Arthritis: Types, Symptoms, Causes, Risks, Complications, Diagnosis, Treatment and Outlook

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man touch his hand suffering from arthritis

Overview

Why are joints so important? A joint is a point at where two bones meet and allow movement of those bones. The joints enable people to be flexible by lubricating the bones and provide movement without any friction.

Bones are too rigid and hard to bend. To help people move, these bones are fused by joints, which are flexible. Joints are important for many activities like walking, running, turning the head, sitting down and even swinging the arms.

Joints are movable, allowing the bones to move. These consist of the cartilage, a type of tissue that protects the surface of a bone and helps decrease the friction of movement in a joint, and ligaments, which are strong elastic bands that give support to the bone. They also consist of tendons, which are connective tissues that control the movement of the joint, and the synovial membrane, a tissue that lines the joint. This membrane produces the synovial fluid to lubricate it.

When the joint is inflamed or swollen, it’s termed as arthritis. Arthritis or joint inflammation is the term used for a group of more than 100 diseases. The most common types of arthritis are osteoarthritis, gout, and rheumatoid arthritis.

Arthritis affects daily activities and it affects one in five adults or 52.5 million of the total population in the United States. In fact, it’s the leading cause of disability among the individuals living in the U.S. and it can affect people across all age groups, even some children.

Out of the people with arthritis, 27.5 million have osteoarthritis and approximately 1.3 million have rheumatoid arthritis. It affects older adults, particularly those who are 65 years old and above. About 60 percent of people with arthritis in the United States are women.

Types

Inflammatory arthritis – These types of arthritis entail the inflammation in the joints, as a result of the body’s action and defense against viruses and bacteria. Some examples include rheumatoid arthritis, reactive arthritis, ankylosing spondylitis and arthritis linked to colitis or psoriasis.

Degenerative arthritis – Also called mechanical arthritis, this refers to a group of problems that involve the damage to the cartilage that covers the bone ends. Osteoarthritis is the most commonly used term for this condition.

Other types:

  • Back pain
  • Soft tissue musculoskeletal pain
  • Connective tissue disease
  • Infectious arthritis
  • Metabolic arthritis
  • Juveline or childhood arthritis

Specific Types

Osteoarthritis – This type of arthritis often develops in adults who are more than 40 years old. It can occur at any age because it’s caused by an injury or joint-related conditions. Osteoarthritis causes the cartilage that protects the ends of the bones from breaking down. As a result, the bones rub against each other. This occurs in older people because aging leads to the degeneration of cartilage. Usually, the most common joints affected are the hands, spine, knees, and hips.

Rheumatoid arthritisThis is an autoimmune disease affecting many individuals. In this condition, the body’s immune cells mistakenly attack the joints, leading to inflammation. The specific part of the joint affected is the synovium.

Gout – Gouty arthritis is a condition wherein the joints become inflamed as result of the accumulation of uric acid crystals in the joints. This usually happens in the big toe, but other joints can be affected too.

The other types of arthritis include ankylosing spondylitis, cervical spondylosis, fibromyalgia, psoriatic arthritis, enteropathic arthritis, reactive arthritis, polymyalgia rheumatic, and secondary arthritis.

Symptoms

The symptoms of arthritis people experience may vary depending on the type of arthritis they have. The most common signs and symptoms include:

  • Joint pain
  • Joint tenderness
  • Joint stiffness
  • Inflammation around the joints
  • Muscle wasting
  • Warm and red skin over the affected area
  • Restricted movement
  • Weakness

Causes

The cause of arthritis depends on the type a person has. However, general causes include genetics and current lifestyle.

Osteoarthritis – The most common type of arthritis is osteoarthritis, which involves the wear-and-tear damage to the cartilage as a result of overuse or excessive weight. When the cartilage becomes damaged, it can result in the bones rubbing against each other, leading to pain and restricted movement.

Rheumatoid arthritis – In rheumatoid arthritis, the body’s immune system mistakenly attacks the joint capsule lining, which protects the joints. Called synovial membrane, the lining will become swollen and could eventually lead to cartilage damage.

Gout – Gout is caused by the excessive amounts of uric acid. As a result, the uric acid will crystallize and deposit in the joints of the body, most commonly in the big toe.

Risk Factors

Some people are at a higher risk of developing arthritis than others. This is because they have the following risk factors:

Age – Older adults are at an increased risk of developing arthritis like rheumatoid arthritis, osteoarthritis, and gout.

Family history or genetics – Some types of arthritis are passed down in families. If you have family members with the disease, you are more likely to develop it.

Gender – Women are at a heightened risk of developing arthritis than men. One of the most commonly experienced types of arthritis in women is rheumatoid. However, gout affects more men than women.

Obesity – People who are overweight or obese are at a higher risk of developing arthritis, especially in the weight-bearing joints such as the spine, hips, and knees.

Previous joint damage or injury – People who once injured their joint may eventually develop arthritis in that joint in the future.

Complications

If arthritis is left untreated, it may lead to complications such as:

Mobility problems – People with arthritis may have a difficult time performing daily tasks that were easy before. When arthritis affects the hands and arms, it’s hard to move and do daily tasks. However, when the condition affects the legs or weight-bearing joints, it can lead to bone deformity and limited range of motion. Walking or running will be extremely difficult.

Eye problemsUntreated rheumatoid arthritis can affect the eyes.

Diagnosis

The doctor can request several diagnostic examinations for arthritis including:

Physical exam – During the physical exam, the doctor can examine the joints for redness, swelling, warmth, and pain. The doctor will also ask you about the symptoms, family history, and medical history.

Laboratory tests – Some laboratory tests can help diagnose arthritis and various body fluids can be tested to see which type of arthritis a patient has. For instance, a blood test can show the levels of uric acid in the body, hinting gouty arthritis.

Imaging tests – Imaging tests may help the doctor visualize the joint to see whether it has inflammation or not.

  • X-rays – An X-ray uses low levels of radiation to visualize a bone, cartilage or joint. When there is cartilage damage, it may signal an inflammation or arthritis.
  • Magnetic resonance imaging (MRI) – An MRI can help produce detailed images of the bones and the soft tissues like the ligaments, tendons, and cartilage.
  • Computerized tomography (CT) scan – A CT scan can take images from various angles and show cross-sectional views of the internal parts of the bones and joints.
  • Ultrasound – Ultrasound uses sound waves to show soft tissue images. This is needed to visualize fluid-containing structures in the joints.

Treatment

The treatment of arthritis focuses on symptom relief and improving the function of the joint.

Medicines – Pain relievers and anti-inflammatory drugs are used to relieve the symptoms of arthritis. This medicine should only be prescribed by a licensed doctor. The most commonly used analgesics include acetaminophen and hydrocodone. Nonsteroidal anti-inflammatory drugs (NSAIDs) are also used, including ibuprofen and naproxen sodium. Other drugs that are used include counterirritants, biologic response modifiers, and disease-modifying antirheumatic drugs. Corticosteroids are used to reduce the inflammation and suppress the immune system.

Therapy – Physical therapy is needed to correct deformities, improve the range of motion and strengthen the adjacent joints.

Surgery – In some cases, joint repair is needed to fix the bones and relieve the pain. Other types of surgeries include joint replacement and joint fusion.

Outlook

The main problem encountered by people with arthritis is the long-term pain and swelling. Moreover, in some cases, arthritis may lead to permanent disability and deformity.

People with arthritis may also experience flare-ups, wherein there is an acute attack triggered by some factors. Other conditions, like gout, can be controlled by medical treatment. On the other hand, some types of osteoarthritis and rheumatoid arthritis are long-term, which means that people may need to live with these diseases.

The prognosis for people with arthritis depends on the type they have. However, the best outcomes are seen in those who get an early diagnosis and have sought medical attention. Moreover, those who followed the treatment plan appropriately are less likely to suffer from dangerous complications.

In many cases, the symptoms of arthritis can be reduced to prevent the progression of the disease. These include:

Weight loss – It is important to maintain a healthy weight to reduce the stress on the weight-bearing joints.

Heat and cold packs – For some people, the use of heat and cold packs have helped in pain relief.

Exercise – Regular and moderate exercise can help keep the joints flexible