Advancing age gives an apprehension of being afflicted by joint pain and resulting disability. Arthritis means any disorder of gradual or sudden onset affecting joints, presenting with pain and stiffness in joints. Symptoms may alternatively flare and wane. They can be mild, moderate or severe. Severe form can result in chronic pain, hampering daily activities including walking or climbing stairs, impacting quality of life.
Arthritis can also cause permanent joint damage, like knobby fingers, reduced joint space and spur in joint cavity.
Pain in Arthritis
Pain of varying severity is a common symptom in all types of arthritis and has following characteristics.
- Pain is associated with swelling, tenderness, warmth and stiffness of joint
- Joint stiffness may be worse in morning
- Decreased range of motion
- Muscle aches and pains
- Inability to use the hand or walk
- Malaise and fatigue
- Weight loss
- Poor sleep
Disability in Arthritis
Arthritis is the leading cause of disability leading to absenteeism and frequent visits to the physician. Joint pain and stiffness can limit physical activity including routine activities and can make one home bound.
Types of Arthritis
Out of 100 different types of arthritis, following are common, each with specific features.
- Rheumatoid arthritis
- Gout and pseudo-gout
- Psoriasis (Psoriatic arthritis)
Osteoarthritis is the most common type of arthritis, mostly affecting both larger and smaller joints, including hands, wrists, feet. It typically affects weight bearing joints, such as back, knee and hip. It is degenerative disease of the elderly and essentially acquired from daily wear and tear of the joint. When joint cartilage at ends of bones wear away, bones of a joint rub against each other, causing pain, swelling and stiffness. Older obese, women with family history are at higher risk of developing this degenerative disease. It presents with minor pain during physical activity, which can become continuous and even occur during resting. The debilitating pain can restrict simple routine activities. Osteoarthritis is most common indication for Total Knee Replacement. Osteoarthritis can be prevented by active lifestyle with healthy weight, and avoiding injury and repetitive movements.
Rheumatoid arthritis (RA) is an autoimmune disease in which defensive antibodies mistakenly start targeting joint tissues, leading to inflammation. If inflammation goes uncontrolled, it can irreversibly damage cartilage and elastic tissue covering joint surfaces as well as bones. Gradually there is loss of bones and cartilage resulting in reduction of joint space. Joints become painful with reduced mobility over time. Rheumatoid arthritis starts with smaller joints like those between your fingers and hands, and between toes and foot. It gradually involves knees, wrists, shoulders, elbows, ankles and hips. It affects symmetrical joints on either side. Usually multiple joints are affected simultaneously. Signs and symptoms may show periods of flare and remission. Over time, rheumatoid arthritis can cause joints to deform.
Gout is inflammation of joint due to deposition of uric acid crystals in the joint. Another uncommon form of gouty arthritis caused by depostion of calcium pyrophosphate is known as pseudogout. Gouty arthritis starts in one joint and with time involves many joints and can be quite crippling. The joints in gout often become swollen, painful and lose function, leading to debility and affecting quality of life.
Psoriasis is an autoimmune disease characterised by scaling of skin and itching. It can develop into psoriatic arthritis, which mostly presents with skin problem first and then the arthritis. Typical symptoms are continuous joint pains, stiffness and swelling, interrupted by periods of remission. Fraction of patients may be afflicted with severe painful and destructive form of psoriatic arthritis which destroys small joints in the hands leading to permanent disability and loss of hand function.
Diagnosis of Arthritis
Typical symptoms and signs clue to diagnosis of specific arthritis. Blood tests like Rheumatoid Factor, anti-cyclic citrullinated peptide (anti-CCP) aid in diagnosis of Rheumatoid Arthritis. CT Scan, X Ray, MRI help in identifying the extent of damage.
Living with Arthritis
Main objectives are to stop destructive inflammation of joints, relieve joint pain and improve mobility. With no known cure for either rheumatoid or osteoarthritis, treatment options vary from active exercise, weight control, medications and orthopaedic bracing. Hip or Knee replacement surgery may be required in patients with unbearable pain, restricted mobility affecting routine daily activities. With early intervention and treatment joint functions can be preserved and you can live better quality of life.