Arthritis is the inflammation of one or more joints. It is characterized by pain and stiffness (especially in the morning or after exercise), swelling, deformity, and/or a diminished range of motion. Bone growths or spurs may develop in the affected joints, increasing pain and decreasing mobility. There may be audible cracking or grating noises when the joint moves. The majority of arthritis patients suffer from osteoarthritis, rheumatoid arthritis, and related conditions including fibromyalgia, gout, lupus, Lyme disease, psoriatic arthritis, bursitis, scleroderma, Reiter’s Syndrome, Sjögren’s syndrome, and ankylosing spondylitis.
Manifestation
These conditions affect the body’s movable, or synovial, joints at the knees, wrists, elbows, fingers, toes, hips, and shoulders. The neck and back also have joints between the bones of the spine.
Etiology
There are six different types of synovial joints (hinge, ball-and-socket, and so on), but although the types of motion they allow are different, their underlying physiological structure is essentially the same: two or more adjoining movable bones, whose adjacent surfaces are covered with a layer of cartilage, surrounded by a fluid-filled capsule made up of ligaments (tough, fibrous tissue). Fluid is secreted by a thin membrane, the synovial membrane, that lines the inside of the joint capsule. Thanks to this viscous fluid, and to the smooth, rubbery, blue-white cartilage covering the ends of the bones, the bones within the joint normally glide smoothly past one another.
In healthy joints, the synovial membrane is thin, the cartilage that covers the bones is smooth, and a thin layer of synovial fluid covers the bone surfaces. A problem in any of these areas can result in arthritis. Arthritis may appear suddenly or come on gradually. Some people feel a sharp burning or grinding pain. Others compare the pain to that of a toothache. Moving the joint usually hurts, although sometimes there’s only stiffness. The swelling and deformity that takes place in arthritic joints can result from a thickening of the synovial membrane, an increase in the secretion of synovial fluid, enlargement of the bones, or some combination of these factors.
Types of Arthritis
Osteoarthritis
Also known as degenerative joint disease, involves deterioration of the cartilage protecting the ends of the bones. It is sometimes caused by injury or an inherited defect in the protein that forms cartilage. More commonly, it is a result of the wear and tear of aging, diet, and lifestyle. The once-smooth surface of the cartilage becomes rough, resulting in friction. The cartilage begins to break down, and the normally smooth sliding surfaces of the bones become pitted and irregular. Osteoarthritis affects the weight-bearing joints – the knees, hips, and back – most severely, but it also commonly affects the hands and the knuckles. The tendons, ligaments, and muscles holding the joint together become weaker, and the joint becomes deformed, painful, and stiff. There is usually but little or no swelling. Any resulting resulting disability is most often minor. However, fractures become an increasing risk because osteoarthritis makes the bones brittle. As osteoarthritis advances, bony outgrowths called osteophytes tend to develop. Often referred to as “spurs,” osteophytes can be detected by X-ray and develop near degenerated cartilage in the neck or in the lower back. This condition does not change a person’s appearance. Osteoarthritis rarely develops before the age of forty, but it affects nearly everyone past the age of sixty, It may be so mild that a person is unaware of it until it appears on an x-ray. Nearly three times as many women as men have osteoarthritis.
Rheumatoid arthritis (RA)
A type of inflammatory arthritis, Rheumatoid arthritis (RA) is an autoimmune disorder. An overactive immune system can be just as harmful as a weak one. As with other autoimmune disorders, rheumatoid arthritis is a “self-attacking-self” disease. In this case, the body’s immune system improperly identifies the synovial membrane as foreign. Inflammation results, in damaging cartilage and tissues in and around the joints. Often, the bone surfaces are destroyed as well because inflammation in the joints triggers the production of enzymes that slowly digest adjacent tissue. The body replaces this damaged tissue with scar tissue, forcing normal spaces within the joints to become narrow and the bones to fuse together. Rheumatoid arthritis creates stiffness, swelling, fatigue, anemia, weight loss, fever, and, often, crippling pain.
Rheumatoid arthritis frequently occurs in people under forty years of age, 75 percent of them female. Juvenile arthritis is a form of rheumatoid arthritis that strikes children under the age of sixteen. The onset of rheumatoid arthritis is associated with physical or emotional stress, poor nutrition, and bacterial infection. Rheumatologists have discovered that the blood of many people with rheumatoid arthritis contains antibodies called “rheumatoid factors,” a finding that can aid in the diagnosis of the condition. While osteoarthritis affects individual joints, rheumatoid arthritis affects all the body’s synovial joints. Joints affected by rheumatoid arthritis tend to make a sound like crinkling cellophane, whereas osteoarthritic joints make popping, clicking, and banging noises.
Arthritis can also be caused by bacterial, viral, or fungal infection of a joint. The microorganisms most commonly involved in this type of disorder are streptococci, staphylococci, gonococci, hemophilus or tubercle bacilli, and fungi such as Candida albicans. Usually, the infecting organism travels to the joint through the bloodstream from an infection elsewhere in the body, but injury or even surgery can result in joint infection as well. Symptoms include redness, swelling, pain, and tenderness in the affected joint, often accompanied by systemic symptoms of infection such as fever, chills, and body aches.
The spondyloarthropathies are a group of rheumatic disorders that tend to affect the spine. Ankylosing spondylitis (AS) is the most common of these. In this disorder, certain joints of the spine become inflamed, then stiffen and become rigid. If confined to the lower back, AS causes virtually no limitation of movement. In some cases, however, the entire spine may become rigid and bent. If the joints between the ribs and spine are affected, breathing problems may result as the chest wall’s ability to expand becomes limited. Postural deformities are common. Twice are many men as women have this disorder.
Gout
Gout, an acute form of inflammatory arthritis, occurs most often in people who are overweight, and/or who indulge regularly in rich foods and alcohol. It typically attacks the smaller joints of the feet and hands, especially the big toe. Deposits of crystallized uric acid salt in the joint cause swelling, redness, and a sensation of heat and extreme pain. Unlike most forms of arthritis, gout overwhelmingly affects men. Ninety percent of those who suffer from gout are male.
Management and treatment of arthritis
Arthritis can be reversible and, in some cases, curable with proper treatment, diet, and lifestyle changes. These simple changes can not only relieve the inflammation and pain but stop degeneration and rejuvenate the affected joints.