Our joints are lined with cartilage. This is a smooth, slippery material that enables our joints to move freely and smoothly. This surface can be damaged through injury or can wear out over time. Once this damage is bad enough, it is called osteoarthritis. It results in pain, stiffness and loss of function in the affected joint.
Some medical conditions can cause arthritis by attacking the other parts of the joint, leading to pain and inflammation. The most common of these is Rheumatoid Arthritis, however, there are many others.
Arthritis causes joint pain and stiffness, making it more difficult to move freely.
Risk factors for arthritis include
- Family history. Some types of arthritis run in families. Your genes can increase you susceptibity to environmental factors that may trigger arthritis.
- Increasing age. The risk of many types of arthritis — including osteoarthritis, rheumatoid arthritis and gout — increases with age.
- Previous injury. People who have injured a joint are more likely to eventually develop arthritis in that joint.
- Obesity. Carrying excess weight puts more stress on joints, particularly the knees and hips. Obesity increases the risk of developing arthritis.
Do I have arthritis?
Getting as assessment from a doctor will help determine if you have arthritis and what sort of arthritis it is. A physical assessment, together with some x-rays is often enough to get a diagnosis. In more complex cases, further investigations may be required. These can include:
Blood tests: Looking a blood levels of factors associated with inflammatory arthritis (eg Rheumatoid arthritis) or infection
Joint fluid tests: This can be needed if there is a lot of fluid in your joint. Sample is taken with a needle and looked at under a microscope
MRI scans: These are particularly useful for the early stages of arthritis, before it shows up on x-rays
Other investigations, including CT scans, Ultrasound or Bone scans are occasionally required. Your specialist will discuss what the appropriate investigations are in your particular case.
Treatments options vary, based on the type of arthritis. The main goal of arthritis treatments is to reduce symptoms and improve quality of life. you may need to try several different treatment options, before you determine what works best for you.
Appropriate exercise is proven to relieve symptoms and improve function, even in severe arthritis.
Some medications and other therapeutic agents act by being directly injected into the affected joint. The most well known of these is steroid (Cortisone or others), however, newer therapies, including injecting some of your bodies own anti-inflammatory cells have increasing evidence to support their use and show great promise for the future. See Injection therapies for more details.
For osteoarthritis ( the wear and tear common pattern of arthritis)
- Pain relievers can help reduce pain. These include paracetamol, codeine and stronger medications.
- Non-steroidal anti-inflammatories (NSAIDs) reduce both pain and inflammation. These include ibuprofen (Brufen), diclofenac (Voltaren) and others. They come in tablet and cream forms that can be rubbed over the affected joint.
For inflammatory arthritis (Rheumatoid arthritis and other auto-immune conditions)
- Steroids. Drugs such as prednisone and cortisone reduce inflammation by suppressing the immune system
- Disease Modifying Agents (DMAs) and Biologic Response Modifiers (BRMs) are powerful drugs that act on the immune system, to limit its attacks on the joints. These medications are prescribed by Rheumatologists, experts in the management of these conditions.
Braces & splints
Some arthritic joints can be protected by using a supportive brace, the ankle or knee may benefit from shoe orthoses or brace treatment. While these don’t work for everyone, bracing may provide benefit with little risk.
If conservative measures don’t help, your doctor may suggest surgery. Several types of operations are used in the treatment of arthritis.
In some instances, joint surfaces can be smoothed or realigned to reduce pain and improve function
This procedure removes your damaged joint and replaces it with an artificial one. Joints most commonly replaced are hips and knees. Joint replacements have a limited lifespan, so other measures are utilized as long as possible, prior to recommending joint replacement.
This procedure is more often used for smaller joints, such as those in the hand and foot. The mobile cartilage covered ends of the two bones in the joint are removed and the bone ends locked together until they heal into one rigid unit.
What about alternative therapies?
Many people use alternative remedies for arthritis, but there is little reliable evidence to support the use of many of these products. The most promising alternative remedies for arthritis include:
- Acupuncture. Some people find acupuncture helpful in temporarily decreasing muscle spasm and pain in arthritis
- Glucosamine. Although study results have been mixed, it now appears that glucosamine works no better than placebo. However, glucosamine and the placebo both relieved arthritis pain better than taking nothing, particularly in people who have moderate to severe pain.
- Yoga or tai chi. Helpful to maintain movement, muscle strength and body control for some people
- Massage. Massage may temporarily relieve pain in an arthritic joint by improving the blood flow to the surrounding muscles. Make sure your massage therapist knows which joints are affected by arthritis.