Arthritis is stiffness, inflammation, and pain in the joints of the body. Some types of arthritis can be found in younger people, and some are more common in adults over the age of 55. Two of the main types of arthritis are osteoarthritis and rheumatoid arthritis.
Osteoarthritis is the most common form of arthritis and is a “wear and tear” condition that occurs when there is damage to the cartilage within the joints. This damage is associated with chronic pain, decreased range of motion, and stiffness or aches in the affected area. In severe cases, bone spurs can form causing what is called Herberden’s nodes that can further restrict movement, especially in the hands.
Bones come together to form the moveable joints in the body. The end of each bone is covered in cartilage, a soft tissue that helps bones slide across one another smoothly. As joints age and are used over a long period of time, it makes sense that they would become worn down. Once the cartilage becomes worn down, though, bone rubs on bone, causing pain and inflammation. This rubbing can also puncture the bursa, the small sacs of fluid that cushion each joint. Hips, hands, knees, and spine are the most common locations of osteoarthritis.
The causes of osteoarthritis are pretty straightforward due to the nature of the disease. Repetitive motion, either at work or in sport, can cause osteoarthritis, as can the simple act of aging. With repeated, long-term use, joints wear out and become painful. Injury or infection in the affected joint can hasten the process of degradation, but overall this is simply a process of age and use.
People over age 55 are most at risk, but osteoarthritis has become more prevalent in young athletes who practice their sport year-round.
Prescription treatments can include corticosteroid injections directly into the affected joint to reduce inflammation and pain, but doctors will often recommend trying over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) first. Alternative treatments such as biofeedback and acupuncture have had some success, and doctors will always recommend adding gentle exercise to the treatment plan.
For athletes, cross training and giving the body time to rest and recover are crucial for healthy joints. Focusing on strengthening the muscles around the joints most used also helps to prevent early onset osteoarthritis.
All patients with osteoarthritis can benefit from changes in the diet to reduce inflammation and increase joint lubrication. Drinking plenty of water is key for joint lubrication, and taking vitamin D and calcium supplements can help strengthen the bone. Anti-inflammatory foods like ginger and tart red cherries can help manage pain and inflammation naturally. Some patients also report good results from chiropractic care, acupuncture, and biofeedback.
Rheumatoid arthritis is an auto-immune disorder that results in systemic inflammation and pain in the joints. This inflammation in the synovial fluids of the joints is a result of the immune system responding to a perceived threat in the body and defending itself by essentially attacking itself. More than one joint is usually affected in symmetrical fashion on each side of the body, as this is a systemic issue, and there will be periods of flare-up and remission. Other symptoms of rheumatoid arthritis include fever and fatigue. This chronic inflammation can cause permanent deformity in the joint, and symptoms do not need to be present for a long time for damage to occur. 80% of people with rheumatoid arthritis have an antibody called the rheumatoid factor.
There are no known causes of rheumatoid arthritis, but some research indicates that there may be a hereditary component to the disease. Other research points to infection or bacteria in the body as a trigger for the immune system to turn on itself. There are environmental factors that may play a role in the development of rheumatoid arthritis, such as smoking, exposure to silica mineral, and periodontal disease, but again, there is no one cause pinpointed. It may be a combination of factors that work together.
There is no cure for rheumatoid arthritis, so treatments focus on slowing down or preventing further damage while building up and strengthening muscles and tendons surrounding the affected joint. Doctors may prescribe “first-line drugs” such as aspirin and corticosteroids to deal with pain and inflammation while the slower-acting “second-line drugs” have a chance to start working. These “second-line drugs” include things drugs such as methotrexate, which can help slow or stop joint destruction. Methotrexate may also encourage remission of the disease.
Other alternative treatments that may help include changing the diet and incorporating exercise. Adding foods that help fight inflammation (e.g., turmeric, ginger, and capsaicin) may be helpful, as does increasing intake of omega-3s, which have been beneficial to patients in short-term studies. Avoiding gluten for those who are sensitive can also help fight inflammation.
Movement helps to ameliorate the stiffness that comes with inactivity, and doctors advocate stretching and strengthening activities such as yoga and Pilates along with walking and other low-impact forms of exercise. Maintaining a healthy weight eases stress on the joints of the legs, which can help with pain if the affected joint is in the lower body.
Less common forms of arthritis
There are over 100 types of arthritis, and some of the less common forms share some characteristics, causes, and treatments with osteoarthritis and rheumatoid arthritis. Here are a few:
- Pseudogout is caused by calcium deposits in the knees that result in pain and inflammation
- Scleroderma is a condition that causes the skin to become thick and hard. Although this mostly affects skin, it can also affects the joints and result in a “frozen” joint that is difficult and painful to move.
- Lupus is the umbrella name given to a cluster of autoimmune disorders that can result in arthritis-like conditions in the joints of the body. Lupus is most common in women from ages 15 to 45 but can be found in all demographics of the population.
- Paget’s Disease causes bones to reform incorrectly and can result in the fracturing of the affected bone. This occurs most commonly in the pelvis, spine, skull, thighbone, and shinbone.
Many of these types of diseases have a hereditary component, but this is not always the case. Treatments are likewise tailored to each individual and their age, lifestyle, and disease progression. In some cases of severe bone deformities, surgery is indicated, but not always. The course of treatment is as individual as the disease itself.
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Image by Michael Dorausch via Flickr