What is Arthritis?
The term arthritis literally means inflammation of a joint but is generally used to describe a number of condition in which there is degeneration or damage to the cartilage surfaces in a joint.
Inflammation is the body's natural response to injury and usually involve redness, swelling, stiffness, heat, and pain.
The cartilage is a padding that absorbs stressful forces. Over time the cartilage can become damaged due to injury, or can start to wear. The amount of change can vary with the type and stage of arthritis and can cause inflammation which affects the cartilage, the bone under the cartilage, and the synovial lining of the joint.
Pain can be a factor in arthritis. The pain early on is often due to inflammation and, in the later stages when the cartilage is worn away, the pain can be due to the mechanical friction of the bony surfaces rubbing on each other.
There are over 100 different types of rheumatic diseases. The most common are:
- Osteoarthritis is also called degenerative joint disease; this is the most common type of arthritis and is often associated with age related changes. This disease affects cartilage, the tissue that cushions and protects the ends of bones in a joint. With osteoarthritis, the cartilage starts to wear away over time. In extreme cases, the cartilage can completely wear away, leaving not protection for the bone underneath the cartilage and is referred to as bone-on-bone contact. Bone spurs sometimes form at the end of a joint.
- Osteoarthritis causes joint pain and can limit a person's normal joint mobility. When severe, the joint may lose all movement, causing a person to become disabled. Disability most often happens when the disease affects the spine, Knees, and Hips.
- Osteoarthritis may develop quite slowly in some people, and quicker in others. Initial symptoms are likely to include pain and stiffness of the joint. You may initially notice this first thing in the morning. Sometimes the joint will feel swollen, warm or red due to inflammation and you may notice a change in the shape of the joint. In more severe cases, it may cause pain at night time and difficulty completing day to day activities.
- Rheumatoid Arthritis is an auto-immune disease in which the body's immune system (the body's way of fighting infection) attacks healthy joints, tissues, and organs. Occurring more commonly in females between 15-44, with a ratio of about 3:1 for female to male.
- RA involves inflammation of the lining of the joints (synovium). It can cause pain, stiffness, swelling, and loss of function in joints. When severe, RA can result in deformation to certain joints. For example, the joints the hands and fingers can bend or curve.
- Rheumatoid Arthritis affects mostly joints of the hands and feet and tends to affect both sides of the body at the same time.
- Arthritis developing following an injury to a joint is called post-traumatic arthritis. The condition may develop years after the trauma which could have been a fracture or ligament injury.
- Psoriatic Arthritis occurs in some persons with psoriasis, a scaling skin disorder, affecting the joints at the ends of the fingers and toes. As with RA, Psoriatic Arthritis is an auto-immune condition that can cause inflammation of the joints. Commonly it also causes changes in the fingernails and toenails. Spinal pain is also commonly involved.
What are the Symptoms of Arthritis?
There are more than 150 different forms of arthritis with symptoms varying between types of arthritis; each form affects the body differently. Arthritic symptoms generally include swelling and pain or tenderness in one or more joints for more than two weeks, redness or heat in a joint, limitation of motion of joint, early morning stiffness, and rash-like skin changes.
What are the Treatments for Arthritis?
There is no specific cure for osteoarthritis, it is more about the management of symptoms and function.
Mild symptoms can often be managed with exercise and pain killers when required. Physiotherapy has been shown to significantly improve function, decrease pain, and delay need for surgical intervention such as a joint replacement. If you are overweight, weight loss may also help by reducing the amount of load that the affected joint needs to support.
In more progressive cases, or when pain is intolerable, surgery may be appropriate. Which type of surgery may depend on factors such as which type of arthritis, extent of joint change and the age of the patient.
Joint replacement surgery, such as for knees and hips, is very common for higher levels of joint damage. With good physiotherapy guidance after your operation, people can often return to very good levels of function and activity including sport and exercise.
A physiotherapist can explain your condition and give you advice on which management option may be suitable for you. If surgery is appropriate, we can help signpost you to a good Orthopaedic Surgeon and help you get the best results possible after the operation.