What is Arthritis?

The word comes from the Greek arthron meaning "joint" and the Latin itis meaning "inflammation". There are over 100 types of arthritis. The most common forms include;

 Osteoarthritis (OA)
 Rheumatoid arthritis (RA)
 Infectious arthritis (septic arthritis)
 Juvenile rheumatoid arthritis (JRA)
 Gout
 Osteoporosis

Osteoarthritis (OA)

The cartilage, which acts as a shock absorber, wears away. This causes the tendons and ligaments to become stretched, causing pain. Eventually the bones may erode each other causing extreme pain.

What are the causes?

Age: Simple wear and tear on the joints. The older you are, the more you have use them. However not everyone gets OA, so it is not an inevitable part of the aging process.

Obesity: Increased body weight adds stress to lower body joints. Your knees, which carry the greatest impact of your weight, are particularly vulnerable. For every kilo you gain you add 4 kilos of pressure on your knees and six time the pressure on your hips.

Injury or Overuse: Athletes and people whose occupation requires repetitive motion (ballet dancing, violinists, landscaping, typing or operating machinery) have a higher risk of developing OA, due to injury and increased stress on certain joints. It can also appear in joints affected by previous bone fractures and surgeries.

Genetics or Heredity: Genetics plays a role in the development and progression of OA. It is most notable in the hands. Also OA is more common in joints that don't fit together smoothly such as people who are bow legged or double jointed. This doesn't mean you will develop OA, but you and your doctor should monitor arthritis signs and symptoms.

Muscle Weakness: Muscle weakness around the knees is associated with OA, particularly with women. It makes the pain and stiffness worse after onset. The risk can be reduced by strengthening thigh muscles.

Knee Osteoarthritis - Higher Risk: A team from the Centers for Disease Control & Prevention (CDC) published a study of more than 3,000 people for over 20 years in 2008.

The results suggest that nearly 1 in 2 people will develop osteoarthritis of the knee before they reach age 85.

By comparison, 1 in 8 women will get breast cancer in their lifetime, and 1 in 3 men and 2 in 5 women will get diabetes in their lifetime. This makes osteoarthritis of the knee more common than either of these ailments.

Although not life threatening OA can have a significant impact on the quality of life.

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RHEUMATOID ARTHRITIS (RA)

This is an inflammatory form of arthritis. The synovial membrane, which encloses each joint, is attacked, resulting in the joints becoming painful, swollen, stiff and deformed. RA is much more common in women than men. It generally strikes when the patient is between 40 and 60 years of age. However older persons as well as children can be affected.

What are the causes?
Despite years of research the cause of RA remains unknown. However most doctors agree a combination of genetic and environmental factors is responsible.

RA occurs when the body's immune system (which normally protects us from infection) mistakenly attacks the synovium (the thin membrane that lines the joints). The result can be joint damage, pain, inflammation - leading to more attacks by the immune system - loss of function and disability.

The joints most affected by RA are the hands, feet, wrists, knees, elbows and ankles. It is usually symmetrical, meaning if one joint is affected, the same joint on the opposite side of the body is also affected. The disease can also affect other organs, including the skin, lining of the heart, blood vessels and lungs.

RA is chronic but the symptoms can come and go. Periods of mild activity can suddenly be marked by intense disease activity and symptoms.

INFECTIOUS ARTHRITIS (SEPTIC ARTHRITIS)

This is an infection in the synovial fluid and tissues of a joint. It is usually caused by bacteria, but could also be cause by fungi and viruses. Bacteria, fungi or viruses may spread through the bloodstream from infected tissue nearby, and infect a joint. Most susceptible people are those who have some form of arthritis and develop an infection that travels in the bloodstream.

JUVENILE RHEUMATOID ARTHRITIS (JRA)

This means arthritis that affects people aged 16 years or less. JRA can take many forms but it means it affects a child. There are three main types;

    1. Pauciarticular JRA the most common and mildest. The child experiences pain in up to 4 joints.
    2. Polyarticular JRA affects more joints and is more severe. It tends to get worse with age.
    3. Systemic JRA is the least common but most serious.. Pain is experienced in many joints. It can spread to other organs.

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GOUT

A form of arthritis that causes sudden severe episodes of pain, redness, warmth and swelling of joints. It usually affects one joint at a time. Typically this is the big toe.
Learn more facts how to prevent gout, which foods trigger it, and how to find relief from Gout - click here >>

OSTEOPOROSIS

Weakened or brittle bones leads to osteoporosis. This condition mainly affects menopausal women, but also men and women with RA. See our separate dMAC Digest article on Osteo -click here>>

HISTORY

Evidence of primary ankle (kaki) osteoarthritis has been discovered in dinosaurs (80 million years ago). The first known traces of human arthritis date back to 4,500 BC. Evidence of arthritis has been found in a mummy in Otzi (on the border of Italy and Austria) circa 3,000 BC and Egyptian mummies circa 2,590 BC.

WHAT DOES THE FUTURE HOLD FOR ARTHRITIS?

A report by UK's OANation 2012, says cases of osteoarthritis will double to over 17 million by 2030. The prediction is driven by the UK's aging population and growing obesity problem. By 2030 half the UK population will be aged 50 or over and the same proportion will be obese.

The same report stated that in 2012, 8.5 million people in the UK have osteoarthritis and 71% of them were in constant pain.

COUNTRY BY COUNTRY:

Australia - Arthritis Australia's survey in March 2012 showed 1 in 5 GP's consider osteoarthritis to be an emotionally draining condition to treat. Also the GP's are aware a significant proportion of their patients are unhappy with their care. GP's find people with OA difficult to treat because many also had multiple other conditions such as high blood pressure, heart disease and diabetes.

Nearly 2 million Australians have osteoarthritis and it costs the nation an estimated A$23 billion annually in health care and lost time at work. (Access Economics Cost of Obesity Report 2008).

United Kingdom - Each year 2 million adults visit their GP because of OA. The NHS in England and Wales perform over 140,000 hip and knee replacement operations every year.

One in five people suffering from OA give up work or retire early because of their condition.

USA -Data collected by Healthcare Cost & Utilization Project in 2006 show osteoarthritis accounted for US$10.5 billion in hospital charges. This made it more expensive than pneumonia, stroke or complications from diabetes. Hospital admissions for OA more than doubled from 1993 to 2006.

Wikipedia states - Arthritis is the most common form of disability in the USA. More than 20 million individuals with arthritis have severe limitations in function on a daily basis. The estimated total cost of arthritis cases alone is close to US$100 billion of which nearly 50% accounts for lost earnings. Each year arthritis results in nearly 1 million hospitalisations and 45 million outpatient visits to health care centres.

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CONCLUSION:

Your primary doctor for rheumatoid arthritis should be a rheumatologist - an internist who has additional training to diagnose arthritis and related diseases that affect the joints , muscles, bone, skin and other tissue.

Although there isn't a cure for arthritis, early aggressive treatment has been shown to prevent disability. Treatment depends on the type of arthritis. Pain killers such as paracetamol and nonsteroidal anti-inflammatory drugs may relieve symptoms.

Physiotherapy may keeps joints mobile.

Fitness programs may reduce pain, increase strength and flexibility. They include;
    ◊  Aquatics or swimming ------->
    ◊  Walking
    ◊  Tai Chi
    ◊  Low impact exercise activity

Severely damaged joints may be replaced surgically.

Joanne Jordan, MD, PhD, professor of medicine and orthopedics at the University of North Carolina said "We hear that you need to lose weight to prevent diabetes and heart disease. We never hear you need to lose weight to prevent arthritis. But it is critical to realise that if you gain weight, you're going to get arthritis in your knees and you are going to be miserable."

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Asthma

Anaemia