The inflammation of joints is known as arthritis. It is not a single disease entity but a general term used for a wide variety of diseases related to our joints. It is most common among women and occurs more frequently in older people.
World Arthritis Day falls on 12 Oct every year. Continue reading this article to find out what are the different types of arthritis and how they are usually being treated!
Arthritis is one of the leading causes of disability. People of all ages, genders, and races can have this condition. As there are many people who do not seek treatment until their symptoms become severe, the exact incidence and prevalence are not known.
Conservative estimates only include patients who report they have doctor-diagnosed arthritis, indicating that more than 54 million adults and almost 300,000 children have arthritis or another type of rheumatic disease in the USA. The prevalence peaked at 65–79 years in males and females in all racial groups of Asia, except in Native Hawaiians and Pacific Islander males where it peaked at 45–54 years. There are more than 100 different types of arthritis and related conditions. The most common types of joint diseases are:
- Psoriatic arthritis
- Reactive arthritis
- Rheumatoid arthritis
- Ankylosing spondylitis
- Juvenile idiopathic arthritis
- Infective arthritis
- Secondary arthritis due to trauma
Causes and risk factors
The specific cause of arthritis depends on its type. It can be due to infection, inflammation, an autoimmune condition, or a certain degenerative process. Some common risk factors include:
- Family history: A person is more likely to develop arthritis if his parents or siblings have the disorder.
- Age: The risk of conditions such as osteoarthritis, rheumatoid arthritis, and gout increases with age.
- Gender: Rheumatoid arthritis is more common in women while most of the people who have gout are men.
- Previous joint injury: People who had joint injury are more likely to eventually develop arthritis in that joint.
- Obesity: Excessive weight gain puts stress on joints, particularly the knees, hips, and spine. This causes a higher risk of developing arthritis.
Symptoms and signs
The common signs and symptoms of arthritis depend on the type and the site involved. The major signs and symptoms may include:
- Decreased mobility of joints
Arthritis can make a person disabled, affecting their day-to-day activity and cause depression as well. The doctor examines the joint involved to see tenderness, deformities, analyses the range of movement, and also notes the number of joints involved.
Clinical, laboratory tests and imaging tests are required for the diagnosis of arthritis depending on its types. Clinical evaluation guides us to narrow our differentials and send relevant tests to confirm the type of arthritis.
Evaluation of the blood, urine, and joint fluid form part of the laboratory tests. Certain types of white blood cells called neutrophils raise in cases of acute infection of joints while lymphocytes rise in tubercular arthritis.
Blood pictures may show the presence of antibodies harming the native cells, called autoantibodies, in cases of autoimmune joint diseases. These fluids can be sent for routine culture to find out the actual pathogen causing the joint infection. Serum uric acid is raised in gouty arthritis due to which urate crystals get deposited in the joint spaces.
They help us to analyse the joints involved, type of arthritis, and the extent of damage that has occurred so that we can plan our management and monitor the progression of the disease accordingly.
The major complications of arthritis are:
- Physically handicapped to do daily activities.
- Permanent deformity of the involved joints can occur.
- Life-threatening infections such as sepsis can occur in cases of infectious arthritis.
- Stress and depression can occur due to the long-term disability and financial burden of treatment.
The main aim of treatment is to reduce pain and prevent further damage. Treatments differ based on the type of arthritis you have. The treatment modalities may include:
Acetaminophen and other NSAIDs are given for pain relief and to reduce inflammation. In cases of severe pain, opioids are also prescribed. Apart from these, drugs that modulate your immune system are required for rheumatoid arthritis. These are called disease-modifying anti-rheumatic drugs (DMARDs). Newer drugs known as biologic response modifiers such as Tumour necrosis factor (TNF) inhibitors and corticosteroids may also be used to suppress autoimmune diseases. Antibiotics may be prescribed for infective arthritis.
There are non-pharmacological measures like physiotherapy, occupational therapy, heating pads or ice packs, etc that may help relieve arthritis pain. Assistive devices such as canes, shoe inserts, walkers, braces, raised toilet seats, and other assistive devices can help protect the joints and improve the ability to perform daily tasks. Regular physical exercise, swimming, cycling, and water aerobics are recommended to improve the function and strengthen the muscles. In addition to this, a healthy diet and weight loss help to decrease disability.
Surgery and other procedures
Surgery is done only if all the conservative methods fail. Some procedures practiced to cure arthritis include:
- Injection of steroids into the joints for pain relief.
- Joint repair: The joint surfaces are smoothed or realigned to reduce pain and improve function. These types of procedures can often be performed arthroscopically through small incisions over the joint.
- Joint replacement: In this procedure, the damaged joint is removed and replaced with an artificial one. The joints most commonly replaced are hips and knees.
- Joint fusion: This procedure is more often used for smaller joints, such as the wrist, ankle, and fingers. The ends of the two bones in the joint are removed, then the ends are locked together until they heal into one rigid unit.
Some of the promising treatment options are glucosamine, chondroitin, hyaluronic acid, platelet-rich plasma (PRP) injection, acupuncture, yoga, and massage.