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Arthritis

The information in this section provides insights, facts, and tips to make living with arthritis a little more manageable. Click on the links below to go to a specific topic.

What is arthritis?

The term arthritis literally means inflammation of a joint, but is generally used to describe any condition in which there is damage to the cartilage. Inflammation is the body’s natural response to injury. The warning signs of inflammation are redness, swelling, heat, and pain.

The cartilage is similar to padding that absorbs shock. The amount of cartilage damage and synovial inflammation varies with the type and stage of arthritis. Initially, the pain is usually due to inflammation. In the later stages, when the cartilage is worn away, most of the pain comes from the mechanical friction of bones rubbing on each other.

What are the different types of arthritis?

There are over 100 different types of arthritis. The most common are:

Osteoarthritis

Osteoarthritis is sometimes called degenerative joint disease. This is the most common type of arthritis, and it occurs most frequently in older people. This disease affects articular cartilage, the tissue that cushions and protects the ends of the bones in a joint. With osteoarthritis, the cartilage wears away over time. In extreme cases, the cartilage may completely wear away, causing bone-on-bone contact. In osteoarthritis, bones may also form bone spurs or osteophytes.

Osteoarthritis may cause joint pain and can limit a person’s normal range of motion. In severe osteoarthritis, a joint may lose the ability to move.

Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune disease in which the body’s immune system attacks healthy joints and tissues. Occurring most often in women of childbearing age, this disease inflames the lining or synovium of joints. Rheumatoid arthritis affects primarily the joints of the hands and feet, and tends to be symmetrical. It can cause pain, stiffness, swelling, and loss of function in joints.

Fibromyalgia

This chronic disorder causes pain throughout the tissues that support and move the bones and joints. Pain, stiffness, and localized tender points occur in the muscles and tendons, particularly those of the neck, spine, shoulders, and hips. Fatigue and sleep disturbances may also occur.

Gout

Higher than normal levels of uric acid in the blood may occur in a person with gout. The body makes uric acid from many of the foods we eat. Too much uric acid causes deposits, called uric acid crystals, to form in the fluid and lining of the joints. The result may be a sudden, painful episode, often affecting the joint at the base of the big toe. Men are more likely to experience gout, but women become increasingly susceptible to gout after menopause. Gout is treatable, to reduce the risk of recurrence.

Infectious arthritis

Arthritis can be caused by an infection, either viral or bacterial, such as Lyme disease. When this disease is caused by bacteria, early treatment with antibiotics can ease symptoms.

Reactive arthritis

Reactive arthritis may develop after a person has an infection in the urinary tract, bowel, or other organs. Joint pain and swelling may occur in the knees, and the joints of the ankles and feet. Inflammation may affect the eyes, skin, and urethra. Reactive arthritis is not common, and symptoms usually disappear within a year.

Psoriatic arthritis

Some people who have psoriasis, a common skin problem that causes scaling and rashes, also have arthritis. This disease often affects the joints at the ends of the fingers, and can cause changes in the fingernails and toenails. Sometimes psoriatic arthritis can also affect the spine.

Systemic lupus erythematosus

Also called lupus or SLE, this is an autoimmune disease. When a person has an autoimmune disease, the immune system attacks itself, damaging healthy cells and tissue. Lupus can inflame and damage a person’s joints, skin, kidneys, lungs, blood vessels, heart, or other organs.

Ankylosing spondylitis

Ankylosing spondylitis most often affects the spine, causing pain and stiffness. It can also cause arthritis in the hips, shoulders, and knees. It affects men more commonly, and in their late teenage and early adult years.

Juvenile rheumatoid arthritis

Juvenile rheumatoid arthritis is the most common type of arthritis in children. This disease may cause pain, stiffness, swelling, and loss of function in the joints. A young person can also have rashes and fever with this disease.

Polymyalgia rheumatica

Polymyalgia rheumatica involves tendons, muscles, ligaments, and tissues around the joints. Symptoms often include pain, aching, and morning stiffness in the shoulders, hips, neck, and lower back. It is sometimes the first sign of giant cell arteritis, a disease of the arteries characterized by inflammation, weakness, weight loss, and fever.

Polymyositis

Polymyositis is an uncommon inflammatory disease that causes muscle weakness, affecting both sides of the body.

Bursitis

This condition involves inflammation of bursae, which are small, fluid-filled sacs that help reduce friction between bones and other moving structures in the joints. The inflammation may result from arthritis in the joint, an injury, or an infection of the bursae. Bursitis produces pain and tenderness, and may limit the movement of nearby joints.

Tendinitis

Tendinitis is inflammation or irritation of a tendon, any one of the thick fibrous cords that attaches muscle to bone. Tendinitis causes pain and tenderness just outside a joint, most commonly the shoulders, elbows, wrists, knees, and heels.

What causes osteoarthritis?

The wearing down of the protective cartilage at the ends of the bones causes osteoarthritis. This form of arthritis may be due to excessive stresses over prolonged periods of time, or due to trauma, or chronic deformity.

Primary osteoarthritis is associated with aging and progressive degeneration of joints.

Secondary osteoarthritis is generally the consequence of another disease or condition, such as repeated trauma to the affected joint, or abnormal joint structures from birth.

Some people may have congenital abnormalities of the joints. For example, Legg-Calve-Perthes disease may cause early degeneration of the hips, and subsequently lead to osteoarthritis.

Predisposing factors to osteoarthritis of the hip

Osteoarthritis tends to affect older adults, and particularly affects the joints that experience repetitive stresses and strains. Some predisposing factors to osteoarthritis of the hip include:

  • A previous fracture that involved the hip joint.
  • A growth abnormality of the hip (such as a shallow acetabulum socket).
  • Some childhood hip problems such as a slipped capital femoral epiphysis and Legg-Calve-Perthes disease.
  • Obesity, which puts an additional burden on the hips, knees, ankles, and feet.
  • A strong family history of hip or knee osteoarthritis.

Predisposing factors to osteoarthritis of the knee

Abnormalities in the function of knee joints, resulting from fractures of the knee, torn cartilage, and torn ligaments can lead to osteoarthritis many years after the injury. The mechanical abnormality may lead to excessive wear and tear of the joint cartilage.

What are the symptoms of arthritis?

There are more than 100 different types of arthritis. Symptoms vary according to the type of arthritis.

How does a doctor diagnose arthritis?

Doctors diagnose arthritis with your medical history, physical exam, and x-rays.

What you can do?

  • Consult a doctor who will determine the type of arthritis you have.
  • Rest the joint until the pain subsides, to prevent further inflammation.
  • To ease the pain or stiffness of the joint, apply ice or heat to the joint, as recommended by your doctor.
  • Take painkillers or anti-inflammatories, as recommended by your doctor.
  • If you are overweight, try to reduce weight to lighten the load on weight-bearing joints.
  • Participate in regular exercise.

What your doctor can do for you?

Arthritis can be managed with treatment that focuses on relieving symptoms and improving joint function. Your doctor may prescribe anti-inflammatory medicine, and may also recommend occupational therapy or physical therapy. In severe cases, surgery may be recommended, such as a hip or knee replacement, which can produce excellent results.

Treatment options

Treatment of osteoarthritis focuses on decreasing pain and improving joint function.

  • Initial treatment for osteoarthritis of the hip or knee is generally conservative, consisting of rest, avoidance of vigorous weight bearing activities, and the use of non-narcotic analgesics, and anti-inflammatory medications.
  • For more severe symptoms, a cortisone or viscosupplementation treatment may relieve pain. As recommended by your doctor, surgery may be the best option for your particular arthritis condition.

Can exercise help relieve arthritis?

Exercise is very important because it increases lubrication of the joints and strengthens the surrounding muscles. This helps put less stress on joints. Exercise in a heated swimming pool (hydrotherapy) can bring substantial relief from pain and stiffness. Studies have also shown that exercise helps people with arthritis by increasing flexibility, muscle strength, and energy. Keeping active also helps with weight reduction and offers an improved sense of well-being.

Can special diets help relieve arthritis?

  • If I have arthritis, is diet and nutrition a simple matter?
  • Can my diet cure my arthritis?
  • Are there foods that can cause my arthritis to ‘flare-up’ or go into remission?
  • What role do vitamins and nutritional supplements play in the treatment of arthritis?
  • Will losing weight help ease my symptoms?

These are examples of questions that people with arthritis often ask, and they are valid questions. Some questions (Can my diet cure your arthritis?) have simple answers (No). Other questions (Are there foods that can cause my arthritis to ‘flare-up’ or go into remission?) are not so simple.

Most of what you need to know about diet and nutrition is common sense; healthy eating is much the same for anyone, whether you have arthritis or not.

 

Click on the topics below to find out more from the Orthopaedic connection website of American Academy of Orthopaedic Surgeons.

  • duke-john-kelly
  • American Board of Orthopaedic Surgery
  • Orange County Medical Association