Arthritis is an inflammation of the joints. It can affect one joint or multiple joints. Arthritis is an umbrella term covering over 100 conditions that affect the joints, tissues around the joint, and other connective tissues with different causes and treatment methods. Two of the most common types are osteoarthritis (OA) and rheumatoid arthritis (RA).
Commonly Associated With
Joint inflammation; Joint degeneration
Arthritis involves the breakdown of structures of the joint, particularly cartilage. Normal cartilage protects a joint and allows it to move smoothly. Cartilage also absorbs shock when pressure is placed on the joint, such as when you walk. Without the normal amount of cartilage, the bones under the cartilage become damaged and rub together. This causes swelling (inflammation), and stiffness.
Other joint structures affected by arthritis include:
• The synovium
• The bone next to the joint
• Ligaments and tendons
• The linings of the ligaments and tendons (bursae)
Joint inflammation and damage may result from:
• An autoimmune disease (the body’s immune system mistakenly attacks healthy tissue)
• Broken bone
• General “wear and tear” on joints
• Infection, most often by bacteria or virus
• Crystals such as uric acid or calcium pyrophosphate dihydrate
In most cases, the joint inflammation goes away after the cause goes away or is treated. Sometimes, it does not. When this happens, you have long-term (chronic) arthritis.
Arthritis may occur in people of any age and sex. Osteoarthritis, which is due to non-inflammatory processes and increases with age, is the most common type.
The symptoms of arthritis usually develop over time, but they may also appear suddenly. Arthritis is most commonly seen in adults over the age of 65, but it can also develop in children, teens, and younger adults. Arthritis is more common in women than men and in people who are overweight.
•Pain, swelling, and stiffness in one or multiple joints.
•Morning stiffness in and around the affected joints lasting at least one hour.
•Pain and stiffness that worsens with inactivity and improves with physical activity (such as exercising, swimming, etc.)
•Reduced range of motion.
•Sometimes fever, weight loss, fatigue, and/or anemia
The underlying cause often cannot be cured. The goal of treatment is to:
Reduce pain and inflammation
Prevent further joint damage
Lifestyle changes are the preferred treatment for osteoarthritis and other types of joint swelling. Exercise can help relieve stiffness, reduce pain and fatigue, and improve muscle and bone strength. Your health e team can help you design an exercise program that is best for you.
Exercise programs may include:
Low-impact aerobic activity (also called endurance exercise) such as walking
Range of motion exercises for flexibility
Strength training for muscle tone
Your provider may suggest physical therapy. This might include:
Heat or ice.
Splints or orthotics to support joints and help improve their position. This is often needed for rheumatoid arthritis.
Other things you can do include:
Get plenty of sleep. Sleeping 8 to 10 hours a night and taking naps during the day can help you recover from a flare-up more quickly, and may even help prevent flare-ups.
Avoid staying in one position for too long.
Avoid positions or movements that place extra stress on your sore joints.
Change your home to make activities easier. For example, install grab bars in the shower, the tub, and near the toilet.
Try stress-reducing activities, such as meditation, yoga, or tai chi.
Eat a healthy diet full of fruits and vegetables, which contain important vitamins and minerals, especially vitamin E.
Eat foods rich in omega-3 fatty acids, such as cold-water fish (salmon, mackerel, and herring), flaxseed, rapeseed (canola) oil, soybeans, soybean oil, pumpkin seeds, and walnuts.
Avoid smoking and excessive alcohol consumption.
Apply capsaicin cream over your painful joints. You may feel improvement after applying the cream for 3 to 7 days.
Lose weight, if you are overweight. Weight loss can greatly improve joint pain in the legs and feet.
Use a cane to reduce pain from hip, knee, ankle, or foot arthritis.
Medicines may be prescribed along with lifestyle changes. All medicines have some risks. You should be closely followed by a doctor when taking arthritis medicines, even ones you buy over-the-counter.
Acetaminophen (Tylenol) is often the first medicine tried to reduce pain. Take up to 3,000 a day (2 arthritis-strength Tylenol every 8 hours). To prevent damage to your liver, do not take more than the recommended dose. Since multiple medicines are available without a prescription that also contains etaminophen, you will need to include them in the 3,000 per day maximum. Also, avoid alcohol when taking etaminophen.
Aspirin, ibuprofen, or naproxen are nonsteroidal anti-inflammatory drugs (NSAIDs) that can relieve arthritis pain. However, they can carry risks when used for a long time. Possible side effects include heart attack, stroke, stomach ulcers, bleeding from the digestive tract, and kidney damage.
Depending on the type of arthritis, a number of other medicines may be prescribed:
Corticosteroids (“steroids”) help reduce inflammation. They may be injected into painful joints or given by mouth.
Disease-modifying anti-rheumatic drugs (DMARDs) are used to treat autoimmune arthritis and SLE
Biologics and kinase inhibitors are used for the treatment of autoimmune arthritis. They may be given by injection or by mouth.
For gout, certain medicines to lower uric acid levels may be used.
It is very important to take your medicines as directed by your provider. If you are having problems doing so (for example, because of side effects), you should talk to your provider. Also make sure your provider knows about your all the medicines you are taking, including vitamins and supplements bought without a prescription.
SURGERY AND OTHER TREATMENTS
In some cases, surgery may be done if other treatments have not worked and severe damage to a joint occurs.
This may include:
Joint replacement, such as a total knee joint replacement
Exams and Tests
The health care provider will perform a physical exam and ask about your medical history.
The physical exam may show:
Fluid around a joint
Warm, red, tender joints
Difficulty moving a joint (called “limited range of motion”)
Some types of arthritis may cause joint deformity. This may be a sign of severe, untreated rheumatoid arthritis.
Blood tests and joint x-rays are often done to check for infection and other causes of arthritis.
The provider may also remove a sample of joint fluid with a needle and send it to a lab to be checked for inflammation crystals or infection.
Courtesy of MedlinePlus from the National Library of Medicine