Contrary to popular belief, arthritis isn't a single ailment but a range of conditions resulting in joint discomfort, stiffness, structure deterioration, or diminished joint functionality. The word itself comes from the Greek terms "arthros" (joint) and "itis" (inflammation), indicating an inflamed joint. Arthritis and rheumatism were previously considered synonymous, but arthritis has since become the universally accepted medical term.
The CDC states that approximately 58.5 million American adults, or one in four people, and 300,000 children suffer from arthritis. This guide will delve into the different types of arthritis, their symptoms, methods for managing the condition, and when to consult a rheumatologist.
What Are The Types of Arthritis
There are over 100 distinct types of arthritis. Some forms emerge gradually due to natural joint wear, while others manifest abruptly and then vanish, only to reappear later. Certain arthritis types are chronic and progressive, worsening as time goes on. The signs and symptoms can differ significantly between individuals, even if they have the same type of disease.
Osteoarthritis (OA)
Osteoarthritis happens when joints get damaged and swollen from wear and tear. Cartilage cushions joints and makes movement smooth and easy. But as osteoarthritis progresses, the cartilage breaks down. Then joints rub together and become painful, stiff, and swollen.
This type of arthritis often starts in one joint, like the knee or hip. Pain gets worse with movement and weight. Rest relieves the pain for a while but not the stiffness. You may hear grinding or popping sounds when joints move. If left untreated, osteoarthritis can make joints misshapen, swollen, and deformed. It can limit mobility and daily activities significantly.
Rheumatoid arthritis (RA)
Rheumatoid arthritis primarily targets the synovial joints, causing inflammation, pain, and swelling. It typically affects the small joints of the hands and feet symmetrically, though any synovial joint can become involved as the disease progresses.
The inflammation increases blood flow to the joints, causing heat, redness, and swelling from excess synovial fluid. The pain stems from the stretching of tissues and bones around the joint. Muscle loss, pain, and swelling lead to loss of joint function. More severe or prolonged inflammation results in greater joint damage, deformity, disability, and handicap. Structures like tendon sheaths may also become inflamed, sometimes rupturing tendons.
Juvenile arthritis (JA)
Juvenile arthritis (JA) refers to any form of arthritis or an autoimmune condition diagnosed in children under 16 years of age. The most common form is juvenile idiopathic arthritis (JIA), an autoimmune disorder in which the immune system targets the synovial membranes that line the joints, causing inflammation.
The cause of JIA is unknown, though genetics and environmental factors may play a role. The condition can affect one or multiple joints, causing pain, swelling, and stiffness that limits the range of motion and mobility. While the course of JIA is unpredictable, treatments focus on controlling inflammation to minimize pain and joint damage.
Spondyloarthropathies
Spondyloarthropathies typically cause inflammation in the joints connecting the spine to the pelvis and limbs. These inherited autoimmune disorders have a predictable genetic predisposition and are influenced by environmental factors that disrupt the immune response. Although the exact cause is unknown, the interaction between environmental triggers and immune system problems is the leading theory.
Frequent symptoms include persistent back discomfort, rigidity, and joint inflammation, particularly affecting areas like the spinal column, sacroiliac joints within the pelvic region, and the knees, ankles, wrists, and elbows. As the condition progresses, inflammation leads to pain, reduced mobility, and even joint fusion. Other common features include inflammation at tendon attachments (enthesitis), swelling of fingers or toes (dactylitis), eye inflammation (uveitis), skin condition (psoriasis), and digestive issues related to inflammatory bowel disease.
Gout
Gout is a form of metabolic arthritis resulting from an accumulation of uric acid crystals within the joints. Uric acid is naturally present in the blood, but excessive production or poor excretion can lead the crystals to accumulate around joints, causing inflammation and pain attacks. The most commonly affected joints are at the base of the big toe, ankle, knee, wrist, and elbow.
Gout causes sudden and severe pain, swelling, redness, and tenderness in the joints. Attacks usually begin at night and are described as one of the worst pains imaginable. Between attacks, there are no joint symptoms. Over time, repeated gout attacks can cause permanent joint damage and deformity.
Infectious and reactive arthritis
This form of arthritis refers to joint inflammation caused by infection or autoimmune reaction rather than joint wear or injury. In infectious arthritis, bacteria, viruses, or other microbes enter the joints, multiply, and trigger an inflammatory response. Common culprits include chlamydia, gonorrhea, salmonella, and Lyme disease.
Reactive arthritis occurs when the immune system mounts an attack against bacterial or viral antigens elsewhere in the body, also attacking joint tissues by mistake. Symptoms include joint pain, swelling, redness, warmth, and tenderness. The joints most often affected include knees, ankles, wraths, small joints of hands and feet, and the spine. Without treatment, the infection or inflammation can lead to permanent joint damage.
Psoriatic arthritis (PsA)
Psoriatic arthritis (PsA) refers to joint inflammation and damage associated with psoriasis, an autoimmune skin condition. About 30% of people with psoriasis will develop PsA. The inflammation of joints and connective tissues leads to pain, swelling, stiffness, and loss of mobility. Any joint can be affected, but PsA most often causes inflammation of joints at the ends of fingers and toes, spine, sacroiliac joints, knees, ankles, and wrists.
PsA causes a predictable pattern of symptoms, including painful and swollen joints, dactylitis (sausage digit swelling), enthesitis (inflammation of tendon attachments), and axial disease (spine and sacroiliac joint inflammation). Skin lesions of psoriasis may appear before, after, or concurrent with joint symptoms, but the conditions are linked.
Managing Arthritis
Lifestyle changes and home remedies
Maintaining a healthy weight, eating a balanced diet, and exercising regularly can help manage arthritis symptoms. Heat and cold therapy, massage, and relaxation
Physical therapy and exercise
Physical therapy can help improve joint function, flexibility, and strength. A physical therapist can design an exercise program tailored to the individual's needs and limitations. Low-impact exercises like swimming and walking are generally recommended for people with arthritis.
Medications and supplements
NSAIDs like acetaminophen, ibuprofen, and naproxen can effectively manage arthritis pain for most patients by reducing inflammation and providing significant relief when used consistently.
For moderate to severe arthritis, prescription treatments like DMARDs or biologic response modifiers are the most effective options, while corticosteroids can be used for short-term relief of severe pain.
Dietary supplements such as glucosamine, chondroitin, ASU, and omega-3 fatty acids may relieve osteoarthritis pain. Still, their effects can be variable, and they lack strong evidence for preventing or reversing joint damage.
Surgical options
In severe cases, surgery may be necessary to repair or replace damaged joints. Common procedures include joint replacement, joint fusion, and arthroscopy.
When to See a Rheumatologist
Research suggests that early diagnosis and treatment of arthritis can lead to better outcomes and potentially prevent joint damage. It is essential to see a rheumatologist if:
You have joint pain, swelling, or stiffness that persists over a few weeks.
The pain is severe or interferes with your daily activities.
You have a family history of autoimmune diseases or inflammatory arthritis.
You experience other symptoms, such as fever, fatigue, unexplained weight loss, and joint pain.
Are you living with the daily effects of arthritis or an autoimmune disease? It's time to get comprehensive rheumatology care from specialists who understand your condition inside and out. Contact OC Rheumatology & Arthritis Clinic for an appointment today.
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