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Arthritis

Nearly 40 million Americans have arthritis, which causes joints to become inflamed or swollen. There are more than 100 types of arthritis that affect the joints and connective tissues (tendons and ligaments) of the body.

The left photo shows advanced rheumatoid arthritis that has casued swelling in all of the joints of the hand and wrist. The right photo shows an unusual form of arthritis caused by a crystal material containing calcium. It causes premature osteoarthritis in many joints.

Arthritis sets off a painful, destructive cycle in which inflammation - part of the body's natural defense system - causes tissue damage that the body tries to deal with by creating more inflammation. The inflammation causes swelling, pain, redness and a loss of motion in the joint. Ultimately, it can change the bones and connective tissues, reducing their ability to function.

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The most common forms of arthritis are:

• Osteoarthritis

• Rheumatoid arthritis , a progressive form of arthritis that causes pain and joint deformity.

• Spinal arthritis

• Lupus

• Gout

• Scleroderma

• Juvenile arthritis

Symptoms

Each type of arthritis has different symptoms and patterns. Each requires different treatments. Common symptoms include:

• Pain or tenderness in the joints

• Swelling in one or more joints

• Warmth and redness in a joint

• Stiffness or difficulty using or moving the joint

Severe rheumatoid arthritis (shown above right) can destroy the joints and deform the wrist, finger and knuckle joints. In the case of rheumatoid arthritis, symptoms include fatigue, weaknesses, loss of appetite, fever and anemia. When a person gets up after sleeping, joints are usually stiff, swollen and tender.

Some forms of arthritis go through cycles of getting better and worse. A flare-up means the disease is more active. During this time, there is increased morning stiffness, more pain and swelling in the joints, involvement of new joints, and increased tiredness and fatigue. Flare-ups can occur after eating a specific food. Milk is the most common offender. Other foods are shrimp, wheat products, and certain meats.

Causes and Risk Factors

It is not yet known what causes arthritis. Inflammation occurs in a damaged area of a joint. Damage can be caused by injury, infection, neurogenic disturbances, metabolic disturbances, among others.

New research indicates that people with certain gene types seem to be more likely to get certain kinds of arthritis. There are also signs that microorganisms may trigger its start.

Diagnosis

To find out whether you have arthritis, a doctor will take your medical history and do a physical examination. He or she may also have X-rays or other imaging procedures done along with blood and lab tests. Lab tests may include:

• Antinuclear antibody (ANA) test to check levels of antibodies in the blood

• Sampling the synovial fluid, which surrounds and lubricates the joints, to see if it has crystals, bacteria or viruses

• Complete blood counts to see if white blood cell, red blood cell and platelet levels are normal

• Creatinine to monitor for underlying kidney disease

• Erythrocyte sedimentation rate to detect inflammation

• Rheumatoid factor test to determine if rheumatoid factor is present in the blood

• Urinalysis to determine levels of protein, red blood cells, white blood cells, and casts

Treatment

There is no cure for arthritis yet. But most people with the condition can do normal activities of daily living.

Some of the ways in which arthritis is treated include:

• Drugs, such as pain relievers, nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids and cortisone injections

• Rest. Being tired and feeling pain are signs of arthritis and show that it may be time to rest joints and muscles

• Exercise, when balanced with rest, can help reduce pain and stiffness, making muscles stronger and joints more flexible. Consult your doctor first, however, before beginning an exercise program.

• Maintaining proper body weight and eating a well-balanced diet. Extra weight increases pressure on the joints and can make some types of arthritis worse.

• Using devices such as splints, braces, canes or shoe inserts to protect joints from the stresses of daily activities and relieve symptoms.

• Heat and cold therapies. Heat therapy (paraffin wax, ultrasound or moist heat) increases blood flow and flexibility in the joint. Cold therapy (cold packs, cold-water soaks, over-the-counter sprays and ointments) numbs the nerves and relieves inflammation.

• Surgery to repair or remove a diseased or damaged joint, fuse the bones in a joint or replace joints with artificial ones.