Arthritis

WHAT IS ARTHRITIS?

Arthritis is not a single chronic disease but an informal way of referring to joint pain or joint disease. More than 100 different types of arthritis and related conditions exist. People of all ages and races have arthritis, as more than 58.5 million adults and 300,000 children have some form. It is more common among women than men and occurs more frequently as people age. Arthritis is the leading cause of disability in the United States. The most common areas of the body afflicted with arthritis joint pain are the feet, hands, hips, knees and lower back.

COMMON TYPES OF ARTHRITIS

The most common types are osteoarthritis (OA), rheumatoid arthritis (RA), psoriatic arthritis (PsA), fibromyalgia, lupus, reactive arthritis and gout. All cause pain in different ways.

Osteoarthritis

Over time, the protective cartilage inside joints breaks down to cause osteoarthritis. This makes joint function more difficult and painful. Eventually, the bones may rub directly against one another, causing severe pain, which can also come from other parts of your joint, such as the synovium and ligaments. OA pain intensity varies from person to person and can range from mild to severe. Researchers used only to consider OA as a wear-and-tear condition but now believe it is a disease affecting the entire joint. Bones in the affected area become weaker, with connective tissue and joint cartilage deteriorating and inflammation damaging the joint lining.

Rheumatoid Arthritis

Rheumatoid arthritis is the most common form of inflammatory arthritis that affects people. It's also one of the most common autoimmune diseases where the body’s immune system attacks the joints and other organs by becoming overactive and affecting healthy tissue. RA primarily affects the lining of the joints, known as the synovium. Over time, the persistent inflammation breaks down the joint and damages it permanently. Bones and ligaments, in addition to the synovium, can also be the source of pain in RA. What causes RA is unknown, but the consensus says that an environmental trigger such as viral infections, stress or smoking can trigger it in genetically predisposed people. Gut microbes may also play a role.

Gout

Gout, also called metabolic arthritis, is an inflammatory form resulting from a building of uric acid crystals but does not cause body-wide inflammation. Uric acid crystals that build up when your body produces too much uric acid or can’t get rid of the excess fast enough cause joint pain. Crystals form in the joints, and typically affects the big toe, resulting in excruciating joint inflammation. Gout can also affect other joints. With a flare-up, you can go to bed feeling fine and wake up with severe pain that makes it difficult to walk.

Some people only experience one gout attack, never have other symptoms and don't need medications to reduce joint pain. Others go on to develop chronic gout, requiring drugs and lifestyle modifications to treat high uric acid levels.

Lupus

Lupus is an autoimmune disorder. It's also a connective tissue disease (CTD) and can affect various body parts, including joints, kidneys, skin, blood, etc. Common symptoms include joint pain and inflammation, stiffness, swelling and redness. It can affect any joints throughout the body. Untreated or long-standing lupus can damage joints even when not flaring. Sufferers can experience various difficulties in addition to reduced joint function, requiring consultation with several specialists for management.

Psoriatic Arthritis

This is another autoimmune inflammatory disease that causes widespread inflammation and pain. PsA provides a triple dose of problems as it affects the joints, causing arthritis; the connective tissue where tendons or ligaments attach to bones, causing enthesitis; and the skin, causing psoriasis.  Psoriatic arthritis has five forms. These are:

• Distal interphalangeal predominant psoriatic arthritis, affecting the fingers and toes
• Symmetric poly arthritis, affecting five or more joints simultaneously
• Asymmetric oligoarticular psoriatic arthritis, affecting two to four joints on both sides of the body
• Ankylosing spondylitis, affect the spine
• Arthritis mutilans, causing severe arthritis symptoms in the hands and feet

Fibromyalgia

Fibromyalgia is a central pain syndrome where the brain and spinal cord process pain signals differently. It is characterized by widespread pain that may come and go or be constant. In addition to pain, fibromyalgia patients may also have other symptoms such as fatigue, sleep problems, inability to concentrate and mood problems. Patients may also experience pain from a source, such as a slight touch, that doesn’t cause pain in other people.

WHAT CAUSES ARTHRITIS?

Most types of arthritis are caused by several factors acting together. You may be more likely to develop certain disorders as a result of your genetic makeup. Various external factors may increase the risk further if you’re susceptible to a condition. These include factors such as:

• Injuries leading to degenerative arthritis
• Viral infections, like Lyme disease
• Smoking
• Physically demanding occupations

• Immune system problems can trigger RA and lupus

Genetics and Family History

Many forms of arthritis, especially osteoarthritis, run in families, with some conditions having a stronger tendency to be passed on through genetics. How your body is made can make you more susceptible to certain conditions.

Lifestyle and Triggers

Arthritis can start suddenly without any apparent cause at any age. Something involving your lifestyle or medical history, even a combination of the two, could be responsible. Smoking can play a role. A job with heavily repetitive activity can affect joints and worsen symptoms.

One theory about the cause of rheumatoid arthritis is that it may be triggered by infections, although there is no direct evidence for this. Rheumatoid arthritis is more common and more severe in people who smoke.

One of the most significant overall health risk factors for developing arthritis is inactivity. If you become sedentary from joint stiffness and pain, you may face a greater risk for cancer, heart disease, diabetes and other severe conditions.

SYMPTOMS AND TREATMENT

Symptoms for each form of arthritis are slightly different, but generally, patients experience pain, swelling, reduced range of motion and stiffness in joints that include the hips, knees, ankles, back, fingers, hands, shoulders, neck or wrist. Pain can be intermittent or sharp and occurs while sitting for some forms of the disease. Difficulty walking and muscle weakness are also common. Some patients experience fatigue or malaise. According to the article Can apple cider vinegar help with arthritis? by MEDICAL NEWS TODAY, "Many people believe that apple cider vinegar has anti-inflammatory properties, and some sources say that it can relieve the symptoms of arthritis."

Arthritis has no cure, but patients can manage the condition and overall health with several conservative treatments. Anti-inflammatory medicines may relieve symptoms, including biologics, which target the response produced by your immune system. Physical therapy can help improve strength, range of motion, and overall mobility. Those who exercise regularly and maintain a healthy weight can reduce pressure on weight-bearing joints and help preserve joint function through movement.

HOW TO MANAGE ARTHRITIS SYMPTOMS

For some people, pain comes and goes, but for all too many people, pain is chronic. Pain is considered chronic when it lasts three to six months. Many patients have constant pain as well as frequent fatigue from dealing with pain.

Developing an effective treatment plan is the key to managing arthritis pain, whether prone to occasional flare-ups, having constant pain or experiencing symptoms somewhere in between.

Dr. Kaur will work with you to discuss a treatment plan that suits your needs, as the type, severity, and impact of arthritis varies from patient to patient. Your individualized plan may consist of prescription or over-the-counter pain medications, supplements, exercise, working with an occupational therapist and other techniques for pain management, including injections in the affected joints. You may be referred to a specialist like a rheumatologist to review new medications called biosimilars, which can treat these autoimmune disorders and help prevent permanent joint damage. For severe cases, joint replacement may be recommended.

Contact VIVAA today for a no-obligation consultation.