Arthritis
Arthritis is a collective term for a number of conditions
in which damage is caused to the joints. It is a major cause
of disability in the elderly population.
Each different form of arthritis has a different cause
Psoriatic arthritis and Rheumatoid arthritis are kinds of
autoimmune disease, which means that the body has somehow
been deceived into attacking its own tissue. Join infection
can cause what is known as Septic arthritis. Gouty arthritis
is the name used to describe the buildup of uric acid crystals
in a joint, which cause significant pain and inflammation.
There is also another form of gout called ‘pseudogout’, which
is caused by the formation of calcium pyrophosphate crystals.
Osteoarthritis is the most common kind of arthritis, and
is also known sometimes as degenerative joint disease. It
is caused by trauma to the joint, either after an infection
or simply because the body has become old and fragile. Those
with abnormal physical conditions may be predisposed to the
early onset of osteoarthritis.
A key symptom of arthritis is pain. The type and frequency
of this pain can change depending on the type and location
of the arthritis, but pain is present in most cases to a greater
or lesser extent. The pain of osteoarthritis for example is
typically worse at night or following extended periods of
sedentary rest. Rheumatoid arthritis tends to be more painful
in the mornings. One giveaway symptom of arthritis in children
or the elderly, is that they just avoid moving, or moving
the effected limbs, whenever possible.
The history of pain in a case of arthritis can be key to
diagnosing the situation. Your healthcare provider will want
to know when the pain began, which joints are painful, for
how long, what tends to make it worse and what better. A physical
examination is necessary to confirm a diagnosis of arthritis.
More complex or serious cases may also involve the use of
radiographs, blood tests or x-rays of the effected joints
for diagnostic purposes.
Osteoarthritis, or Osteoarthrosis (OA), sometimes known
as degenerative joint disease or degenerative arthritis, is
a condition in which inflammation causes joints to become
painful. The inflammation causes the cartilage that acts as
a cushion inside the joints to become worn, and the effected
bone surfaces are subjected to increased pressure and collision,
often a grinding sensation. An osteoarthritis sufferer may
experience pain when walking or standing, due to the pressure
being exerted on the effected joints. They will probably tend
to move less often as a result, which can cause muscles to
atrophy and ligaments to slacken.
In the US, osteoarthritis accounts for 25% of all visits
to doctors, and half of all prescriptions for non-steroidal
anti-inflammatory drugs (NSAIDS). It affects around 20 million
people in that one country alone, and evidence suggests that
some 80% of people will have some signs of the disease by
the age of 65.
There is no cure for osteoarthritis, as cartilage cannot
yet be made to regenerate, but possible treatment options
include NSAIDS, hyaluronan or glucocorticoid, or in some cases
joint replacement surgery may be needed. It is possible that
in the future, cartilage regeneration using tissue-engineering
technology may be possible and preferential in the treatment
of arthritis.
Rheumatoid arthritis is an autoimmune disease which is
both chronic and inflammatory, and affects many joints. Common
symptoms which may distinguish rheumatoid arthritis from osteoarthritis
include inflammation, the swelling of soft tissues and the
simultaneous involvement of multiple joints. Joints will usually
be infected asymmetrically in the early stages of the disease,
and then progressing symmetrically. Using the afflicted joints,
though painful, can usually improve both long-term pain and
motility. Rheumatoid arthritis is generally worse when joints
have been inactive for many hours, for example first thing
in the morning. This is in contrast to osteoarthritis, which
will generally become more painful as the day goes on.
Most often, the onset of osteoarthritis is irreversible,
and treatment typically involves pain management and other
medication to improve the motility of the joint. As has been
mentioned, joint replacement surgery is another viable option
for serious cases. The application of heat to the affected
area can help to reduce swelling and improve blood flow in
the area, which has a beneficial effect.
Often a mild pain relief drug can be enough to ease the
symptoms of arthritis. Acetaminophen (paracetamol/tylenol)
is often used to treat pain, though it does not have the same
inflammtion-reducing properties as non-steroidal anti-inflammatory
drugs. NSAIDS can reduce both pain and inflammation, at greater
risk of side-effects, particularly involving the gastrointestinal
system. Peptic ulcers are a common side effect of prolonged
NSAID usage.
Sometimes, steroids are prescribed to treat the symptoms
of arthritis, though some medical professionals do not believe
that the benefits of steroids in this particular case are
enough to outweigh the risks of their use. In the case of
sever pain involving arthritis, a narcotic pain reliever may
be employed, such a tramadol or morphine. But these should
be reserved only for extreme cases of acute pain.
Some NSAIDS are available in topical form, for example a gel
or ointment that can be applied directly to the site of the
pain, and may bypass possible side-effects of these drugs.
Severe joint pain can also be treated with targeted injections
of anaesthetics, such as lidocaine.
If all attempts at pain management are unsuccessful, joint
replacement surgery is a viable option, and many patients
experience significant relief as a result of this procedure.
Arthritis
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