Arthritis

What is Arthritis?

Arthritis involves inflammation of one or more joints and the breakdown of cartilage. Cartilage normally protects the joint, allowing for smooth movement. Cartilage also absorbs shock when pressure is placed on the joint, like when you walk or otherwise bear weight. Without the usual amount of cartilage, the bones rub together, causing pain, swelling, and stiffness.

Causes, incidence, and risk factors

You may have joint inflammation for a variety of reasons, including:

• Broken bone
• Infection (usually caused by bacteria or viruses)
• An autoimmune disease (the body attacks itself because the immune system believes a body part is foreign)
• General "wear and tear" on joints
• Rheumatoid arthritis (in adults)
• Juvenile rheumatoid arthritis (in children)
• Systemic lupus erythematosus (SLE)
• Gout
• Scleroderma
• Psoriatic arthritis
• Ankylosing spondylitis
• Reiter's syndrome (reactive arthritis)
• Adult Still's disease
• Viral arthritis
• Gonococcal arthritis
• Other bacterial infections (non-gonococcal bacterial arthritis)
• Tertiary Lyme disease (the late stage)
• Tuberculous arthritis
• Fungal infections such as blastomycosis

Often, the inflammation goes away after the injury has healed, the disease is treated, or the infection has been cleared.

With some injuries and diseases, the inflammation does not go away or destruction results in long-term pain and deformity. When this happens, you have chronic arthritis. Osteoarthritis is the most common type and is more likely to occur as you age. You may feel it in any of your joints, but most commonly in your hips, knees or fingers.

Symptoms

If you have arthritis, you may experience:

• Joint pain
• Joint swelling
• Stiffness, especially in the morning
• Warmth around a joint
• Redness of the skin around a joint
• Reduced ability to move the joint

Treatment

Treatment of arthritis depends on the particular cause, which joints are affected, severity, and how the condition affects your daily activities. Your age and occupation will also be taken into consideration when your doctor works with you to create a treatment plan.

It is possible to greatly improve your symptoms from osteoarthritis and other long-term types of arthritis without medications. In fact, making lifestyle changes without medications is preferable for osteoarthritis and other forms of joint inflammation. If needed, medications should be used in addition to lifestyle changes.

Exercise for arthritis is necessary to maintain healthy joints, relieve stiffness, reduce pain and fatigue, and improve muscle and bone strength. Your exercise program should be tailored to you as an individual. Work with a physical therapist to design an individualized program, which should include:

• Range of motion exercises for flexibility
• Strength training for muscle tone
• Low-impact aerobic activity (also called endurance exercise)

A physical therapist can apply heat and cold treatments as needed and fit you for splints or orthotic (straightening) devices to support and align joints. This may be particularly necessary for rheumatoid arthritis. Your physical therapist may also consider water therapy, ice massage, or transcutaneous nerve stimulation (TENS).

Rest is just as important as exercise. Sleeping 8 to 10 hours per night and taking naps during the day can help prevent exacerbations.

You should also:

• Avoid positions or movements that place extra stress on your affected joints.
• Avoid holding one position for too long.
• Reduce stress, which can aggravate your symptoms. Try meditation or guided imagery. And talk to your physical therapist about yoga or tai chi.
• Modify your home to make activities easier. For example, have grab bars in the shower, the tub, and near the toilet.

Prevention

If arthritis is diagnosed and treated early, you can prevent joint damage. Find out if you have a family history of arthritis and share this information with your doctor, even if you have no joint symptoms.

Osteoarthritis may be more likely to develop if you abuse your joints (injure them many times or over-use them while injured). Take care not to overwork a damaged or sore joint. Similarly, avoid excessive repetitive motions.

Excess weight also increases the risk for developing osteoarthritis in the knees, and possibly in the hips and hands. See the article on body mass index to learn whether your weight is healthy.