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Arthritis

Health    Arthritis

"Arthritis" literally means joint inflammation. Although joint inflammation is a symptom or sign rather than a specific diagnosis, the term arthritis is often used to refer to any disorder that affects the joints. Joints are places where two bones meet, such as your elbow or knee.

There are different types of arthritis. In some diseases in which arthritis occurs, other organs, such as your eyes, heart, or skin, can also be affected.

Fortunately, current treatments allow most people with arthritis to lead active and productive lives.

Types of Arthritis

There are several types of arthritis. Common ones include:

Ankylosing Spondylitis

It is arthritis that affects the spine. It often involves redness, heat, swelling, and pain in the spine or in the joint where the bottom of the spine joins the pelvic bone.

Gout

It is caused by crystals that build up in the joints. It usually affects the big toe, but many other joints may be affected.

Juvenile Arthritis

It is the term used to describe arthritis in children. Arthritis is caused by inflammation of the joints.

Osteoarthritis

It usually comes with age and most often affects the fingers, knees, and hips. Sometimes osteoarthritis follows a joint injury. For example, you might have badly injured your knee when young and develop arthritis in your knee joint years later.

Psoriatic Arthritis

It can occur in people who have psoriasis (scaly red and white skin patches). It affects the skin, joints, and areas where tissues attach to bone.

Reactive Arthritis

It is pain or swelling in a joint that is caused by an infection in your body. You may also have red, swollen eyes and a swollen urinary tract.

Rheumatoid Arthritis

It happens when the body's own defense system doesn't work properly. It affects joints and bones (often of the hands and feet), and may also affect internal organs and systems. You may feel sick or tired, and you may have a fever.

Arthritis is seen with other conditions. These include:

Lupus

It happens when the body's defense system harms the joints, heart, skin, kidneys, and other organs.

Infection

Infection gets into a joint and destroys the cushion between the bones.

Symptoms of Arthritis

Symptoms of arthritis can include:

These symptoms may also be signs of other illnesses.

Causes of Arthritis

Some genes have been identified in certain types of arthritis, such as rheumatoid arthritis and juvenile arthritis. People with osteoarthritis may have inherited cartilage weakness.

If you have the gene, something in your environment may trigger the condition. For example, repeated joint injury may lead to osteoarthritis.

Diagnosis of Arthritis

To diagnose you with arthritis, your doctor may:

  • Ask you about your medical history.
  • Give you a physical exam.
  • Take samples of blood for a laboratory test.
  • Take x-rays.

Treatment of Arthritis

Your doctor will talk to you about the best way to treat your arthritis, based upon the type you have. Possible treatments include:

  • Medications such as:
    • Pain relievers that are taken by mouth.
    • Creams or ointments that are rubbed into the skin over sore muscles or joints to relieve pain.
    • Medications that may slow the course of the disease and prevent further damage to joints or other parts of the body.
  • Surgery, such as joint replacement.

Who Treats Arthritis?

Doctors who diagnose and treat arthritis and other rheumatic diseases include:

  • A general practitioner, such as your family doctor.
  • A rheumatologist, who specializes in arthritis and other diseases of the bones, joints, and muscles.

Living With Arthritis

Some people may worry that arthritis means they won't be able to work or take care of their children and their family. Others think that you just have to accept things like arthritis. It's true that arthritis can be painful. But there are things you can do to feel better:

  • Take your medications when and how you're supposed to.
  • Exercise to reduce joint pain and stiffness. It also helps with losing weight, which reduces stress on the joints. You should speak to your doctor about a safe, well-rounded exercise program.
  • Use heat and cold therapies to reduce joint pain and swelling.
  • Try relaxation therapy to help reduce pain by learning ways to relax your muscles.
  • Use splints and braces to support weakened joints or allow them to rest. You should see your doctor to make sure your splint or brace fits well.
  • Use assistive devices, such as a cane or shoe insert, to ease pain when walking. Other devices can help you open a jar, close zippers, or hold pencils.

Arthritis and Rheumatic Diseases

The term arthritis is often used to refer to any disorder that affects the joints. These disorders fall within the broader category of rheumatic diseases. There are more than 100 rheumatic diseases that together affect millions of People.

"Arthritis" literally means joint inflammation, which is a symptom of the disease.

Symptoms of rheumatic diseases include inflammation (redness or heat, swelling, pain) and loss of function of one or more of the body's support structures. They especially affect joints, tendons, ligaments, bones, and muscles. Some rheumatic diseases can also involve internal organs.

Some rheumatic diseases are more common among certain populations. For example:

Types of Arthritis and Rheumatic Diseases

There are numerous types of arthritis and other rheumatic diseases, including:

Osteoarthritis

It is the most common type of arthritis, damages both the cartilage (the tissue that cushions the ends of bones within the joint) and the underlying bone. Osteoarthritis can cause joint pain and stiffness. Disability results most often when the disease affects the spine, knees, and hips.

Rheumatoid Arthritis

It is a less common type of arthritis that occurs when the immune system attacks the lining of the joint (synovium). This produces pain, swelling and loss of joint function. The most commonly affected joints are those in the hands and feet.

Gout

It is a type of arthritis caused by needle-like crystals of uric acid that gather in the joints, usually beginning in the big toe. Symptoms may come and go and include inflammation, swelling, and pain in the affected joint(s).

Infectious Arthritis

It is caused by infectious agents such as bacteria or viruses. Parvovirus arthritis and gonococcal arthritis are examples of infectious arthritis, as is the arthritis that occurs with Lyme disease, a bacterial infection caused by the bite of infected ticks.

Juvenile Idiopathic Arthritis

It is the most common form of arthritis in childhood. Symptoms include pain, stiffness, swelling, and loss of joint function. It may be associated with rashes or fevers and may affect various parts of the body.

Spondyloarthropathies

It is a group of rheumatic diseases that usually affect the spine. There are a few forms:

* Ankylosing spondylitis may also affect the hips, shoulders, and knees.
* Reactive arthritis is caused by infection of the lower urinary tract, bowel, or other organ. It is commonly associated with eye problems, skin rashes, and mouth sores.
* Psoriatic arthritis is a form of arthritis that occurs in some patients with the skin disorder psoriasis. Psoriatic arthritis often affects the joints at the ends of the fingers and toes and is accompanied by changes in the fingernails and toenails. Back pain may occur if the spine is involved.

Bursitis

It occurs due to inflammation of the bursae (small, fluid-filled sacs that help reduce friction within the joint). Symptoms include pain and tenderness. Movement of nearby joints may also be affected.

Fibromyalgia

The symptoms include widespread muscle pain and tender points—areas on the body that are painful when pushed. Many people also experience fatigue and sleep disturbances.

Polymyalgia Rheumatica

It involves tendons, muscles, ligaments, and tissues around the joint. Symptoms include pain, aching, and morning stiffness in the shoulders, hips, neck, and lower back. It is sometimes the first sign of giant cell arteritis, a disease of the arteries characterized by headaches, inflammation, weakness, weight loss, and fever.

Polymyositis

It causes inflammation and weakness in the muscles. The disease may affect the whole body and cause disability.

Scleroderma

It is also known as systemic sclerosis. The disease is caused by excessive production of collagen (a fiber-like protein), leading to thickening of and damage to the skin, blood vessels, joints, and sometimes internal organs such as the lungs and kidneys.

Systemic Lupus Erythematosus

It is also known as lupus or SLE. This disease is caused when the immune system attacks the body's own healthy cells, resulting in inflammation of and damage to the joints, skin, kidneys, heart, lungs, blood vessels, and brain.

Tendinitis

Inflammation of tendons (tough cords of tissue that connect muscle to bone). This is caused by overuse, injury, or a rheumatic condition and may restrict movement of nearby joints.

Symptoms of Arthritis and Rheumatic Diseases

Different types of arthritis and rheumatic diseases have different signs and symptoms. In general, people who have arthritis feel pain and stiffness in one or more joints. There may also be tenderness, warmth, redness in a joint, and/or difficulty using or moving a joint normally.

Causes of Arthritis and Rheumatic Diseases

There are probably many genes that make people more likely to have rheumatic diseases. Some genes have been identified in certain diseases, such as rheumatoid arthritis, juvenile arthritis, and lupus. People with osteoarthritis may have inherited cartilage weakness.

If you have the disease gene, something in your environment may trigger the disease. For example, scientists have found a connection between Epstein-Barr virus and lupus. In addition, repeated joint injury may lead to osteoarthritis.

Diagnosis of Arthritis and Rheumatic Diseases

To diagnosis you with arthritis or another rheumatic disease, your doctor may:

  • Ask you about your medical history.
  • Give you a physical exam.
  • Take samples of blood, urine or synovial fluid (lubricating fluid in the joint) for a laboratory test.
  • Take x-rays.

Treatment of Arthritis and Rheumatic Diseases

Although there is no cure for arthritis and rheumatic diseases, medications may slow the course of the disease and prevent further damage to joints or other parts of the body. Exercise and diet changes may also help. Surgery may be recommended in some cases.

  • Common medications include:
    • Pain relievers that are taken by mouth. These include over-the-counter or prescription medications, depending on the severity of pain.
    • Creams or ointments that are rubbed into the skin over sore muscles or joints to relieve pain.
    • Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to treat pain and inflammation. Ibuprofen and naproxen sodium, are available over the counter, whereas other NSAIDs are available by prescription only.
    • Disease-modifying antirheumatic drugs (DMARDs) slow or stop the immune system from attacking the joints and causing damage.
    • Biologic response modifiers block specific immune pathways that are involved in the inflammatory process.
    • Janus kinase inhibitors are a new class of medications that block specific pathways that are involved in the body's immune response.
    • Corticosteroids are strong inflammation-fighting drugs that are given by mouth, in creams applied to the skin, intravenously, or by injection directly into the affected joint(s).
  • Surgery may be required to repair damage to a joint after an injury or to restore function or relieve pain in a joint damaged by arthritis. Many types of surgery are performed for arthritis, such as:
    • Outpatient procedures performed arthroscopically (through small incisions over the joints).
    • Total joint replacement, or replacement of a damaged joint with an artificial joint.

Exercise and Diet

Physical activity can reduce joint pain and stiffness and increase flexibility, muscle strength, and endurance. Although there is not a specific diet that helps arthritis, a well-balanced diet, along with exercise, helps people manage their body weight and stay healthy.

Who Treats Arthritis and Rheumatic Diseases?

Doctors who diagnose and treat arthritis and other rheumatic disease include:

  • General practitioners, such as your family doctor.
  • Rheumatologists, who specialize in arthritis and other diseases of the bones, joints, and muscles.
  • Orthopaedists, who specialize in treatment and surgery for bone and joint diseases.
  • Physical therapists, who help improve joint function.
  • Occupational therapists, who teach ways to protect joints, minimize pain, perform activities of daily living, and conserve energy.
  • Dietitians, who teach about good diets and maintaining a healthy weight.
  • Nurse educators, who help you understand your condition and help start treatment plans.
  • Rehabilitation specialists, who help you make the most of your physical potential.
  • Licensed acupuncture therapists, who reduce pain and improve physical functioning by inserting fine needles into the skin at specific points on the body.
  • Psychologists or social workers, who help with social challenges caused by medical conditions.
  • Chiropractors, who focus treatment on the relationship between the body's structure—mainly the spine and its functioning.
  • Massage therapists, who press, rub, and otherwise manipulate the muscles and other soft tissues of the body.

Living with Arthritis and Rheumatic Diseases

There are many things you can do to help you live with arthritis and other rheumatic diseases, including the following:

  • Exercise can reduce joint pain and stiffness and increase flexibility, muscle strength, and endurance. Exercise can help people lose weight, which reduces stress on painful joints. You should speak to your doctor about a safe, well-rounded exercise program.
  • Diet is especially important if you have gout. You should avoid alcohol and foods that are high in purines, such as liver, kidney, sardines, anchovies, and gravy.
  • Heat and cold therapies can reduce the pain and inflammation of arthritis. Heat therapy increases blood flow, tolerance for pain, and flexibility. Cold therapy numbs the nerves around the joint to reduce pain and may relieve inflammation and muscle spasms.
  • Relaxation therapy can help reduce pain by teaching you ways to release muscle tension throughout the body.
  • Splints and braces support weakened joints or allow them to rest. You should see your doctor before wearing a splint or brace to ensure proper fit. Otherwise, incorrect use of a splint or brace can cause joint damage, stiffness, and pain.
  • Assistive devices, such as a cane to help with walking, can reduce some of the weight placed on a knee or hip affected by arthritis. A shoe insert (orthotic) can ease the pain of walking caused by arthritis of the foot or knee. Other devices can help with activities such as opening jars, closing zippers, and holding pencils.

What exactly is a joint?

A joint (joynt) is where two or more bones are joined together. Joints can be rigid, like the joints between the bones in your skull, or movable, like knees, hips, and shoulders. Many joints have cartilage (KAHRT-lij) on the ends of the bones where they come together.

Healthy cartilage helps you move by allowing bones to glide over one another. It also protects bones by preventing them from rubbing against each other.

Keeping your joints healthy will allow you to run, walk, jump, play sports, and do the other things you like to do. Physical activity, a balanced diet, avoiding injuries, and getting plenty of sleep will help you stay healthy and keep your joints healthy too.

What can go wrong

Some people get arthritis (ar-THRY-tis). The term arthritis is often used to refer to any disorder that affects the joints. Although you might think arthritis affects only older people, it can affect young people, too. There are many different forms of arthritis:

Osteoarthritis

It is the most common type of arthritis and is seen especially among older people. In osteoarthritis, the surface cartilage in the joints breaks down and wears away, allowing the bones to rub together. This causes pain, swelling, and loss of motion in the joint. Sometimes, it can be triggered by an injury to a joint, such as a knee injury that damages the cartilage.

Rheumatoid Arthritis

It is known as an autoimmune (aw-toh-i-MYOON) disease, because the immune system attacks the tissues of the joints as if they were disease-causing germs. This results in pain, swelling, stiffness, and loss of function in the joints. People with rheumatoid arthritis may also feel tired and sick, and they sometimes get fevers. It can cause permanent damage to the joints and sometimes affects the heart, lungs, or other organs.

Gout

Gout is a form of arthritis that is caused by a buildup of uric acid crystals in the joints, most commonly in the big toe. It can be extremely painful. There are several effective treatments for gout that can reduce disability and pain.

Juvenile Arthritis

Juvenile arthritis is a term often used to describe arthritis in children. Children can develop almost all types of arthritis that affect adults, but the most common type that affects children is juvenile idiopathic (id-ee-uh-PATH-ik) arthritis.

Other forms of arthritis

Arthritis may be associated with diseases like lupus (LOO-puhs), fibromyalgia (fi-bromy-AL-juh), psoriasis (suh-RYE-uh-sis), or certain infections. In addition, other diseases might affect the bones or muscles around a joint, causing problems in that joint.

How do i keep my joints more healthy?

Physical Activity

Being physically active is one of the most important things you can do to keep your joints healthy. Regular activity helps keep the muscles around your joints strong and working the way they should. Even people who already have arthritis can benefit from regular physical activity, which will help reduce disability and keep the joints working well.

Children and teenagers should get 60 minutes or more of physical activity each day. When exercising or playing sports, be sure to wear the proper protective equipment to avoid injuring your joints. Remember that injuries to your knee early in life can lead to osteoarthritis later on, so be sure to wear protective pads and shoes that fit well.

It's also important to warm up and stretch before exercise. If you have any concerns about your health, talk to your doctor or a physical therapist to find out what kinds of activities are right for you.

Kim's dad is only 43, but he already has arthritis in his knees. He played football and ran track in high school and had a few knee injuries. These are likely to have caused arthritis at a pretty young age. So he reminds Kim to warm up and never to "play through the pain"—no matter what anyone says and to take care of injuries as soon as they happen.

Eat a Healthy Diet

Physical activity, along with a balanced diet, will help you manage your weight. Avoiding excess weight puts less stress on your joints, especially in your knees, hips, and feet. This can help reduce the wear and tear that may lead to arthritis later in life.

Speaking of diet, no specific diet will prevent or cure arthritis. However, eating a balanced diet will help manage your weight and provide a variety of nutrients for overall health. A balanced diet:

  • Emphasizes fruits, vegetables, whole grains, and fat-free or low-fat dairy products like milk, cheese, and yogurt.
  • Includes protein from beans, eggs, and nuts.
  • Is low in solid fats, saturated fats, cholesterol, salt (sodium), added sugars, and refined grains.
  • Balances calories taken in through food with calories burned in physical activity to help maintain a healthy weight.

What about dietary supplements?

Many people take dietary supplements such as glucosamine and chondroitin for joint health. Current research shows that these supplements may not have much benefit for people with osteoarthritis. However, they do seem to reduce moderate or severe osteoarthritis pain in some, but not all, people. There is no evidence that they can prevent any form of arthritis.

Scientists are also researching the effects of other dietary supplements, such as green tea and various vitamins, to see if they can keep your joints healthy. Check with your doctor before taking dietary supplements.

Osteoporosis and Arthritis

Two Common but Different Conditions

Many people confuse osteoporosis and some types of arthritis. This fact sheet discusses the similarities and differences between these conditions.

Osteoporosis

Osteoporosis is a condition in which the bones become less dense and more likely to fracture. It can result in a loss of height, severe back pain, and change in one's posture. Osteoporosis can impair a person's ability to walk and can cause prolonged or permanent disability.

Risk factors for developing osteoporosis include:

  • thinness or small frame
  • family history of the disease
  • being postmenopausal and particularly having had early menopause
  • abnormal absence of menstrual periods (amenorrhea)
  • prolonged use of certain medications, such as those used to treat lupus, asthma, thyroid deficiencies, and seizures
  • low calcium intake
  • lack of physical activity
  • smoking
  • excessive alcohol intake.

Osteoporosis is known as a silent disease because it can progress undetected for many years without symptoms until a fracture occurs. Osteoporosis is diagnosed by a bone mineral density test, which is a safe and painless way to detect low bone density.

Although there is no cure for the disease, the Food and Drug Administration has approved several medications to prevent and treat osteoporosis. In addition, a diet rich in calcium and vitamin D, regular weight-bearing exercise, and a healthy lifestyle can prevent or lessen the effects of the disease.

Arthritis

Arthritis is a general term for conditions that affect the joints and surrounding tissues. Joints are places in the body where bones come together, such as the knees, wrists, fingers, toes, and hips. Two common types of arthritis are osteoarthritis and rheumatoid arthritis.

  • Osteoarthritis (OA) is a painful, degenerative joint disease that often involves the hips, knees, neck, lower back, or small joints of the hands. OA usually develops in joints that are injured by repeated overuse from performing a particular task or playing a favorite sport or from carrying around excess body weight. Eventually this injury or repeated impact thins or wears away the cartilage that cushions the ends of the bones in the joint.

As a result, the bones rub together, causing a grating sensation. Joint flexibility is reduced, bony spurs develop, and the joint swells. Usually, the first symptom of OA is pain that worsens following exercise or immobility. Treatment usually includes analgesics, topical creams, or nonsteroidal anti-inflammatory drugs, appropriate exercises or physical therapy; joint splinting; or joint replacement surgery for seriously damaged larger joints, such as the knee or hip.

  • Rheumatoid arthritis (RA) is an autoimmune inflammatory disease that usually involves various joints in the fingers, thumbs, wrists, elbows, shoulders, knees, feet, and ankles. An autoimmune disease is one in which the body releases enzymes that attack its own healthy tissues. In RA, these enzymes destroy the linings of joints.

This causes pain, swelling, stiffness, malformation, and reduced movement and function. People with RA also may have systemic symptoms, such as fatigue, fever, weight loss, eye inflammation, anemia, subcutaneous nodules (bumps under the skin), or pleurisy (a lung inflammation).

Although osteoporosis and osteoarthritis are two very different medical conditions with little in common, the similarity of their names causes great confusion. These conditions develop differently, have different symptoms, are diagnosed differently, and are treated differently.

Osteoporosis and arthritis do share many coping strategies. In general, exercises that emphasize stretching, strengthening, posture, and range of motion are appropriate. Examples include low-impact aerobics, swimming, tai chi, and low-stress yoga.

However, people with osteoporosis must take care to avoid activities that include bending forward from the waist, twisting the spine, or lifting heavy weights. People with arthritis must compensate for limited movement in affected joints. Always check with your doctor to determine whether a certain exercise or exercise program is safe for your specific medical situation.

Most people with arthritis will use pain management strategies at some time. This is not always true for people with osteoporosis. Usually, people with osteoporosis need pain relief when they are recovering from a fracture. In cases of severe osteoporosis with multiple spine fractures, pain control also may become part of daily life. Regardless of the cause, pain management strategies are similar for people with osteoporosis, OA, and RA.

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