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Arthritis

Arthritis

Arthritis is inflammation of one or more joints that causes pain, swelling, stiffness, and limited movement.

There are more than 100 different types of arthritis.

Causes

Arthritis involves the breakdown of cartilage. Cartilage normally protects the joint, allowing smooth movement.

Cartilage also absorbs shock when pressure is put on the joint, such as when walking. Without the usual amount of cartilage, the bones rub together, causing pain, swelling (inflammation), and stiffness.

You may have joint inflammation for a variety of reasons, including :

• An autoimmune disease (the body attacks itself because the immune system believes that a part of the body is foreign)
• Broken bones
• General “wear and tear” on the joints
• Infection (usually caused by bacteria or viruses)

Often, the inflammation goes away after the injury has healed, the disease is treated, or the infection has been cleared.

With some injuries and illnesses, inflammation does not go away or destruction in long-term pain and deformity.

When this happens, you have chronic arthritis. Osteoarthritis is the most common type and is more likely to occur as you age.

You can feel in any joint, but most often in the hips, knees, or fingers. Risk factors for osteoarthritis include :

• Excess weight
• Having previously injured the affected joint
• Use of the affected joint in a repetitive action that puts stress on the joint (baseball players, ballet dancers, and construction workers are all at risk)
Arthritis can occur in men and women of all ages. About 37 million people in the United States have some type of arthritis, which is almost 1 in 7 people.
Other types or causes of arthritis include:
• Adult Still’s disease
• Ankylosing spondylitis
• Yeast infections such as blast mycosis
• Gonococcal arthritis
• The drop
• Juvenile rheumatoid arthritis (in children)
• Other bacterial infections (non-gonococcal bacterial arthritis)
• Psoriasic arthritis
• Reactive arthritis (Reiter’s syndrome)
• Rheumatoid arthritis (in adults)
• Scleroderma
• Systemic lupus erythematosus (SLE)
• Tertiary Lyme disease
• Tuberculous arthritis
• Viral arthritis
The symptoms
If you have arthritis, you may experience:
• Pain in the joints
• Inflammation of the joints
• Reduced ability to move the joint
• Redness of the skin around a joint
• Stiffness, especially in the morning
• Heat around a joint

Signs and tests

First, your doctor will take a detailed medical history to see if arthritis or another musculoskeletal problem is the likely cause of your symptoms.

Then a complete physical exam may show that fluid is building up in the joint. (This is called a “spill”).

The joint may show tenderness when gently pressed, and may be hot and red (especially in infectious arthritis and autoimmune arthritis). It may be painful or difficult to rotate the joint in some directions.

This is known as “limited range of motion.”

In some autoimmune forms of arthritis, the joints can become deformed if the disease is not treated.

These deformities are hallmarks of severe untreated rheumatoid arthritis.

Tests vary depending on the suspected cause.

These usually include blood tests and X-rays of the joints. To check for infection and other causes of arthritis (such as gout caused by crystals), joint fluid is removed from the joint with a needle and examined under a microscope.

See specific types of arthritis for more information.

Treatment

Treatment of arthritis depends on the cause, which joints are affected, how severe it is, and how the disease affects your daily activities.

Your age and occupation will also be taken into account when the doctor works with you to create a treatment plan.

If possible, treatment will focus on eliminating the cause of the arthritis. However, the cause is not necessarily curable, such as osteoarthritis and rheumatoid arthritis.

Treatment, therefore, is aimed at reducing pain and discomfort and preventing further disability.

Symptoms of osteoarthritis and other long-term types of arthritis can be greatly improved without medication.

In fact, making lifestyle changes without medication is preferable for osteoarthritis and other forms of joint inflammation. If necessary, medications should be used in addition to lifestyle changes.

Exercise for arthritis is necessary to maintain joint health, relieve stiffness, reduce pain and fatigue, and improve bone and muscle strength. Your exercise program should be tailored to you as an individual.

Work with a physical therapist to design an individualized program, which should include :

• Low-impact aerobic activity (also called resistance exercises)
• Range of motion flexibility exercises
• Strength training for muscle tone

A physical therapist can apply heat and cold treatments as needed and shaped by splints or orthotic (correction) devices to support and align the joints.

This may be especially necessary for rheumatoid arthritis. Your physical therapist may also consider water therapy, ice massage, or transcutaneous nerve stimulation (TENS).

Rest is as important as exercise. Sleeping 8 to 10 hours at night and napping during the day can help you recover from a crisis more quickly and may even help prevent flare-ups. You must also:

• Avoid holding a position for a long time.
• Avoid positions or movements that put additional stress on the affected joints.
• Modify your home to make the activity easier. For example, they have grab bars in the shower, the tub, and near the toilet.
• Reduce stress, which can make your symptoms worse. Try meditation or guided imagery. And talk to your physical therapist about yoga or Thai chi.
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