Arthritis

Arthritis

Definition:

Arthritis is inflammation of one or more of your joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. The two most common types of arthritis are osteoarthritis and rheumatoid arthritis.

Osteoarthritis is usually caused by normal wear and tear, while rheumatoid arthritis is an autoimmune disorder. Other types of arthritis can be caused by uric acid crystals, infections or even an underlying disease — such as psoriasis or lupus.

Treatments vary, depending on the type of arthritis. The main goals of arthritis treatments are to reduce symptoms and improve quality of life.

Symptoms:

The most common signs and symptoms of arthritis involve the joints. Depending on the type of arthritis you have, your signs and symptoms may include:

• Pain
• Stiffness
• Swelling
• Redness
• Decreased range of motion

Causes:

The pain associated with arthritis is caused by joint damage. Joints are made up of the following parts:

• Cartilage. A hard, but slick, coating on the ends of bones, cartilage allows bones of the joint to slide smoothly over each other.
  
• Joint capsule. This tough membrane encloses all the joint parts.
  
• Synovium. This thin membrane lines the joint capsule and secretes synovial fluid, which lubricates the joint and nourishes the cartilage.

How arthritis damages joints
The two main types of arthritis damage joints in different ways.

• Osteoarthritis. In osteoarthritis, wear-and-tear damage to cartilage can result in bone grinding directly on bone, which causes pain and restricts movement. This wear and tear can occur over many years, or it can be hastened by a joint injury or infection.
  
• Rheumatoid arthritis. In rheumatoid arthritis, the body's immune system attacks joints and inflames the synovium, causing swelling, redness and pain. The disease can eventually destroy cartilage and bone within the joint.

Complications:
 Severe arthritis, particularly if it affects your hands or arms, can make it difficult for you to take care of daily tasks. Arthritis of weight-bearing joints can keep you from walking comfortably or sitting up straight. In some cases, joints may become twisted and deformed.


Treatments and drugs:

Arthritis treatment focuses on relieving symptoms and improving joint function. You may need to try several different treatments, or combinations of treatments, before you determine what works best for you.

Medications
The medications used to treat arthritis vary, depending on the type of arthritis. Commonly used arthritis medications include:

• Analgesics. These types of medications help reduce pain, but have no effect on inflammation. Examples include acetaminophen (Tylenol, others), tramadol (Ultram, Ryzolt) and narcotics containing oxycodone (Percocet, Oxycontin, others) or hydrocodone (Vicodin, Lortab, others).
  
• Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs reduce both pain and inflammation. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin, others) and naproxen (Aleve). Some types of NSAIDs are available only by prescription. Oral NSAIDs can cause stomach irritation, and some may increase your risk of heart attack or stroke. Some NSAIDs are also available as creams or gels, which can be rubbed on joints.
  
• Counterirritants. Some varieties of creams and ointments contain menthol or capsaicin, the ingredient that makes hot peppers spicy. Rubbing these preparations on the skin over your aching joint may interfere with the transmission of pain signals from the joint itself.
  
• Disease-modifying antirheumatic drugs (DMARDs). Often used to treat rheumatoid arthritis, DMARDs slow or stop your immune system from attacking your joints. Examples include methotrexate (Trexall) and hydroxychloroquine (Plaquenil).
  
• Biologics. Typically used in conjunction with DMARDs, biologic response modifiers are genetically engineered drugs that target various protein molecules that are involved in the immune response. Examples include etanercept (Enbrel) and infliximab (Remicade).
  
• Corticosteroids. This class of drug, which includes prednisone and cortisone, reduces inflammation and suppresses the immune system. Corticosteroids can be taken orally or be injected directly into the painful joint.

Therapy
Physical therapy can be helpful for some types of arthritis. Exercises can improve range of motion and strengthen the muscles surrounding joints. In some cases, splints or braces may be warranted.

Surgery
If conservative measures don't help, your doctor may suggest surgery, such as:

• Joint replacement. This procedure removes your damaged joint and replaces it with an artificial one. Joints most commonly replaced are hips and knees.
• Joint fusion. This procedure is more often used for smaller joints, such as those in the wrist, ankle and fingers. It removes the ends of the two bones in the joint and then locks those ends together until they heal into one rigid unit.