Doctor Stephen Ferguson: Arthritis

Arthritis is a condition that affects the joints in the body. It causes pain, stiffness, poor mobility, discomfort, swelling and inflammation in a joint. It is not a condition that is prevalent in senior citizens only; it affects people of all ages, including children too. It is estimated that 10 million people in the United Kingdom are affected by arthritis in many different ways and living with this painful condition. There is no clear indication what causes arthritis and currently no specific cure. The length of time and severity of the condition is related on the type of arthritis you have. They have good days and bad days. Bad days are usually impeded with limited activities of daily living, impacting mobility, joint pain, swelling fatigue and stiffness. It sometimes leads to frustrations, anger, and restlessness in young adults, working adults impacting their work and family. Senior citizens may potentially have the unwarranted fear of a fall and overall challenge of embracing life more fully in their golden years of retirement.

Nevertheless, those suffering from arthritis can still lead an active and a full life. It takes a little more effort and can be met under one’s control and the will to continue to enjoy life.

Arthritis is not a single disease that affects many people. The term arthritis is used to cover a host of medical conditions that adversely affect the

musculoskeletal structure in the body. Two most common types of arthritis are osteoarthritis and rheumatoid arthritis. Arthritis can also cause problems in the eye, and other organs in the body including the skin.

As stated earlier, there is no clear indication of what causes arthritis, but to help us understand better, one way is to understand how a joint in the body works.

In essence, a joint is where one bone moves on another bone. There are three things to support joint movement. They are:

Ligaments

Cartilage

Synovial fluids

Ligaments hold the two bones together like elastic bands. It helps support the bones in place when your muscle relaxes or contracts to make the joint mobile or move.

Cartilage covers the bone to prevent it from rubbing directly against each other. It is a firm, soft and flexible connective tissue that supports smooth and painless movements of the joints. In other words, it acts like a shock absorber.

The synovial fluid is a special fluid found within the space of the joint and the joint cavity. It nourishes the joint and cartilage.

So, what happens when you have arthritis? Something goes wrong with the joint. It is also depends on what type of arthritis you may have, the culprit could be that the cartilage is wearing away, reduced synovial fluid, infection, autoimmunity where your body is attacking itself or the complication of many factors.

It is generally thought that most types of arthritis are caused by several combined complications and health problems. Some contributing factors are: repetitive strains caused by an industrialised and physically demanding job, an old sports injury, your genetic makeup and potential infections causing temporary arthritis. In certain people, specific foods can bring about

symptoms of arthritis and being overweight can consistently place a strain on the joints.

Another contributing factor to arthritis is autoimmune disease. When an intruder attacks the body, your immune system responds by protecting you. Here, the intruder could be in a form of bad bacteria, a viral cold or something that enters the body through the skin and attack any part of the body such as the joints, lungs, heart, eyes, blood vessels, muscles and many more areas of the body. Sometimes, complications with your immune system mistakenly invade the healthy cells in the body and attack it. “Autoimmune” means immunity against the self. The typical sign of this disease causes inflammation such as redness, swelling, tenderness and pain. In situations such as rheumatoid arthritis, joint pain and stiffness are experienced.

The two most common types of arthritis are osteoarthritis and rheumatoid arthritis. It is worth noting that there are over 200 kinds of arthritic conditions or musculoskeletal disease. As it gradually progresses, it spreads from smaller joints in the hands, ankles, feet and wrists to the knees, hips, elbows, shoulders, neck and jaws.

Osteoarthritis is a condition where it affects the cartilage of the joint. The cartilage loses its elasticity and gradually becomes damaged easily. It reduces the capacity of acting like a shock absorber causing pain which increases as the cartilage wears away. With the gradual damage of the cartilage, it also gradually wears and tears the tendons and stretches the ligaments bringing discomfort and frequent pain to the joint area. Severe pain is experienced when the bones gradually start rubbing each other with minimal support.

Developing osteoarthritis is a gradual process over time. Pain and swelling can be experienced in a joint, during and after use. It can impact the activities of daily living over time. At the same time, inactivity can also cause pain and swelling. When pressure is applied to the affected area, pain is felt, the joint feels stiff, and movement is limited. It is common to experience discomfort first thing in the morning or when the weather feels cold. Flexibility becomes a problem and hard lumps or bone spurs may be noticeable around the joint area. Osteoarthritis is common in the knees, spine, hands and hips.

Rheumatoid arthritis is a form of inflammation that commonly affects the same joints in each side of the body. It attacks the synovial membrane also known as “synovium” presenting symptoms of swelling, tenderness, stiffness and varying degrees of pain. If ignored and left untreated, it can lead to gradual deformity of the affected body part. The hands may appear puffy, hot and tender. Swelling may be experienced. There may be rheumatoid nodules. They appear as small bumps under the skin of the arms. Rheumatoid arthritis is prevalent in women more than men. It can occur within the ages of 40 to 60 years of age. It is also noted occurs in younger adults such as children and senior citizens over the age of 60 too. Sufferers of rheumatoid arthritis feel fatigue most of the time and there is a tendency to lose weight.

During the first 10 years of being diagnosed with rheumatoid arthritis, there is a higher chance of developing blood clots.

As mentioned earlier, arthritis can be contracted through an infection. Also known as infectious arthritis, you may have a fever, pain, inflammation of the joint, tenderness and swelling. The affected areas are usually experienced in the shoulder, wrist, knee, elbow and even the finger. In most cases, one joint is usually affected.

Younger adults may sometimes experience rheumatoid arthritis too. It is commonly known as juvenile rheumatoid arthritis. Discoloration of the skin or rash like appearance on the legs and arms of the young child is noticeable. The young adult’s mobility is impeded with possibly a limp, complain of a painful wrist, knee or elbow. The joint may suddenly flare up causing a swelling that persists for a little while too long. Stiffness in the hips and neck may cause sudden pain and gradual discomfort In younger adults, the child may have bouts of fever which gradually heightens, causing irritability especially in the evening and the fever suddenly subsides. Restlessness, weight loss and maintaining a healthy appetite becomes increasingly challenging.

Another common type of arthritis is psoriatic arthritis. The exact cause is unknown but it is a condition that causes the body to be painful, sore and inflamed. Stiffness experienced usually first thing in the morning or after long periods of resting. Flexibility in the morning becomes a challenge with

increased stiffness. It gradually develops into psoriasis. Psoriatic arthritis can effect more than one joint. Specific conditions may be displayed as:

* Swollen sore joints at the tips of the fingers and toes

* Fatigue

* Spondylitis which is a condition that presents a painful, stiff and inflamed spine or back-bone and neck

* Irritation and inflammation around the pupil of the eye, also known as iritis.

Systemic lupus erythematosis is an autoimmune disease where the immune system starts to attach rather than protect the body. It is not yet understood in depth how people contract lupus. It is prevalent in young women and generally from Asian, African and Caribbean descent. Lupus can affect many different parts of the body and can flare up and suddenly vanishes for a period or completely. Common symptoms of lupus are:

* Joint and muscle pain

* Fatigue

* Fever with flu like symptoms

* Blotchy skin rash that worsens with sun exposure and ultra-violet light

* Straightening the fingers is challenging due to stiffness and inflamed tendons.

A form of inflammatory arthritis is ankylosing spondylitis. It affects the joints in the base of the spine connecting to the pelvis causing lower back pain, achy feeling and stiffness in the lower back region. At times it mayt may also cause gradual discomfort in the upper back. This condition is prevalent in young men more than women. It is said to be no cure for this condition, but a sufferer may go into remission like most inflammatory arthritis.

Severe pain and inflammation of the big toe, commonly termed as gout is a form of arthritis. Gout is a condition that is prevalent in men more so than women. Gout is one of the few forms of arthritis where damage can be treated and future complications of the painful toe or joint can be avoided.

The culprit of gout is urate, a form of uric acid that passes out during the process of urination. Urate is produced by the body and flushes out a

substance called purine, a by- product of urate. If excess urate is produced from the body abuild-up of crystals form around the joints, especially in the big toe causing inflammation, pain, tenderness and swelling. Purine can also be found in certain foods such as red meat, shellfish, even alcohol beverages such as stout and beer. High alcohol intake can dehydrate the body leading to symptoms of gout. It is worth noting that not everyone with elevated urate levels in the body will develop gout.

On discussing various forms of arthritis, it is worth noting some facts about fibromyalgia which is also termed as fibromyalgia syndrome. Is fibromyalgia a form of arthritis? It is said to be a separate condition to arthritis although it may display similar symptoms to arthritis. Fibromyalgia causes pain and stiffness in the muscles, ligaments and tendons. It is not to be confused with arthritis because it does not affect the joints although the sufferer may experience joint pain, affect restful sleep and pronounced tiredness during the day. Fibromyalgia may affect the body in several different areas such as the neck, back and limbs. Just like arthritis, there is no one simple cure for fibromyalgia. Generally, symptoms of fibromyalgia are:

* Feeling generally tired and the need for restful sleep

* Pain, achy feeling and overall stiffness

* headaches

* lack of concentration

* bowel irritability and discomfort

The adverse conditions of living with various forms of arthritis are the constant and varying degrees of pain that impacts one’s activities of daily living.

Is there a link with arthritis and changes in the weather? There is no conclusive report to prove that question. A change in weather will not cause arthritis but it can worsen the symptoms and it also depends on the type of arthritis you may have.

There are numerous forms of arthritis, mentioned earlier approximately 200 types of arthritis. Majority of these are not hereditary. It has been recently suggested that osteoarthritis in the hands can be hereditary but more studies are required to prove it conclusive. Some people may have a genetic predisposition to contracting certain types of arthritis such as lupus and ankylosing spondylitis but it is not the same as arthritis being hereditary.

It is said that approximately 12,000 young adults under 16 suffer from some type of arthritis. Most childhood arthritis is commonly termed as juvenile idiopathic arthritis. It presents with symptoms of swelling, tenderness and pain in the joints for approximately six weeks. The causes are unknown. There are several common juvenile arthritis, namely:

Oligoarticular

Polyarticular

Oligoarticular arthritis is a condition that is most common in young adults presenting symptoms of painful joints, swelling, tenderness and pain in the knee and or ankles. It tends to affect four or fewer joints in the body. It may also affect the eyes and therefore will need special attention.

Poly articular arthritis usually starts ealier in young children potentially before the age of seven or sometimes later in childhood. Pain, stiffness in the joints, inflammation of the eye and fatigue are experienced by the child.

Some children may develop joint damage in the long run but a higher number of young adults and children become better and lead normal lives.

 

 

 

 

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