a disease that causes
pain and loss of movement of the
joints. The word arthritis literally means joint
inflammation (arth=joint, ritis=inflammation), and
refers to more than 100 different diseases.
Description of Arthritis:
the movements you rely on for everyday activities.
Arthritis is usually chronic. This means that it can
last on and off for a lifetime.
There are over 100 kinds of arthritis
that can affect many different areas of the
body. In addition to the joints, some forms of arthritis
are associated with diseases of other tissues and organs
in the body. People of all ages, including children and
young adults, can develop arthritis. Inflammation is a
reaction of the body that causes swelling, redness,
pain, and loss of motion in an affected area. It is the
major physical problem in the most serious forms of
arthritis. Normally, inflammation is the way the
responds to an injury or to the presence of disease
agents, such as viruses or bacteria.
During this reaction, many cells of the
body's defense system
immune system) rush to the injured area to wipe out the
cause of the problem, clean up damaged cells and repair
tissues that have been hurt. Once the "battle" is won,
the inflammation normally goes away and the area becomes
healthy again. In many forms of arthritis, the
inflammation does not go away as it should. Instead, it
becomes part of the problem, damaging healthy tissues of
the body. This may result in more inflammation and more
damage - a continuing cycle.The damage that occurs can
change the bones and other tissues of the joints,
sometimes affecting their shape and making movement hard
and painful. Diseases in which the immune system
malfunctions and attacks healthy parts of the
called autoimmune diseases.
pain and inflammation of joints has many forms.
Rheumatoid arthritis can be one of the most disabling
types of arthritis. Its
course varies, from a few symptoms to severe and
painful deformities. Three times as many women
as men are affected, usually at a fairly young
age (between 25 and 50). The disease may come on
slowly or appear suddenly. Rheumatoid arthritis
typically affects the small finger joints,
wrists, knees and toes. All joints of the
however, are potential targets. Along with
swelling and pain of joints, some of the early
symptoms of the disease may include fatigue,
loss of appetite, weight loss and fever.
Stiffness in the joints and surrounding muscles
that lasts for several hours after getting up in
the morning is a regular symptom. Sometimes the
disease involves other organs, causing damage to
the heart, lungs, eyes, skin and nerves. Many
individuals with rheumatoid arthritis feel their
arthritis is influenced by the weather, stress,
temperature and exercise. A few have periods of
remission when the disease seems to have gone
away. Unfortunately, in most cases, the symptoms
eventually return. The cause of rheumatoid
arthritis is unknown. Some scientists feel that
it may result from an
infection, but there is no
evidence that it is contagious. For whatever
reason, the joint lining becomes very inflamed
and thickened, slowly destroying cartilage and
bone. The goal of treatment is to halt the
inflammation and prevent the destruction of
joints. Medical supervision is a must, because
this form of arthritis can be crippling, other
organs may be affected and all treatments may,
on occasion, cause side effects. Doctors now
have many ways of treating rheumatoid arthritis.
Large doses of aspirin or aspirin-like drugs can
be effective in reducing
pain and inflammation.
If the arthritis is aggressive, drugs called DMARDs or SAARDs (disease-modifying
antirheumatic drugs, or slow-acting
antirheumatic drugs) such as the anti-malarial
may be used. Certain immunosuppressant biologic
response modifiers, corticosteroids, or gold
therapy may be used. All these drugs require
close supervision, since they may have hazardous
Rest, heat and physical therapy are important
adjuncts to drug therapy. A healthy diet and
exercise also helps patients retain mobility and
strength, maintain or lose weight, sleep better,
and even help maintain a positive attitude.
Although there is no scientific evidence that
eating or not eating certain foods reduces or
aggravates symptoms of rheumatoid arthritis,
some recent studies indicate that omega-3 fatty
acids (found in certain fish and plant seed
oils) may reduce the inflammation of rheumatoid
arthritis. Joint deformity or
pain is sometimes
so severe that surgery is the best alternative.
A patient can have added years of mobility due
to the hip, elbow, shoulder and knee
replacements that can be performed today.
Surgeries include joint replacement (replacing
the joint with an artificial joint), tendon
reconstruction (reconstructing damaged tendons)
and synovectomy (removal of the inflamed
tissue). The use of a splint or brace can also
help straighten some joints. Although surgery
cannot cure all deformities, advances in the
field have given rheumatoid patients, who
previously would have been wheelchair-bound, the
ability to continue in relatively normal lives.
One form of chronic arthritis (less widely
known) is one that attacks children, juvenile
rheumatoid arthritis. It may start with
symptoms as general as fever and rash, and it
may take a long time for a definite diagnosis to
be reached. Some children complain of swelling
and stiffness in a few scattered joints. When
the disease threatens the function of the
joints, skilled professional treatment is called
for to prevent permanent deformity.
disease in its juvenile form often stops
progressing within 10 years, but the damage may
be permanent and cause further deterioration of
the joints. The
major concern for the child, parent and doctor
is to provide treatment that will spare the
child a deformity that might persist long after
the disease itself has disappeared.
Osteoarthritis is a disease that causes the
breakdown of joint tissue, leading to joint
and stiffness. It can affect any joint, but
commonly occurs in the hips, knees, feet and
spine. It also may affect some finger joints,
the joint at the base of the thumb and the joint
at the base of the big toe. It rarely affects
the wrists, elbows, shoulders, ankles or jaw,
except as a result of injury or unusual stress.
Osteoarthritis is one of the oldest and most
common diseases in humans. It probably affects
almost every person over age 60 to some degree,
but only some have it badly enough to notice any
symptoms. Osteoarthritis is also known by many
other names, such as degenerative
joint disease, arthrosis, osteoarthrosis, or
Although there is no cure for osteoarthritis,
proper treatment can help relieve the symptoms
and prevent or correct serious joint problems.
(See Health Profile: Osteoarthritis.)
Treatment of Arthritis:
A cornerstone of therapy of any form of arthritis is
physical therapy and occupational therapy to
maintain joint mobility and range of motion. The
proper kind and amount of this therapy will vary
depending upon the underlying cause and upon
individual factors that your physician will
discuss with you.
Many drugs are now used to treat the
pain associated with arthritis.
Aspirin and other nonsteroidal anti-inflammatory
drugs (NSAIDs), such as ibuprofen (Motrin, and
others), naproxen (Naprosyn, and others) and
dicolfenac (Voltaren), have immediate analgesic
and anti-inflammatory effects and are relatively
Second-line drugs used for treatment of rheumatoid
arthritisinclude hydroxychloroquine, gold,
penicillamine, azathioprine, sulfasalazine and
methotrexate. These agents (which have no
immediate analgesic effect) can control symptoms
and may possibly delay progression of the
disease, but many of them can also cause severe
adverse effects and diminish in effectiveness
over time. NSAIDs are usually taken concurrently
with the slower acting second-line drugs, which
may take months to produce a therapeutic
Aspirin in high doses is as effective as any
other NSAID and much less expensive, but some
patients cannot tolerate the gastrointestinal
toxicity. Aspirin interferes with platelet
function and can rarely cause serious bleeding;
this effect can persist for four to seven days
after the drug has been discontinued.
in the ears) and rarely, hepatitis (liver
inflammation) or renal (kidney) damage can also
occur with high-dosage aspirin therapy.
Enteric-coated aspirin is safer but may not be
fully absorbed. Nonacetylated salicylates, such
as sodium salicylate, salsalate (Disalcid, and
others), and choline magnesium salicylate
(Trilisate, and others), do not interfere with
platelet function and may be safer than
acetylated salicylates for aspirin-sensitive
patients, but some clinicians have questioned
Questions To Ask Your Doctor About Arthritis
What tests need to be done to determine if it is
arthritis and what type of arthritis it is?
What type of arthritis is it?
Will this type of arthritis cause any
Will it be crippling
Will it affect other organs?
Should a Rheumatologist be consulted?
Are there any risks or complications after
How long will it take for recovery?
What are some precautions that need to be taken
after the surgery?
What medications are available now and what are
their side effects?
What about the use of vitamins or alternative