Arthritis

Information

Arthritis is inflammation of one or more joints. The inflammation is most often the result of injury or disease and is characterized by swelling, pain and stiffness.

The most common types of arthritis are osteoarthritis and rheumatoid arthritis, but there are more than 100 different forms. Although arthritis is a disease that occurs mainly among adults, many arthritis-related conditions also affect children.

What are the most common ways of managing the problem?

Since arthritis worsens over time, the sooner treatment begins, the better. If left untreated, arthritis can progress and lead to serious damage.

Lifestyle changes

Learning that you have arthritis can be discouraging. Your treating physician may recommend lifestyle changes to protect your joint and slow the progression of the disease. In addition to the many treatment options, there are things you can do yourself to reduce the impact the disease has on your life.

• Talk to your doctor - If your symptoms are getting worse or you are struggling to cope, your treating physician can review your treatment plan.
• Physical therapy and exercise - A physical therapist will show you exercises to improve strength and flexibility, and certain exercises can improve the range of motion in the affected joints. They can also help you find new ways of carrying out some of your daily activities - simple changes can ease joint pain. Regular exercise can reduce stiffness and strengthen the muscles that support the joints. If you regularly do high-impact exercise (running), switching to low-impact activities will reduce the strain on weight-bearing joints - walking, cycling and swimming are suitable for this purpose. Braces, splints and other devices can also help relieve arthritis pain by reducing the load on the joints.
• Weight loss - If you are overweight, losing even a few kilograms can significantly reduce the load on weight-bearing joints (hip, knee and ankle). Weight loss can make it easier to move around and, in this way, help you stay more independent.
• Rest - Arthritis can make you more tired, and symptoms can worsen when you are tired. Try to get a full night's sleep and take short naps during the day if needed.
• Discuss alternative methods - Some alternative therapies appear to relieve arthritis pain. Talk to your treating physician before trying alternative treatments, as they may conflict with your prescribed treatment.

Medications

There are numerous medications that help relieve pain and reduce inflammation.

• Acetaminophen - Suitable for mild pain.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) - Drugs such as aspirin and ibuprofen reduce pain and swelling.
• Steroid injections - Cortisone is a powerful anti-inflammatory agent that can be taken orally or injected into the affected joint.
• Disease-modifying and antirheumatic agents - These medications are used to slow the progression of rheumatoid arthritis. Drugs such as methotrexate, sulfasalazine and gold injections are aimed at protecting the joint from destruction caused by the altered immune system.

Surgery

Your treating physician may suggest surgical treatment if the pain increases and leads to damage.

• Osteotomy - the axis of the bones forming the joint is changed, thereby reducing the load on the joint in question.
• Synovectomy - The damaged lining (joint capsule) in rheumatoid arthritis is removed to reduce pain and swelling.
• Arthrodesis - In this procedure, the joint is removed by "fusing" the bones that form it, which eliminates pain and deformity.
• Joint replacement - This surgery replaces the damaged joint with an artificial one.

What is rheumatoid arthritis?

Rheumatoid arthritis is a chronic disease that can affect many joints in the body. It most often begins in the small joints of the hands and feet, usually affecting symmetrical joints. For example, if you have pain and swelling in your right knee, you will also have pain and swelling in your left knee. In most cases, the joints are affected at the same time.

Anatomy

The joints of the body are lined on the inside by what is known as the synovial membrane, which lubricates the joint and makes its movement easier. Rheumatoid arthritis causes this lining to swell and thicken, which causes pain, swelling and stiffness in the joints.

How does it happen?

Rheumatoid arthritis is an autoimmune disease. This means that the immune system attacks its own tissues. In rheumatoid arthritis, instead of protecting the joints, the immune system begins to produce substances that destroy the joints, as well as the ligaments, tendons and muscles that support them. This can lead to joint deformity.

Symptoms

Autoimmune diseases affect the whole body. Rheumatoid arthritis can cause not only joint pain and stiffness, but also fever, loss of appetite and fatigue. Since it is a chronic disease, rheumatoid arthritis is a lifelong condition. However, symptoms can disappear for a period of time and then reappear.

What is osteoarthritis?

Osteoarthritis is the most common type of arthritis. Also known as "wear-and-tear" arthritis, osteoarthritis often appears in middle age. It develops slowly, and the pain it causes worsens over time.

Anatomy

Healthy joints move easily thanks to a smooth, slippery tissue called articular cartilage. Cartilage covers and protects the ends of the bones where they meet to form the joint. Osteoarthritis causes the cartilage to wear down. It can wear down cartilage in any joint, but it most often occurs in the so-called weight-bearing joints (ankle, knee, hip, spine).

How does it happen?

Osteoarthritis develops over time. As the cartilage wears down, it becomes frayed and rough. The movement of the bones over this exposed surface causes pain. If the cartilage wears away completely, this can lead to bone rubbing against bone. To compensate for the lost cartilage, the damaged bones may begin to grow outward and form painful bone spurs.

Symptoms

The most common symptoms of osteoarthritis are pain, stiffness and swelling around the joint. Symptoms usually worsen at night or after a period of inactivity.

Treatment of osteoarthritis

There are various treatment methods depending on the severity of the disease and which joint is affected. If other methods fail, the last step is surgical treatment.

For questions and further information: Dr. Chanko Chankov