Arthritis

What is arthritis?  

Arthritis is a condition that causes damage to the joints in your body, leading to pain and stiffness. Joints are the parts of the body where two bones meet to allow movement and prevent friction. These joints naturally wear down as you age, which is why some people may develop arthritis later in life. Arthritis can affect any joint in the body, but it is most commonly found in your hands, wrists, hips, knees, feet, ankles, shoulders and lower back.  

What are the different types of arthritis?  

Arthritis is a term given to a group of more than 100 conditions that cause pain and stiffness in your joints. The two most common types of arthritis are osteoarthritis and rheumatoid arthritis.  

  • Osteoarthritis is a degenerative disease that affects joints within the body by wearing down cartilage that acts as a protective cushion at the end of the bones. Cartilage is a firm, rubbery tissue made up of water and protein that reduces friction in the joints and acts as a shock absorber. When the cartilage is worn away, bones rub against each other causing you to feel pain. Osteoarthritis is the most common form of arthritis, affecting over 400,000 people in Ireland and millions around the world. The disorder most commonly affects joints in your hands, hips, knees, and spine.  
  • Rheumatoid arthritis is a chronic inflammatory disorder caused by the immune system mistakenly attacking the healthy tissue within your body. Unlike osteoarthritis that causes cartilage to wear down, rheumatoid arthritis affects the lining of the joints, causing swelling that may lead to joint deformity and bone erosion. In addition to its effects on the joints, inflammation caused by rheumatoid arthritis can also affect your skin, eyes, mouth, lungs, heart, and kidneys.   

What causes arthritis?  

The specific causes of arthritis depend on the type of condition you are experiencing. Osteoarthritis can be caused by the natural wear and tear of the joints as you age or can be hastened by an injury or infection that caused premature damage to the joints. Lifestyle factors, including low levels of physical activity and weight gain, can put additional strain on the joints causing them to wear down at a faster rate.  

However, in the case of rheumatoid arthritis, the exact cause remains unknown as we don’t know what causes the immune system to start attacking the body.  

What are the symptoms of arthritis?  

Your symptoms may vary depending on the type, severity and progression of the arthritis and can include:  

  • Joint pain 
  • Decreased range of motion 
  • Feeling of heat / warmth near the joint 
  • Skin discolouration / redness 
  • Stiffness 
  • Swelling (inflammation) 
  • Tenderness / sensitivity around the joint 

What are the risk factors?  

Although anyone can develop arthritis due to the gradual deterioration of the joints, there are certain factors that may increase the risk of developing the condition, including: 

  • Smoking: smoking affects bone health, making them more prone to developing arthritis.  
  • Family history: if your family members suffer from arthritis, it may increase your risk of developing it.  
  • Activity level: low levels of physical activity can contribute to the development of arthritis as it may lead to weight gain, causing additional pressure being put on the joints, and loss of strength and muscle mass.  
  • Other health conditions: autoimmune conditions, obesity and other conditions can have an impact on the health of your joints.  
  • Age: natural deterioration of the joints that occurs over the course of your life. 
  • Lifestyle: a physically demanding job that requires you to stand for long periods of time or carry heavy loads, can put an additional strain on your joints. 

How is arthritis diagnosed?  

The process of diagnosing arthritis begins with physical examination, during which your healthcare provider will assess the mobility of your joints and provide you with the opportunity to discuss your symptoms in detail. The physical exam is followed by an X-ray to highlight the location and progression of the arthritis. In some cases, an MRI may be used if the arthritis cannot be examined with an X-ray.  

How is arthritis managed and treated?  

Following your diagnosis, you will be offered a range of treatment options ranging from conservative and non-surgical to surgical. Your healthcare professional will recommend the best treatment pathway for you and your case, but the final decision is entirely up to you and depends on what you are comfortable with. The different treatment options include:  

Conservative 

Conservative treatment options are recommended to patients with early stage of arthritis to delay the need to use non-surgical and surgical treatment options.   

  • Weight loss: by losing weight, you can elevate some of the extra pressure being applied to the joints.  
  • Limit / quit smoking: not smoking can help improve the health of your bones. 
  • Physiotherapy: can improve the function of the affected joint(s) by strengthening and conditioning the muscles and tendons and improving mobility. Physiotherapy cannot reverse the damage caused by arthritis but can slow down the progression of the condition and alleviate some of the pain.  
  • Tablets: your healthcare provider may prescribe different forms of medication to help with the pain and reduce inflammation, allowing you to live more comfortably and to continue working with your physiotherapist. 

Non-surgical 

If you are experiencing moderate amount of pain while employing conservative treatment options, injections may be recommended to alleviate the pain and reduce inflammation caused by arthritis.  

Injections are a targeted form of treatment and the type administered depends on your specific needs. The different types of injections include:  

  • Corticosteroids: used to reduce inflammation around the joint. 
  • Platelet rich plasma (PRP): used to stimulate healing and enhance repair of soft tissue and cartilage.  
  • Hyaluronic acid (HA): used to act as a lubricant, preventing bones from rubbing against each other to delay further degradation of the joint. 

Surgical 

Surgical intervention may be recommended to you regardless of the stage of your arthritis (mild / moderate / advanced) if the symptoms experienced have a severe impact on your quality of life. Your healthcare provider will discuss the different surgical options with you and make a recommendation based on your specific needs.  

 

This content has been reviewed by Paulo Melo, Orthopaedic Advanced Nurse Practitioner at Mater Private Network in Dublin.