into osteoarthritis and Rheumatoid Arthritis, there are other forms of arthritis that we will talk in-depth further in this article. Arthritis is mostly seen in people who are above 65 years of age, however, there have been instances where people of all ages including children were affected by this condition. There are more than 100 types of joint pains that a human suffers and these are together referred to as Arthritis. Arthritis is incurable but there are many medications and therapeutic measures that help patients keep symptoms under check.

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2.Symptoms of Arthritis

The symptoms of Arthritis may vary from mild to severe depending on the condition and the joints it affects. Arthritis affects at least one-third of the world’s adults and sometimes, it can get very painful. Clinical trials have witnessed patients demonstrate pain that marks a bearing of seven on ten on the pain scale. The major symptoms of Arthritis include:

  • Pain
  • Stiffness
  • Decreased range of motion
  • Swelling and redness

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3.Types of Arthritis

There are over 100 forms of arthritis that affect the joints in the knees, ankles, wrists, thumbs, vertebral column, and more. The most common forms of Arthritis are:

Types of Arthritis

Osteoarthritis:

Osteoarthritis is the most common form of arthritis and is caused when the soft cushiony cartilage layer between bones gets worn out and the bones start directly rubbing with each other. This causes a lot of pain and is a degenerative disease. This is also known as wear and tear disease as the cartilage gets worn out. Though this is a disease that every person slowly develops as they age, other factors contribute to Osteoarthritis. These include obesity, sex, genetic reasons, joint injuries, repeated stress on certain joints, and a few metabolic diseases that also cause osteoarthritis. It is advised to consult an orthopaedic doctor if you feel pain in your joints and is not going away even after taking painkillers and muscle relaxants.

Rheumatoid Arthritis:

Rheumatoid Arthritis

Rheumatoid Arthritis is an autoimmune condition where the body starts attacking the joints. It causes painful inflammation (swelling) between the joints making it extremely uncomfortable. This is not limited to just the bone cells, but also affects the skin, eyes, lungs, heart, and blood vessels. When a person is affected by rheumatoid arthritis, the immune system of the body starts affecting the lining between the bones, thereby making it painful and difficult to resume physical activities. In its early stages, rheumatoid arthritis attacks smaller joints like the ones present in your fingers and the ones that attach your toes to the foot. As the disease progresses, it starts attacking larger joints like knees, ankles, hip, elbows, and shoulders. It is advisable to visit a doctor if you are experiencing swelling in the joints, and/or are finding it difficult to move the joints after waking up or when trying to resume physical activity after a long break.

Psoriatic Arthritis:

People suffering from Psoriasis are more susceptible to Psoriatic Arthritis. Having a family history may make you more prone to it. Along with the regular symptoms of arthritis such as joint pains and swellings, Psoriatic arthritis also exhibits redness in the skin in the form of rashes and these rashes generally tend to have silver-lined scales. The underlying condition of Psoriatic arthritis sometimes begins even before the skin-related symptoms start to show. Currently, there is no cure for psoriatic arthritis, hence, the symptoms must be treated to ensure minimal damage to the joints in the fingertips and spine. Maintaining a healthy diet and weight can help treat the conditions and slow the progress of this condition.

Fibromyalgia:

Fibromyalgia is a condition where the pain receptors in the brain amplify any pain caused and in this, the patient experiences constant fatigue, sleep apnea, memory loss, and muscle ache. This condition is often triggered when people undergo a lot of stress. Women are most affected by Fibromyalgia. Genetic conditions, stress, and trauma can lead to Fibromyalgia. Currently, there is no cure for this condition, however, certain medicine can help in controlling the pain.
Fibromyalgia Fog is a condition that most patients suffering from the disease exhibit, where the attention span is significantly reduced.

Gout:

Gout is a very common form of arthritis. In this, there is a lot of inflammation and swelling in the big toe that causes sudden pain that lasts up to twelve hours in the first instance. Later, the pain subsides and mild pain tends to linger on for a few days, and sometimes, for a few weeks. Gout happens when there are excess amounts of Uric acid in the blood. Urate crystals from the Uric acid deposit in the joint and cause inflammation and redness. Gout begins with the big toe and when left unattended, moves on to larger joints like ankles and knees. Gout in people tends to progress into Advanced Gout and kidney stones. This can be avoided by following the medication program recommended by the physician. Maintaining a clean diet, exercising a lot, and controlling the consumption of alcohol can help treat the symptoms of the condition and reduce the chances of the disease’s progression.

Lupus:

Lupus is an autoimmune disease that causes the patient’s immune system to attack the joints and cartilage around it. In this, the patient experiences skin rashes, body aches, fatigue, and prolonged joint pain among others. While most patients suffering from Lupus experience rashes that resemble a butterfly with its wings open, this alone cannot be taken as a diagnostic test. There is currently no cure for arthritis caused by Lupus, but there are medicines available to treat the symptoms and reduce the progression rate. Apart from affecting the joints, Lupus also disorients normal activity in the Lungs, Heart, Kidney, blood vessels, and the nervous system.

Septic Arthritis:

In the case of Septic Arthritis, the virus and bacteria travel through the bloodstream to the joints and cause an infection. This condition is also triggered when the person suffers an injury and Staph enters the body through the open wound. Septic arthritis mostly affects the knees, shoulders, hips, and other joints. Septic Arthritis has symptoms of fever, swelling in joints, and redness in joints. Antibiotics are generally used to treat septic arthritis. In some cases, the fluid from the joints is drained with a needle or treated surgically. People suffering from Psoriasis, rheumatoid arthritis, weak immune systems, and weak skin are generally prone to get affected by this condition as it creates a favourable condition for Staph to multiply exponentially. Septic Arthritis can cause physical inability if left untreated.

Thumb Arthritis:

Aging is the common cause of thumb arthritis. In this, the cartilage that lubricates the thumb joints gets worn out and makes the thumb stiff, causes severe pain, swelling, and reduces the motion range in it. Thumb arthritis which is also known as Carpometacarpal Joint is common in people who are over 40 years of age. Women are more susceptible to this condition when compared to men.

There are several medication options to treat thumb arthritis, these include:

  • Painkillers: Tylenol, Ibuprofen, and Aleve are recommended pain relievers
  • A splint is also recommended treatment option as it helps reposition the joint, reduces pain and rests your joints.

When splints and pain killers are not delivering the desired effect, the patient can choose to opt for surgery as a treatment option. The most common surgical options for Thumb arthritis include:

  • Joint fusion
  • Osteotomy
  • Joint replacement (arthroplasty) and
  • Trapeziectomy

Reactive Arthritis:

Reactive Arthritis is when the joints in the knee, hip, and ankles start swelling as a reaction to an infection in the Urethra, intestines, or stomach. Reactive arthritis is also known as Reiter's Syndrome. The symptoms include swollen eyes, back pain, skin problems, joint pains, swollen thumbs and fingers, and urinary problems. Both men and women between 20- 40 years of age are susceptible to this condition. Reactive arthritis is not a conventional communicable disease but is known to spread through sex in rare cases. This is caused by food-borne viruses and bacteria like Salmonella, Chlamydia, Shigella, and clostridium deficit among others.
As it is a food-borne disease, storing food at the right temperature and eating healthy food can help prevent disease-causing bacteria like salmonella from entering the body. Using condoms can also help mitigate the risk of transmission significantly.

Though there is no cure for Reactive Arthritis, there are non-steroidal anti-inflammatory drugs, corticosteroids that treat Rheumatoid Arthritis too. Patients can also choose to get the built-up fluid in joints extracted through needles.

Juvenile Idiopathic Arthritis

In this condition, the body tends to attack its own tissues and organs and in Juvenile Idiopathic Arthritis (JIA), the body starts attacking joints which include knees, ankles, feet, hands, shoulders, etc. The causes of arthritis in this form are not known yet. However, studies show that these conditions are either because of Inherent genetic structure or are triggered by a virus in the environment. Diagnosing Juvenile Idiopathic Arthritis can be tricky as it exhibits symptoms that mimic those of fracture, rheumatoid arthritis, and other forms of inflammatory arthritis.
To treat JIA, doctors club a variety of treatments to slow the progress of the disease and prevent the disease from hindering the growth of the child. According to the nature of progress and its effect on the child, the medical practitioner might recommend TNF blockers, Humira, corticosteroids, non-steroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs, and therapy.

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4.Causes of Arthritis

There are a lot of factors that could begin the onset of arthritis in people. While a few causes contribute to the progression of this disease actively, there are passive reasons that could lead to the onset of this condition. A few causes include:

Consuming alcohol and tobacco: The consumption of alcohol and tobacco have shown a direct increase in the risk of being affected by Arthritis in a study conducted by the Nurses Health Study.

Obesity: Body weight more than the optimum levels can cause the body to exert more pressure on the joints, thereby acting as a catalyst in the wear and tear of the protective cartilage between the joints. Thereby, increasing the chances of arthritis.

Sex: Specific types of arthritis only affect men while a few affect women only. Thus, gender plays a major contributor to the onset of the condition.

STDs: Certain forms of arthritis are known to spread from one patient to a healthy host through sexual intercourse. As a preventive measure, it is always advised to use latex-based contraceptives when involved with anal, vaginal, or oral sex.

Family history: Sometimes, when a person in the patient’s immediate family or close relatives have a history of arthritis, it is likely for the patient to be prone to the condition. Psoriatic arthritis is a classic example of such an instance.

Induced trauma through physical injuries: Injuries near joints can either damage the joint or act as an entrance for disease-causing bacteria and viruses through the open wound, thereby causing arthritis.

Age: Many forms of arthritis are common in people who are old, while this is a gradual progression, some conditions affect only specific age groups. JIA affects children under 16 years of age while reactive arthritis affects people between 20-40 years of age. According to the nature of the condition, age plays a significant role.

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5.Steps to prevent Arthritis

Arthritis can be prevented by following these basic steps:

  • Quit smoking: if you are a smoker, quit smoking right now, as active and passive smoking contributes significantly to making the body prone to this disease.
  • Avoid injury: When involved in recreational sports like Volleyball, Soccer, basketball, Skiing, or any other sports, avoid scenarios that could cause damage to your bones. As few forms of arthritis are born out of trauma to the joints in the form of injury.
  • Take necessary precautions: When lifting heavy weights or pulling or pushing large objects, take proper care to ensure that the weight does not fall on the joints. Maintaining the right posture when involved with labor-intensive activities can go a long way in preventing arthritis.
  • Maintaining weight: Maintaining a healthy weight and physical activity can help prevent arthritis.

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6.Diagnosis of Arthritis

Arthritis can be diagnosed through blood reports, testing samples of fluids from inflamed joints, and through imaging tests. Diagnosticians take a thorough report of the patient, their daily routine, level of physical activity, recreational habits like smoking, alcohol consumption and drug intake along with a thorough family history.

Based on the arthritis symptoms, the physician further narrows down the diagnostic method to a suitable process.

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7.Treatment of Arthritis

The symptoms of Arthritis can be managed by following a regime of painkillers, corticosteroids, non-steroidal Anti-inflammatory drugs(NSAD), Counter irritants, Disease-Modifying Anti-Rheumatic Drugs(DMARD), and biological response modifiers. Patients suffering from arthritis can choose to turn towards therapy to help improve movement in joints. There are surgical options like joint repair, joint replacement, and joint fusion that the patient could opt for when considering treatment options.

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8.Innovations in Arthritis treatment

Though the cure for arthritis has not been discovered yet, the global medical community has taken large strides in treating and managing the symptoms. The NSAIDs and DMARDs have become more effective in slowing the progress of arthritis symptoms. The introduction of Tofacitinib citrate and Apremilast have significantly changed the phase of treating arthritis. These oral pills when consumed twice a day, attack the source of inflammation and prevent the cells that are causing this to swell, thereby preventing the damage of cartilage and exposed joint-endings.

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9.Outlook and Prognosis

Arthritis is a chronic condition that currently has no cure. However, there are treatment options available that make the condition less painful and slow the rate of progression. According to the nature of the condition and the physical and social attributes of the patient, the outlook and prognosis vary.

If the condition is on a rapid onset, the patient can expect:

  • Increase in joint pains and swellings
  • Decreased motion range
  • Fatigue
  • The onset condition spreading to new joints
  • Pain when resuming physical activities after a nap or a break

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10.Road to Recovery and Aftercare

The road to recovery and aftercare for a person diagnosed with Arthritis include maintaining their weight, eating healthy vegetables and meat that include vitamins, minerals, proteins, and roughage that is required for healthy bone development. It is imperative that all the medication and physical therapy prescribed by the consulting physician are followed to ensure that the condition is not worsened. The patient can choose to opt for orthotic soles, shoes, canes, crutches, or walkers to prevent the chances of falling and preventing the condition from spreading to other unaffected joints.

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11.Physiotherapy and Exercise plan for Arthritis

Arthritis Management

Physiotherapy is a therapy that helps you manage pain, improve joint movement and improve fitness levels. In this patients can choose to opt from massages, Accu-puncture, electro-therapy and manipulation. All of these offer to aid in reducing pain while moving the affected joints, improve fitness and take the road towards managing the symptoms of arthritis and slowing the progress of the condition.

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12.Arthritis FAQs: All your concerns addressed

Q.  What causes arthritis?

  1. The exact cause of arthritis is still unknown, however, there are a variety of factors that could affect the rate of arthritis and the most major ones are smoking, alcohol consumption, obesity, Vitamin deficiency, STDs, and injuries.

Q.  Does arthritis lead to other flu-like complications?

  1. Rheumatoid arthritis and reactive arthritis can cause skin rashes, cold, fever, swelling, eye pain, and problems in the lungs, kidneys, and heart.

Q.  Will reactive arthritis damage my eyes?

  1. The inflammation caused in the eyes when the patient is diagnosed with reactive arthritis can be lethal. It is advised to visit a doctor immediately and begin treatment to prevent the condition from becoming worse.

Q.  Will a joint-replacement surgery make me free of the condition?

  1. In a joint replacement surgery, the damaged portion of the joint is cut out and replaced with metal parts. This is done when the arthritis pain becomes unbearable for the patient. As this is a chronic disease with no cure, joint replacement surgery should only be considered as an option to manage the disease but not to treat it.

Q.  What exactly is arthritis?

  1. Arthritis is a rheumatic condition of joint inflammation. It is often used to describe around 200 conditions of joints, muscles, or fibrous tissue. It is also known as rheumatoid arthritis. Osteoarthritis is the most common form of arthritis. Other common rheumatic conditions related to arthritis include gout, fibromyalgia, etc.

Q.  What are the early signs of arthritis?

  1. Warning Signs of Arthritis:
    • Fever
    • Weight loss
    • Fatigue
    • Anaemia
    • Swelling, stiffness, and pain in one or multiple joints
    • Morning stiffness in and around the affected joints
    • Pain and stiffness that worsens with inactivity and improves with physical activity.

Q.  At what age does arthritis usually start?

  1. Rheumatoid arthritis often starts at an age between 40 and 50 years old. Women are three times more likely to be affected by arthritis than men. Not only do women get more arthritis than men, but they also experience worse pain. Arthritis tends to affect different joints in women than in men. Men get arthritis in their hip joints while women tend to have it more on their knees and hands.

Q.  What are the most common types of Arthritis?

  1. Here are few types of arthritis and related conditions:
    • Osteoarthritis - It is the most common form of arthritis which occurs when the protective cartilage that cushions the ends of bones wears out.
    • Rheumatoid Arthritis (RA) - When the immune system attacks various body parts, especially the joints, this type of arthritis is known as RA.
    • Psoriatic Arthritis - It is an inflammatory joint condition that can affect people with psoriasis.
    • Ankylosing Spondylitis - It is an inflammatory condition which mainly affects the muscles, ligaments, and bones of the spine.
    • Cervical Spondylosis - It affects the joints and bones in the neck, which leads to pain and stiffness.
    • Gout - It is caused by too much uric acid in the body.
    • Lupus - Lupus (also called SLE or systemic lupus erythematosus) is an autoimmune disease that can affect many different organs and the body's tissues.

Q.  What is the best treatment for arthritis?

  1. There's no cent per cent cure for arthritis, but medications and treatment like physiotherapy and surgery can help slow it down. Patients with Osteoarthritis are suggested to change lifestyle and to be on medications. Whereas treatment for rheumatoid arthritis primarily aims to slow down the condition's progress and minimise joint inflammation.

Q.  What foods make arthritis worse?

  1. The following types of food cause inflammation. Arthritis patients should avoid them at any cost:
    • Processed Food
    • Omega-6 fatty acids (Vegetable Oil, Seed Oil etc.)
    • Sugar and certain sugar alternatives
    • Red meat and fried foods
    • Refined carbohydrates
    • Cheese and high-fat dairy

    Inflammation which is the primary cause of arthritis can be reduced by eating anti-inflammatory foods, such as tomatoes, fruits, nuts, olive oil, leafy green vegetables, fatty fish etc.

Q.  How can I get relief from Arthritis pain naturally?

  1. Here are a few tips you can use for pain relief and avoid the side effects of pain medications:
    • Hot and Cold therapy - Take long warm showers, use a heating pad, or wrap gel ice pack on joints.
    • Exercise - This is more of movements than exercising to lose weight. Such low impact exercises help maintain flexibility in joints.
    • Acupuncture - It is the most researched complementary therapy and is recommended by the World Health
    • Organization for the treatment of arthritis.
    • Lose weight - Lose the extra weight which puts more pressure on your joints.
    • Fatty acids - Fats like omega-3 fatty acids and gamma-linolenic acid, helps in reducing joint stiffness and pain.

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