Arthritis is basically the inflammation of one or more of your joints. The main symptoms of arthritis are joint pain and stiffness, which worsens with age. The most common kind of arthritis are osteoarthritis and rheumatoid arthritis.
Osteoarthritis makes cartilage — the hard, slippery tissue that covers the ends of bones where they form a joint — to get broken down. Rheumatoid arthritis is an autoimmune disorder that first targets the lining of joints (synovium).
Uric acid crystals, infections or underlying ailments, such as psoriasis or lupus, can create other types of arthritis.
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Treatments options vary depending on the type of arthritis. The main goals of arthritis treatments are to lower symptoms and improve quality of life.
The most common signs and symptoms of arthritis involve the joints. Depending on the type of arthritis you observe, your signs and symptoms may include:
- Decreased range of motion
The two main classes of arthritis — osteoarthritis and rheumatoid arthritis — damage joints in different ways.
The most frequent type of arthritis, osteoarthritis involves wear-and-tear damage to your joint’s cartilage — the hard, slick coating on the ends of bones. Enough damage can be caused by bone grinding directly on bone, which produces pain and restricted movement. This wear and tear can happen over many years, or it can be hastened by a joint injury or infection.
In rheumatoid arthritis, the body’s immune system tends to attacks the lining of the joint capsule, a tough membrane that encloses all the joint parts. This lining, also called the synovial membrane, gets inflamed and swollen. The disease process can eventually destroy cartilage and bone within the joint.
Risk factors for arthritis may include:
- Family history.Some types of arthritis flow in families, so you may be more prone to develop arthritis if your parents or siblings have the disorder. Your genes can make you more susceptible to environmental factors that may trigger arthritis.
- The risk of many kinds of arthritis — including osteoarthritis, rheumatoid arthritis and gout — increases with age.
- Your sex.Women are more likely than are men to have rheumatoid arthritis, while most of the people who have gout, another type of arthritis, are men.
- Previous joint injury.People, who got a joint injury, perhaps while playing a sport, are more likely to eventually develop arthritis in that joint.
- Carrying excess pounds puts stress on joints, particularly your knees, hips and spine. Obese people have a higher risk of having arthritis.
Severe arthritis, especially if it affects your hands or arms, can make it hard for you to do daily tasks. Arthritis of weight-bearing joints can keep you from walking comfortably or sitting up straight. In some situations, joints may become twisted and deformed.
During the physical exam, your doctor will inspect your joints for swelling, redness and warmth. He or she will also want to see how well you can move your joints. Depending on the type of arthritis thought to be, your doctor may suggest some of the following tests.
The analysis of different types of body fluids can help pinpoint the type of arthritis you may have. Fluids commonly analyzed include blood, urine and joint fluid. To obtain a sample of your joint fluid, your doctor will cleanse and numb the area before inserting a needle in your joint space to withdraw some fluid (aspiration).
These types of tests can show problems within your joint that may be causing your symptoms. For examples:
- X-rays.Using low levels of radiation to visualize bone, X-rays can indicate cartilage loss, bone damage and bone spurs. X-rays may not reveal early arthritic damage, but they are often used to track progression of the disease.
- Computerized tomography (CT).CT scanners take X-rays from many different angles and add the information to create cross-sectional views of internal structures. CTs can visualize both bone and the surrounding soft tissues.
- Magnetic resonance imaging (MRI).Combining radio waves with a strong magnetic field, MRI can create more-detailed cross-sectional images of soft tissues such as cartilage, tendons and ligaments.
- This technology makes use of high-frequency sound waves to image soft tissues, cartilage and fluid-containing structures such as bursae. Ultrasound also is used to guide needle placement for joint aspirations and injections.
Arthritis treatment targets on relieving symptoms and improving joint function. You may have to try several different treatments, or combinations of treatments, before you know what works best for you.
The medications used to treat arthritis vary depending on the type of arthritis. Commonly used arthritis medications include:
- These medications help lower pain, but have no effect on inflammation. Examples include acetaminophen (Tylenol, others), tramadol (Ultram, Ultracet, others) and narcotics containing oxycodone (Percocet, Oxycontin, others) or hydrocodone (Norco, Vicoprofen, others).
- Nonsteroidal anti-inflammatory drugs (NSAIDs).NSAIDs lower both pain and inflammation. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve). Some kinds of NSAIDs are offered only by prescription. Oral NSAIDs can cause stomach irritation, and some may increase your risk of heart attack or stroke. Some NSAIDs are also offered as creams or gels, which can be rubbed on joints.
- Some varieties of creams and ointments have menthol or capsaicin, the ingredient that makes hot peppers spicy. Rubbing these preparations on the skin over your aching joint may interfere with the transmission of pain signals from the joint itself.
- Disease-modifying antirheumatic drugs (DMARDs).Often used for treatment of rheumatoid arthritis, DMARDs slow or stop your immune system from attacking your joints. Examples include methotrexate (Trexall) and hydroxychloroquine (Plaquenil).
- Biologic response modifiers.Typically used in conjunction with DMARDs, biologic response modifiers are genetically engineered drugs that target different protein molecules that are involved in the immune response. Examples include etanercept (Enbrel) and infliximab (Remicade).
- This type of drug, which includes prednisone and cortisone, lowers inflammation and suppresses the immune system. Corticosteroids can be taken orally or be injected directly into the painful joint.
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Physical therapy can be useful for some types of arthritis. Exercises can improve range of motion and strengthen the muscles surrounding joints. In some situations, splints or braces may be required.
If conservative measures don’t help, your doctor may suggest surgery, such as:
- Joint repair.In some situations, joint surfaces can be smoothed or realigned to lower pain and improve function. These types of procedures can often be performed arthroscopically — through small incisions over the joint.
- Joint replacement.This procedure takes out your damaged joint and replaces it with an artificial one. Joints most commonly replaced are hips and knees.
- Joint fusion.This procedure is more often used for smaller joints, such as those in the wrist, ankle and fingers. It takes out the ends of the two bones in the joint and then locks those ends together until they heal into one rigid unit.