What is Arthritis?
Arthritis isn’t a single disease; the term refers to joint pain or joint disease, and there are more than 100 types of arthritis and related conditions. People of all ages, races, and sexes live with arthritis, which can be considered the leading cause of disability. It’s most common among women, and although it’s not a disease of aging, some types of arthritis occur in older people more than in younger people.
To clarify, arthritis is defined as inflammation of one or more joints, resulting in pain and stiffness that can worsen with age. Different types of arthritis exist, each with different causes, including wear and tear, infections, and underlying diseases. Symptoms include pain, swelling, a reduced range of motion, and stiffness. This requires mandatory medication, physiotherapy, or sometimes surgery to help reduce symptoms and improve quality of life.
Symptoms vary from mild to severe and may come and go. Some may stay about the same for years, but symptoms can also progress and get worse over time. Severe arthritis can cause chronic pain, make daily activities difficult, and make walking and climbing stairs painful and arduous.
People may experience:
Pain areas: in the joints, ankle, back, fingers, hands, muscles, neck, or wrist
Pain types: can be intermittent or sharp
Pain circumstances: can occur while sitting
Joints: stiffness, tenderness, or swelling
Muscular: decreased range of motion, difficulty walking, or muscle weakness
Hand: bump on the finger or bony outgrowth in fingers or toes
Whole body: fatigue or malaise
Also common: flare, physical deformity, redness, or stiff neck
Most forms of arthritis are thought to be caused by a fault in the immune system that causes the body to attack its own tissues in the joints. This may be inherited genetically. Other forms of arthritis can be caused by problems with the immune system or by a metabolic condition, such as gout.
Arthritis can also cause permanent joint changes. These may be visible, such as knobby finger joints, but often the damage can be seen only on X-rays. Some types of arthritis affect the heart, eyes, lungs, kidneys and skin as well as the joints.
Types of Arthritis
Osteoarthritis (OA) is by far the most common type of arthritis. It can damage almost any joint but mainly occurs in the hands, spine, hips and knees. OA was once considered a wear-and-tear disease in which cartilage — the protective layer on the ends of bones — wore down after years of use. But with further research, the thinking about OA has changed. Doctors now know that OA is a disease of the whole joint, not just cartilage. Bones in affected joints become weaker, the connective tissue that holds the joint together deteriorates and inflammation damages the joint lining. Contrary to decades of belief, inflammation plays a key role in OA, just as it does in most
Autoimmune Inflammatory Arthritis
A healthy immune system is protective. It generates inflammation to clear infections and heal injuries. But in inflammatory arthritis, the immune system is overactive, attacking healthy tissue, including joints in the spine, hands and feet. In some people, inflammation becomes systemic, damaging the eyes, skin, heart and other organs. Many, but not all types of inflammatory arthritis are considered autoimmune diseases because the immune system loses the ability to distinguish self from not-self and attacks the body it’s supposed to protect.
This is usually best achieved with a combination of medications and a healthy lifestyle — regular exercise, restful sleep, healthy food choices and less stress. The medication depends on the type of arthritis, the severity of symptoms and how well someone responds to a particular drug. For some people, the first medicine tried may not be the best fit. And some arthritis drugs can have unpleasant side effects or lose their effectiveness over time. It may take a few tries to find the right medication.
A bacterial, viral or fungal infection triggers infectious arthritis. It usually starts when an infection from another part of the body travels to a joint, usually the knee. Symptoms like swelling, pain and fever can be sudden and intense, but treatment with antibiotics or antifungals usually clears the infection pretty quickly. Most viral infections last a week or two and go away on their own. Some people with infectious arthritis may need to have their joint fluid drained to remove infected synovial fluid, reduce pain and inflammation and prevent joint damage.
Gout (Metabolic Arthritis)
Metabolic or gouty arthritis — commonly known as gout — results from a buildup in joints of painful uric acid crystals. These are a byproduct of the breakdown of purines — substances normally found in human cells and many foods, especially red meat, organ meats, some seafoods and alcohol. Normally the body gets rid of excess uric acid, but when it doesn’t, it can accumulate in joints, causing sudden and intense bouts of pain, especially the big toe.
However, most people with high uric acid levels never develop gout and many gout patients have normal uric acid. Some research suggests that certain factors in addition to uric acid might trigger gout. Possible culprits include damage from OA, disruptions in the microbiome and even white blood cells in the fluid inside joints.
Some people experience only one gout attack, or flare, and never have other symptoms. They don’t typically require medication. People who have more than one gout flare or severe symptoms are typically prescribed uric acid-lowering drugs. Those drugs can have serious side effects (and may not address the real problem), so in addition to taking medication, patients are advised to adopt a mostly plant-based, low-purine diet, rich in fruit, vegetables, whole grains, olive oil and low-purine fish.
What You Can Do
The first step is to get an accurate diagnosis of what’s causing your joint pain. Talk to your primary care doctor about your symptoms. You may be referred to a rheumatologist or orthopedist, doctors who specialize in arthritis and other musculoskeletal conditions. Many things can be done to preserve joint function, mobility and quality of life. Learning about the disease and treatment options, making time for physical activity and maintaining a healthy weight are essential.