Arthritis is an umbrella term for over 100 conditions affecting the bony joints of the musculoskeletal system and causing painful inflammation of joints and their internal structures.
There are many different types of arthritis. However, some types are more common than others. Osteoarthritis and rheumatoid arthritis are the most common types.
Advances in our understanding and treatment of severe arthritis means that we generally no longer see the severe damage and deformities in joints that were common in the past.
Symptoms & causes
A common symptom is painful inflammation of joints and structures inside a joint, including the joint lining (synovium), bones, cartilage, and/or supporting tissues.
As there are many different types of arthritis, the symptoms and causes of arthritis also vary according to type.
Symptoms
The main symptoms of arthritis are joint pain, stiffness and swelling of an affected joint. Symptoms may also include redness and a decreased range of motion.
Arthritis can affect one, a few, or many joints throughout the body.
Causes
Given the many types of arthritis, there are also many possible causes. Causes of arthritis include age-related wear and tear of joints (e.g. osteoarthritis), or autoimmune conditions such as rheumatoid arthritis psoriasis or lupus.
For example, some common forms of arthritis are caused by different underlying problems:
- Osteoarthritis, a common form of arthritis which is often seen with increasing age, is caused by breakdown of cartilage (the hard, slippery tissue that covers the ends of joints).
- Rheumatoid arthritis is an autoimmune condition, where the body’s immune system attacks the body’s tissues, starting with the lining of the joints. The painful swelling associated with rheumatoid arthritis over time may lead to bone loss and joint deformity. Other body systems (e.g. skin, eyes, lungs, heart & blood vessels) can also be affected.
- Gout occurs when excess uric acid in the blood causes uric acid crystals to form.
Prevention
Some risk factors for arthritis are out of our control. For example, there are sex-related differences in the prevalence of some forms of arthritis, meaning that more women than men develop that particular disease. Increasing age and family history are, likewise, beyond our control. That said, there are ways in which we can help to prevent arthritis.
Eat a healthy diet
Poor nutrition has been linked to a number of chronic health conditions.
Achieve and maintain an ideal body weight
Being overweight increases the load on knees and increases wear and tear, which can contribute to the development of osteoarthritis.
Regularly exercise
Regular exercise increases flexibility and endurance and helps to maintain healthy bones, muscles and joints. Weight-bearing exercise helps maintain bone mass which can help prevent osteoporosis. Exercise also helps reduce joint pain and stiffness and builds strong muscles around joints.
Avoid or quit smoking
Smoking increases the risk of rheumatoid arthritis.
Avoid injury
As our joints wear out over time, it’s important to avoid joint and cartilage damage through accidental injury. Using correct techniques and appropriate safety equipment can help in this regard when we exercise, play sports, and exert ourselves in other leisure and domestic activities.
Protect your joints
We can protect our joints from strain and injury by using good techniques for everyday activities such as sitting, lifting and working. For example, when lifting objects it is important to bend from the knees–never the back; carrying objects close in to your body can prevent wrist strain.
Diagnosis
Early diagnosis is important. It enables people to receive prompt treatment and prevent irreversible joint damage.
The diagnosis of arthritis involves taking a medical history and performing a physical examination, which usually includes checking joints for swelling, redness and warmth.
Laboratory tests (e.g. blood, urine, joint fluid), imaging tests [e.g. x-rays, computerised tomography (CT), magnetic resonance imaging (MRI) or Ultrasound] and other tests may also be undertaken.
For example, plain x-rays may be used to view and monitor the bony structures of a joint and help identify bone damage or other abnormalities. X-rays may also be used to monitor the progression of arthritis over time, as it can take months or years for changes in joints to become visible.
Treatment
Some types of arthritis respond well to treatment; however other types can be difficult to manage and may be disabling, over time.
Arthritis treatments aim to relieve symptoms and improve joint function. Treatment decisions depend upon the underlying cause, and include medication(s), therapy and/or surgery.
For example commonly used medications include:
Simple analgesics
Simple analgesics (e.g. paracetamol) which relieve pain but do not affect inflammation are used, alongside nonsteroidal antiinflammatory agents (NSAIDS) (e.g. ibuprofen) which manage both pain and inflammation.
Disease modifying antirheumatic drugs
Disease modifying antirheumatic drugs (DMARDS) are used in rheumatoid arthritis to prevent the body’s immune system attacking joints.
Biologic response modifiers
Biologic response modifiers (e.g. Tumor Necrosis Factor or TNF 6) are genetically engineered drugs, often used in combination DMARDS, to target proteins involved in the body’s immune response.
Corticosteroids
Corticosteroids (e.g. prednisolone) can be used to manage inflammation and to suppress the immune system.