The most common form of arthritis is Osteoarthritis (degenerative joint disease). This normally develops gradually over a period of several years. Osteoarthritis can affect any joint, but some of the most commonly affected joints include the fingers, knees, hips, feet and spine. Osteoarthritis tends to occur more frequently in older people, and is associated with wear and tear of the joint surfaces. It is thought that injury to a joint can accelerate this process, but this is often not apparent until many years later. However, it is important to note that Osteoarthritis can occur at any age, and there is no known specific cause.
Osteoarthritis normally begins with changes in the cartilage (a covering of tissue that protects the bone surfaces). Healthy cartilage is smooth and hard but when the cartilage becomes damaged, it can become brittle and rough, and can sometimes soften. As a result, the bone can start to change to try and reduce the load on the cartilage. To do this, the body may produce extra bony tissue to try and thicken the bone, producing small bony growths called osteophytes. These results in a smaller space within the joint, meaning it becomes more difficult to move and is often painful. In more advanced cases of Osteoarthritis, the cartilage can wear away and leave the bone ends exposed. This is sometimes referred to as ‘bone on bone’, which can be very painful.
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.
There is no cure for osteoarthritis, but the symptoms can be eased by using a number of different treatments. 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 has to support.
Rheumatoid Arthritis (RA) is an autoimmune disease of the joints. It is called an autoimmune disease because the immune system starts to attack the body instead of defending it. Rheumatoid Arthritis causes inflammation of the lining of the joints and the surrounding structures.
It is not known exactly what triggers Rheumatoid Arthritis. It can develop in people of any age, but it is most common between the ages of 30 and 50 years. It is more common in women than in men. We also know that certain genes may trigger the development of rheumatoid arthritis, which means it can sometimes run in families.
The inflammation causes the affected joint (or joints) to become swollen and red, and can be warm to the touch. Eventually, this process can lead to thinning of the cartilage that covers the ends of the bones, and may cause the bone to be worn away. In more advanced cases of RA, the joints can change shape or appear deformed. The disease will often start in the wrists, hands or feet, and may spread to other joints and other parts of the body.
People who suffer from RA will often find that they have times when they feel well and the disease is inactive, and other times they will have a flare-up of symptoms. During a flare up, symptoms include pain, swelling and stiffness in the affected joints and feeling generally unwell and tired. It is important that during a flare up, the joints are well supported and are kept gently mobile, without aggravating the symptoms.
If you think you may have Rheumatoid Arthritis, this will need to be diagnosed by a doctor. A rheumatologist can discuss the best forms of treatment, including some drugs, which can help the condition. A physiotherapist can help to design a personalised exercise programme and give practical advice on how to stay active and manage some of your symptoms.