What is Arthritis?	Find out more
Arthritis is he name of a broad set of rheumatic diseases causing pain, stiffness and swelling in or around joints A disorder that can be prevented in certain cases by risk-reduction strategies

What are the types of arthritis?

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Two common types of arthritis are rheumatoid arthritis and osteoarthritis. These are separate diseases that affect people in different ways. Rheumatoid arthritis involves inflammation of the joints and results from the body's abnormal attack on the joints, not from overuse of joints. It can affect a person's entire body, and often causes overall symptoms in addition to joint pain. Rheumatoid arthritis is most commonly diagnosed in people aged 25 to 50, but can affect people of all ages, including babies. Osteoarthritis is the most common type of arthritis. It is also called "degenerative joint disease", and most often involves the weight-bearing joints. The disorder results from mechanical joint damage - whether from long-term "wear and tear", or previous injury. Osteoarthritis is usually diagnosed in people older than 40. Nearly everyone over 70 has osteoarthritis in at least one joint, but not all develop symptoms. There are many other types of rheumatic disorders. Not all of them are primarily diagnosed in adults. Juvenile arthritis is the name of a group of arthritis-related conditions that affect children.

How can a person prevent arthritis?	Find out more
A person can reduce the risk for developing symptomatic osteoarthritis by maintaining a normal weight. Being overweight puts more stress on weight-bearing joints, and increases the risk for knee pain (and possibly hip pain). If a person is already overweight, losing just 10 or 11 pounds will significantly reduce the risk for developing osteoarthritis in knees.

OSTEOARTHRITIS

What is osteoarthritis?

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Osteoarthritis (OA) is an age-related disease involving the breakdown of the joint cartilage. The loss of joint cartilage causes pain, stiffness, and decreased mobility in the affected joints. In most people with OA, joint cartilage becomes damaged through mechanical "wear and tear" - a lifetime of walking or running on hard surfaces, for example. Other possible causes of OA include previous joint injury, or heredity. The disease most often affects the knees, fingers, hips, neck, and lower back. It is not usually found in the wrists, elbows, shoulders, ankles, or jaw, unless these joints have been injured or put under heavy stress. OA occurs in both men and women, and is most often diagnosed in middle-aged and older people. It can occur in people who have other forms of arthritis as well.

How osteoarthritis affects the joints?

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A joint is the place where two bones meet. Cartilage normally covers and cushions the ends of the two bones. This prevents the hard surfaces of the bones from rubbing together and causing damage. After "wear and tear" or a joint injury damages the cartilage, it becomes torn and frayed, loses its elasticity, and eventually wears away altogether. The bones begin to rub together as the joint is moved. Bony growths, or "spurs," begin to form on the ends of the bone. The joint becomes painful, is stiff after periods of inactivity, and its movement may ultimately be limited.

Symptoms

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If persons have OA, the joints will probably hurt most after using them too much, or after a long period of not using them much at all. In the morning, patients may get up feeling stiff, but the stiffness goes away as the person is going about to daily movements. Pain in the joints may cause to limp, and patients may find it difficult to go up or down stairs. The knuckles of the hands may swell and feel painful. Patients may feel pain and even a "grating" sensation as they move the knee. Other joints, such as hip or the large joint at the base of the big toe, may also feel stiff and tender.

Diagnosis and treatment

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Doctors commonly diagnose OA by listening to a patient's history and performing a physical examination. The doctor may also order x-rays, to evaluate the condition of the joints, and in some cases may perform joint aspiration. A may be treated with medications to control pain and reduce inflammation, if any. These medications include: Non-narcotic pain relievers (paracetamol) Narcotics, for short-term pain relief (codeine, and oxycodone) Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen, and naproxen Injectable corticosteroids (may be injected into an arthritic joint after joint aspiration) Topical pain relievers (creams, rubs, or sprays applied directly to the skin) Other treatment strategies for OA include physical therapy, aerobic exercise that does not put undue stress on the joints, and maintaining a normal weight or losing weight. Ultimately, in some cases, surgery may be needed to remove bone spurs within a joint, reposition the bones, or otherwise repair bony damage. Some patients may need to have their damaged joints surgically replaced with artificial ones.

Is osteoarthritis the same as osteoporosis?

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No, although the two conditions may sound similar. Osteoarthritis is a type of arthritis involving damage to joints. Osteoporosis is an unrelated disease in which bones gradually lose their mass and become weak and brittle. Eventually, people with osteoporosis may suffer vertebral fractures as the bone fails to support the weight of the spinal column, or hip fractures after minor falls. Osteoporosis is best prevented by building strong bone over the years through an adequate calcium intake, avoiding smoking, and exercising regularly. In contrast, the calcium intake does not directly affect the risk for osteoarthritis.

What is the difference between osteoarthritis and rheumatoid arthritis?

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Osteoarthritis is usually found in middle-aged to older people, developing slowly over many years. Inflammation of the joints is not very common, although pain, stiffness and limitation of motion may be present. If one joint is affected, the corresponding joint on the other side of the body may not be. In addition, pain is usually limited to the affected joint only. Weight-bearing joints like the knees and hips are most often involved. Patients may get up in the morning with joint stiffness, but it usually goes away gradually as the joint is used. Rheumatoid arthritis is usually first manifested in people between 25 and 50, but can occur in young children and even small babies. The disorder may develop quickly after the first symptoms appear, over a period of weeks or months. It typically causes inflammation of the joints, and usually involves the joints on both sides of the body. Many joints may be affected. Patients may have a sense of overall sickness and fatigue, and may experience fever and weight loss. Morning joint stiffness may be prolonged.

MANAGING PAIN OF ARTHRITIS

What is Pain?

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Pain is the body's warning system, an unpleasant sensation alerting a person that something is wrong. Specialized nerve cells within the body transmit pain signals in response to tissue damage or injury. Most forms of arthritis are associated with two types of pain: acute and chronic. Acute pain is temporary. It can last a few seconds or longer, but goes away as healing occurs. Chronic pain ranges from mild to severe, and may last for months, years or a lifetime.

What causes arthritis pain, and why is it so variable?

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The pain of arthritis may come from different sources, such as inflammation of joint tissue, tendons, or ligaments; muscle strain; and fatigue. A combination of these factors contributes to the intensity of the pain. Doctors do not yet understand completely why the pain of arthritis varies so widely from person to person. Factors that contribute to pain include swelling within the joint, the amount of heat or redness present, and the extent of damage within the joint. Activities affect pain differently: some patients note joint pain after first getting out of bed in the morning, while others develop pain after prolonged use of the joint. Each individual has a different threshold and tolerance for pain. A person's subjective experience of pain is affected by both physical and emotional factors. These can include depression, anxiety, and even hypersensitivity at the affected joints due to inflammation and tissue injury.

How do doctors measure arthritis pain?	Find out more
Pain is a private, unique experience that cannot be seen. The most common way for a doctor to measure pain is to ask about the symptoms. If patients use terms like aching, burning, stinging, throbbing, or others as appropriate, they will give the doctor a clearer idea of what type of pain they're feeling.

Who can treat arthritis pain?	Find out more
Both the patient and his/her physician should be involved in treating and managing arthritis pain. There is no specific pain treatment that works for all people with arthritis. However, the doctor or medical team should develop a pain management plan designed to minimize the specific pain and improve the joint function.

What Treatments are used to provide short-term relief for arthritis pain?

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Medications Because people with osteoarthritis have very little inflammation, pain relievers like acetaminophen (eg, Napa) may be effective. People with rheumatoid arthritis generally have pain caused by inflammation, and often benefit from aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. Heat and cold The effectiveness of either heat or cold for joint pain depends on the type of arthritis. Moist heat, such as a warm bath or shower, or dry heat, such as a heating pad, may relieve pain if placed on the painful area of the joint for about 15 minutes. An ice pack or bag of frozen vegetables wrapped in a towel and placed on the sore area for about 15 minutes may help to reduce swelling and stop pain. If patients have poor circulation or suffer from Reynaud's phenomenon, they should not use cold for pain. Joint protection Using a splint or brace to allow joints to rest and protect them from injury can be helpful. Massage A therapist lightly strokes and/or kneads the painful muscle, to increase blood flow and bring warmth to a stressed body area. However, arthritis-stressed joints are very sensitive, so the therapist must be very familiar with arthritis.

What treatments are used to provide long-term relief for arthritis pain?

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These drugs, which include aspirin and ibuprofen, reduce pain and inflammation and may be used for both short- and long-term pain reliefs for people with osteoarthritis or rheumatoid arthritis. Disease-modifying anti-rheumatic drugs (DMARDs) These drugs are thought to influence and correct the abnormalities of the immune system that are responsible for diseases like rheumatoid arthritis. They include drugs like methotrexate, hydroxychloroquine, penicillamine, gold injections, and newer, recently-approved drugs. Treatment with these medications requires careful monitoring by a physician, because of possible side effects. Corticosteroids These drugs reduce inflammation, and can be very effective in treating arthritis, although they may also have significant side effects. Patients with rheumatoid arthritis may take prednisone by mouth, while patients with either osteoarthritis or rheumatoid arthritis may receive injections of corticosteroids directly into the affected joint. Since frequent injections may cause damage to the joint cartilage, this procedure should be done only once or twice a year. Weight reduction Being overweight puts extra stress on weight-bearing joints such as the knees or hips. Studies show that losing only 11 pounds can substantially reduce the risk of developing osteoarthritis in the knees - and even if a person already has osteoarthritis in one knee, weight reduction will reduce the risk of it occurring in the other knee. Exercise Swimming, walking, low-impact aerobic exercise, and range-of-motion exercises may reduce joint pain and stiffness. In addition, stretching exercises are helpful. Surgery In certain patients with arthritis, surgery may be necessary. Surgeons can perform operations to remove inflamed joint tissue, or replace very damaged joints with artificial devices. These devices are not without disadvantages, but in appropriate cases can provide not only pain relief but also improvement in motion for the involved joint.

What alternative therapies may relieve arthritis pain?

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Many people look for other ways of treating their arthritis, such as special diets or supplements. Although these methods are not necessarily harmful, there is also no real proof that they help. Because the pain of arthritis may come and go, a person taking an alternative treatment may mistakenly think that the remedy worked. It's also true that pain is a very subjective experience, and people with pain sometimes feel better simply because of their strong faith in a particular treatment. This is why researchers rely on clinical trials involving hundreds or thousands of people, in which patients and doctors are not told what medications are being tested until the end of the trial, before they claim that a new method for relieving pain works. If the doctor agrees that an alternative treatment helps to cope without doing any harm, then it can be incorporated into the treatment plan. However, patients should not let themselves be taken advantage of by unscrupulous people who would promise quick and easy answers to the pain of arthritis, then sell "remedies" that may be ineffective or even harmful. It should be considered carefully about whether the claims of an alternative treatment are reasonable or likely, and the doctor should be asked before taking such a treatment.

How can a person cope with arthritis pain?

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Osteoarthritis and rheumatoid arthritis are chronic diseases that may last a lifetime. Learning how to manage the pain is important in controlling the disease and maintaining a good quality of life. A positive attitude should always be maintained. The patients should not dwell on negative thoughts, and should use distraction or relaxation techniques to reduce stress and focus thoughts outside of the body, on the things they enjoy. Studies show that depression, stress and anxiety actually increase perception of pain. If the patient can improve sense of control and mental well-being, perception of pain will be lessened and they will feel better. Patients should try to eat a healthy diet and get enough sleep at night, again to lessen perception of pain and increase ability to cope with it.