Arthritis Explained

What is Arthritis 

Arthritis affects the movements you rely on for everyday activities. Arthritis is usually chronic. This means that it can last on and off for a lifetime.

There are over 100 kinds of arthritis that can affect many different areas of the body. In addition to the joints, some forms of arthritis are associated with diseases of other tissues and organs in the body. People of all ages, including children and young adults, can develop arthritis.

Arthritis - Greek arthro-, joint + -itis, inflammation) is a sum of conditions that affect the health of the bone joints in the human body. About 1/3 of adult Americans suffer from some form of arthritis and the disease affects about twice as many females as men. Arthritis affects the movements you rely on for everyday activities. Arthritis is usually chronic. This means that it can last on and off for a lifetime.

The exact cause of thumb arthritis, as with osteoarthritis in general, isn't known. Researchers suspect that it's a combination of factors, including being overweight, the aging process, joint injury or stress, heredity, muscle weakness and "cumulative load" to the joint

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Arthritic diseases include rheumatoid arthritis and psoriatic arthritis, which are autoimmune diseases; septic arthritis, caused by joint infection; and the more common osteoarthritis, or degenerative joint disease. Arthritis can be caused from strains and injuries caused by repetitive motion, sports, overexertion, and falls. Unlike the autoimmune diseases, osteoarthritis largely affects older people and results from the degeneration of joint cartilage. Other forms are discussed below.

Arthritic joints can be sensitive to weather changes. The increased sensitivity is thought to be caused by the affected joints developing extra nerve endings in an attempt to protect the joint from further damage.

Signs & Symptoms

The hallmark symptom of rheumatoid arthritis is morning stiffness that lasts for at least an hour. (Stiffness from osteoarthritis, for instance, usually clears up within half an hour.) Even after remaining motionless for a few moments, the body can stiffen. Movement becomes easier again after loosening up.

Swelling and Pain

Swelling and pain in the joints must occur for at least 6 weeks before a diagnosis of rheumatoid arthritis is considered. The inflamed joints are usually swollen and often feel warm and "boggy" when touched. The pain often occurs symmetrically but may be more severe on one side of the body, depending on which hand the person uses more often.

Specific Joints Affected

All arthritides feature pain, which is generally worse in the morning and on initiating movement but resolves in the course of time. In elderly people and children, the pain may not be the main feature, and the patient simply moves less (elderly) or refuses to use the affected limb (children).

When faced with joint pain, a doctor generally will ask about several other medical symptoms (such as fever, skin symptoms, breathlessness, Raynaud's phenomenon) that may narrow down the differential diagnosis to a few items, for which testing can be done.

Monoarthritis (arthritis of one joint) and fever together are pointers toward septic arthritis . This is a medical emergency and requires urgent referral to an orthopedic surgeon for analysis of joint aspirate and consideration for joint washout.

Diagnosis

What tests need to be done to determine if it is arthritis and what type of arthritis it is?

The various types of arthritis can be distinguished by the pace of onset, the age and sex of the patient, the amount of (and which) joints affected, additional symptoms (such as psoriasis, iridocyclitis, Raynaud's phenomenon, and rheumatoid nodules), and other clues.

Blood tests and X-rays of the affected joints are often performed to make the diagnosis. X-rays can show erosions or bone appositions.

Screening blood tests: full blood count, electrolytes, renal function, liver enzymes, calcium, phosphate, protein electrophoresis, C-reactive protein and the erythrocyte sedimentation rate (ESR). Specific tests are the rheumatoid factor, antinuclear factor (ANF), extractable nuclear antigen and specific antibodies whenever the ANF is found to be positive.

Recommended reading: Arthritis Free In One Month.

Treatment

 cornerstone of therapy of any form of arthritis is physical therapy and occupational therapy to maintain joint mobility and range of motion. The proper kind and amount of this therapy will vary depending upon the underlying cause and upon individual factors that your physician will discuss with you.

Treatment options vary depending on the precise condition, but include surgery, and drug treatment, reduction of joint stress, physical and occupational therapy, and pain management. There are also numerous herbal remedies that purportedly treat arthritis, including Harpagophytum procumbens. For specifics, see the articles on the individual conditions listed below.

A cornerstone of therapy of any form of arthritis is physical therapy and occupational therapy to maintain joint mobility and range of motion. The proper kind and amount of this therapy will vary depending upon the underlying cause and upon individual factors that your physician will discuss with you.

Many drugs are now used to treat the inflammation and pain associated with arthritis. Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Motrin, and others), naproxen (Naprosyn, and others) and dicolfenac (Voltaren), have immediate analgesic and anti-inflammatory effects and are relatively safe.

In March 2005, researchers at Harvard Medical School and Brigham and Women's Hospital in the USA found that a diet rich in oily fish raised the body's production of an anti-inflammatory fat, and may thus reduce the effects of arthritis. According to their study published in the Journal of Experimental Medicine, this diet worked best when combined with low aspirin doses.

Types of Arthritis

Primary forms of arthritis:

Septic arthritis
Rheumatoid arthritis
Osteoarthritis
Gout and pseudogout
Juvenile arthritis
Still's disease
Ankylosing spondylitis

Secondary to other diseases:

Systemic lupus erythematosus (SLE)
Henoch-Schönlein purpura
Psoriatic arthritis
Reiter's syndrome
Reactive arthritis
Hemochromatosis
Hepatitis
Wegener's granulomatosis (and many other vasculitis syndromes)
Familial Mediterranean fever (FMF), HIDS (hyperimmunoglobulinemia D and periodic fever syndrome) and TRAPS (TNF-alpha receptor associated periodic fever syndrome).
Diseases that can mimic arthritis:

Pierre Marie-Bamberger syndrome (hypertrophic pulmonary osteoarthropathy, a paraneoplastic phenomenon of lung cancer)
multiple myeloma
osteoporosis
others 

 Some History of Arthritis

While evidence of primary ankle osteoarthritis has been discovered in dinosaurs, the first known traces of human arthritis date back as far as 4500 BC. It was noted in skeletal remains of Native Americans found in Tennessee and parts of what is now Olathe, Kansas. Evidence of arthritis has been found throughout history, from Ötzi, a mummy (circa 3000 BC) found along the border of modern Italy and Austria, to the Egyptian mummies circa 2590 BC. Around 500 BC willow bark gained popularity when it was discovered to help relieve some of the aches and pains of arthritis. It wasn't until more than 2,000 years later, in the early 1820s, that European scientists began to scientifically study the chemical compound in willow bark that alleviated the arthritis symptoms. They discovered the compound was salicin. When they isolated salicin, however, they found it was very noxious to the stomach. Almost 80 years later, in 1897, an employee of Bayer Company -- then a dye production company -- named Felix Hoffman discovered how to isolate the compound and make it less irritating to the stomach. Hoffman was attempting to make the drug in order to help his father, who was suffering from arthritis. In 1899, Bayer Company trademarked Hoffman's discovery under the name "Aspirin." Today it is believed that over a trillion tablets of aspirin have been sold worldwide