Arthritis Overview

What is arthritis?

Arthritis is a condition that causes pain and stiffness of the joints. It sometimes also causes redness, swelling, and warmth. In severe cases, joints may become deformed.

There are different kinds of arthritis. Two common forms are osteoarthritis and rheumatoid arthritis (RA). Both of these forms of arthritis are 2 to 3 times more common in women than in men.

Examples of other forms of arthritis include gout, ankylosing spondylitis, and arthritis that occurs after an injury or with certain infections such as gonorrhea.

How does it occur?

Osteoarthritis is a disease in which the cartilage in joints breaks down. Cartilage is the joint's cushion. It covers the ends of bones and allows free movement. If it becomes rough, frays, or wears away, bones grind against each other. As a result, the joint becomes irritated and inflamed. Sometimes the irritation causes abnormal bone growths, called spurs. Bone spurs increase swelling. The disease normally affects the knees, lower back, hips, and fingers. Symptoms of osteoarthritis begin to appear by middle age. Most people over age 60 have some osteoarthritis, although they may not have symptoms.

Rheumatoid arthritis (RA) affects the lining of the joints. RA is an autoimmune disease. This means that the body's defenses against infection attack the body's own tissue. It causes redness and swelling, stiffness, and deformity. It usually affects the joints of the hands, arms, and feet. Rheumatoid arthritis usually starts in early adulthood or middle age.

What are the symptoms?

Possible symptoms of arthritis include:

• mild to severe pain in joints
• red, swollen joints
• stiffness and limited movement, especially in the morning
• deformed joints.

Fatigue is a symptom with some types of arthritis.

How is it diagnosed?

Your health care provider will review your medical history and examine you. You may have blood tests and x-rays to confirm the diagnosis and measure the extent of the disease.

How is it treated?

The goal of treatment is to keep the joints working properly by:

• relieving pain and stiffness
• reducing any swelling.

Your health care provider may suggest using heat or cold therapy, depending on the type of arthritis you have. Sometimes a splint or brace is used to let the joint rest and protect it from injury.

Transcutaneous electrical nerve stimulation (TENS) may relieve some types of arthritis pain. TENS directs mild electric pulses through the skin to the nerves in the painful area.

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can help relieve pain and inflammation. COX-2 inhibitors such as celecoxib (Celebrex) are prescription NSAIDs. While they may help arthritis symptoms, COX-2 inhibitors have been linked to a greater risk of heart attacks and stroke. Talk with your health care provider about this.

When NSAIDs do not work, several other kinds of medicines may be used, such as:

• Disease-modifying antirheumatic drugs (DMARDs) for people with rheumatoid arthritis
• Biological response modifiers to help reduce inflammation in the joints
• Corticosteroids, which can be taken by mouth or injected into a joint.

Treatment with these medicines must be watched carefully by your provider to avoid side effects.

Hyaluronic acid can be injected into the knee joint to act as a lubricant. It helps the knee to move without pain. Very severe rheumatoid arthritis may be treated by filtering harmful antibodies out of the blood.

Several kinds of exercise may help arthritis:

• Range of motion exercises help keep the joints moving normally.
• Strengthening exercises keep the muscles strong, which is important to support and protect the joints.
• Aerobic activities, such as walking and bicycling, help to control weight and maintain cardiovascular fitness. Aerobic exercise may reduce the inflammation in some joints.

A well-balanced diet is important to help control body weight and stay healthy. Proper weight control is important as extra weight can put extra pressure on some joints and worsen some types of arthritis.

If your joints are severely damaged, surgery may be necessary. Surgeries that can be done are:

• synovectomy to remove the inflamed joint tissue
• osteotomy to realign a joint
• joint replacement to replace a damaged joint with an artificial joint.

How long will the effects last?

If you have arthritis, you will probably have it for the rest of your life. How often you have symptoms of arthritis depends, at least in part, on the type of arthritis you have. You might be reminded of the arthritis every time you use the affected joints. Or you may have periods when you have symptoms and then other times when you do not. The periods of no symptoms are called remissions.

How can I take care of myself?

• Take the medicine your health care provider recommends for controlling your arthritis.
• Follow your provider's advice for weight control if you are overweight.
• Do the exercises recommended by your provider or physical therapist.
• Keep your body healthy by eating a healthy, varied, low-fat diet.

What can I do to prevent arthritis?

No one knows how to prevent arthritis. However, it is a condition that can usually be managed by taking medicine, protecting the affected joints, and keeping the joints mobile.