What are the causes and types of arthritis?
Treatment, Causes, Types, Natural remedies, Early signs
Arthritis means joint inflammation, but the term is used to describe around 200 conditions that affect joints, the tissues that surround the joint, and other connective tissue. It is a rheumatic condition.
The most common form of arthritis is osteoarthritis. Other common rheumatic conditions related to arthritis include gout, fibromyalgia, and rheumatoid arthritis (RA).
Rheumatic conditions tend to involve pain, aching, stiffness, and swelling in and around one or more joints. The symptoms can develop gradually or suddenly. Certain rheumatic conditions can also involve the immune system and various internal organs of the body.
Some forms of arthritis, such as rheumatoid arthritis and lupus (SLE), can affect multiple organs and cause widespread symptoms.
According to the Centers for Disease Control and Prevention (CDC), 54.4 million adults in the United States have received a diagnosis of some form of arthritis. Of these, 23.7 million people have their activity curtailed in some way by their condition.
Arthritis is more common among adults aged 65 years or older, but it can affect people of all ages, including children.
Facts on arthritis
Arthritis refers to around 200 rheumatic diseases and conditions that affect joints, including lupus and rheumatoid arthritis.
It can cause a range of symptoms and impair a person’s ability to perform everyday tasks.
Physical activity has a positive effect on arthritis and can improve pain, function, and mental health.
Factors in the development of arthritis include injury, abnormal metabolism, genetic makeup, infections, and immune system dysfunction.
Treatment aims to control pain, minimize joint damage, and improve or maintain quality of life. It involves medications, physical therapies, and patient education and support.
Treatment
The doctor will likely recommend a course of physical therapies to help you manage some of the symptoms of arthritis.
Treatment for arthritis aims to control pain, minimize joint damage, and improve or maintain function and quality of life.
A range of medications and lifestyle strategies can help achieve this and protect joints from further damage.
Treatment might involve:
medications
non-pharmacologic therapies
physical or occupational therapy
splints or joint assistive aids
patient education and support
weight loss
surgery, including joint replacement
Medication
Non-inflammatory types of arthritis, such as osteoarthritis, are often treated with pain-reducing medications, physical activity, weight loss if the person is overweight, and self-management education.
These treatments are also applied to inflammatory types of arthritis, such as RA, along with anti-inflammatory medications such as corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs), disease-modifying anti-rheumatic drugs (DMARDs), and a relatively new class of drugs known as biologics.
Medications will depend on the type of arthritis. Commonly used drugs include:
Analgesics: these reduce pain, but have no effect on inflammation. Examples include acetaminophen (Tylenol), tramadol (Ultram) and narcotics containing oxycodone (Percocet, Oxycontin) or hydrocodone (Vicodin, Lortab). Tylenol is available to purchase online.
Non-steroidal anti-inflammatory drugs (NSAIDs): these reduce both pain and inflammation. NSAIDs include available to purchase over-the-counter or online, including ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve). Some NSAIDs are available as creams, gels or patches which can be applied to specific joints.
Counterirritants: some creams and ointments contain menthol or capsaicin, the ingredient that makes hot peppers spicy. Rubbing these on the skin over a painful joint can modulate pain signals from the joint and lessen pain. Various creams are available to purchase online.
Disease-modifying antirheumatic drugs (DMARDs): used to treat RA, DMARDs slow or stop the immune system from attacking the joints. Examples include methotrexate (Trexall) and hydroxychloroquine (Plaquenil).
Biologics: used with DMARDs, biologic response modifiers are genetically engineered drugs that target various protein molecules involved in the immune response. Examples include etanercept (Enbrel) and infliximab (Remicade).
Corticosteroids: prednisone and cortisone reduce inflammation and suppress the immune system.
Natural remedies
A healthful, balanced diet with appropriate exercise, avoiding smoking, and not drinking excess alcohol can help people with arthritis maintain their overall health.
Diet
There is no specific diet that treats arthritis, but some types of food may help reduce inflammation.
The following foods, found in a Mediterranean diet, can provide many nutrients that are good for joint health:
fish
nuts and seeds
fruits and vegetables
beans
olive oil
whole grains
Foods to avoid
There are some foods that people with arthritis may want to avoid.
Nightshade vegetables, such as tomatoes, contain a chemical called solanine that some studies have linked with arthritis pain. Research findings are mixed when it comes to these vegetables, but some people have reported a reduction in arthritis symptoms when avoiding nightshade vegetables.
Self-management
Self-management of arthritis symptoms is also important.
Key strategies include:
staying physically active
achieving and maintaining a healthy weight
getting regular check-ups with the doctor
protecting joints from unnecessary stress
Seven habits that can help a person with arthritis to manage their condition are:
Being organized: keep track of symptoms, pain levels, medications, and possible side effects for consultations with your doctor.
Managing pain and fatigue: a medication regimen can be combined with non-medical pain management. Learning to manage fatigue is key to living comfortably with arthritis.
Staying active: exercise is beneficial for managing arthritis and overall health.
Balancing activity with rest: in addition to remaining active, rest is equally important when your disease is active.
Eating a healthful diet: a balanced diet can help you achieve a healthy weight and control inflammation. Avoid refined, processed foods and pro-inflammatory animal-derived foods and choose whole plant foods that are high in antioxidants and that have anti-inflammatory properties.
Improving sleep: poor sleep can aggravate arthritis pain and fatigue. Take steps to improve sleep hygiene so you find it easier to fall asleep and stay asleep. Avoid caffeine and strenuous exercise in the evenings and restrict screen-time just before sleeping.
Caring for joints: tips for protecting joints include using the stronger, larger joints as levers when opening doors, using several joints to spread the weight of an object such as using a backpack and gripping as loosely as possible by using padded handles.
Do not sit in the same position for long periods. Take regular breaks to keep mobile.
Physical therapies
Doctors will often recommend a course of physical therapy to help patients with arthritis overcome some of the challenges and to reduce limitations on mobility.
Forms of physical therapy that may be recommended include:
Warm water therapy: exercises in a warm-water pool. The water supports weight and puts less pressure on the muscles and joints
Physical therapy: specific exercises tailored to the condition and individual needs, sometimes combined with pain-relieving treatments such as ice or hot packs and massage
Occupational therapy: practical advice on managing everyday tasks, choosing specialized aids and equipment, protecting the joints from further damage and managing fatigue
Physical activity
Research suggests that although individuals with arthritis may experience short-term increases in pain when first beginning exercise, continued physical activity can be an effective way to reduce symptoms long-term.
People with arthritis can participate in joint-friendly physical activity on their own or with friends. As many people with arthritis have another condition, such as heart disease, it is important to choose appropriate activities.
Joint-friendly physical activities that are appropriate for adults with arthritis and heart disease include:
walking
swimming
cycling
A health care professional can help you find ways to live a healthful lifestyle and have a better quality of life.
Natural therapies
A number of natural remedies have been suggested for different types of arthritis.
According to the organization Versus Arthritis, based in the United Kingdom (U.K.), some research has supported the use of devil’s claw, rosehip, and Boswellia, from the frankincense tree. Devil’s claw and Boswellia supplements can be purchased online.
There is some evidence that turmeric may help, but more studies are needed to confirm their effectiveness.
Various other herbs and spices have been recommended for RA, but again, more research is needed. They include turmeric, garlic, ginger, black pepper, and green tea.
Many of these herbs and spices are available to purchase online in supplement form, including turmeric, ginger, and garlic.
Anyone who is considering using natural remedies for any type of arthritis should speak to a doctor first.
Causes
There is no single cause of all types of arthritis. The cause or causes vary according to the type or form of arthritis.
Possible causes may include:
injury, leading to degenerative arthritis
abnormal metabolism, leading to gout and pseudogout
inheritance, such as in osteoarthritis
infections, such as in the arthritis of Lyme disease
immune system dysfunction, such as in RA and SLE
Most types of arthritis are linked to a combination of factors, but some have no obvious cause and appear to be unpredictable in their emergence.
Some people may be genetically more likely to develop certain arthritic conditions. Additional factors, such as previous injury, infection, smoking and physically demanding occupations, can interact with genes to further increase the risk of arthritis.
Diet and nutrition can play a role in managing arthritis and the risk of arthritis, although specific foods, food sensitivities or intolerances are not known to cause arthritis.
Foods that increase inflammation, particularly animal-derived foods and diets high in refined sugar, can make symptoms worse, as can eating foods that provoke an immune system response.
Gout is one type of arthritis that is closely linked to diet, as it is caused by elevated levels of uric acid which can be a result of a diet high in purines.
Diets that contain high-purine foods, such as seafood, red wine, and meats, can trigger a gout flare-up. Vegetables and other plant foods that contain high levels of purines do not appear to exacerbate gout symptoms, however.
Risk factors for arthritis
Certain risk factors have been associated with arthritis. Some of these are modifiable while others are not.
Non-modifiable arthritis risk factors:
Age: the risk of developing most types of arthritis increases with age.
Sex: most types of arthritis are more common in females, and 60 percent of all people with arthritis are female. Gout is more common in males than females.
Genetic factors: specific genes are associated with a higher risk of certain types of arthritis, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and ankylosing spondylitis.
Modifiable arthritis risk factors:
Overweight and obesity: excess weight can contribute to both the onset and progression of knee osteoarthritis.
Joint injuries: damage to a joint can contribute to the development of osteoarthritis in that joint.
Infection: many microbial agents can infect joints and trigger the development of various forms of arthritis.
Occupation: certain occupations that involve repetitive knee bending and squatting are associated with osteoarthritis of the knee.
Comorbidities
More than half of adults in the U.S. with arthritis report high blood pressure. High blood pressure is associated with heart disease, the most common comorbidity among adults with arthritis.
Around 1 in 5 of adults in the U.S. who have arthritis are smokers. Smoking is associated with chronic respiratory conditions, the second most common comorbidity among adults with arthritis.
Types
There are around 200 types of arthritis, or musculoskeletal conditions. These are split into seven main groups:
Inflammatory arthritis
Degenerative or mechanical arthritis
Soft tissue musculoskeletal pain
Back pain
Connective tissue disease
Infectious arthritis
Metabolic arthritis
Inflammatory arthritis
Inflammation is a normal part of the body’s healing process. The inflammation tends to occur as a defense against viruses and bacteria or as a response to injuries such as burns. However, with inflammatory arthritis, inflammation occurs in people for no apparent reason.
Inflammatory arthritis can affect several joints, damaging the surface of the joints and the underlying bone.
Inflammatory arthritis is characterized by damaging inflammation that does not occur as a normal reaction to injury or infection. This type of inflammation is unhelpful and instead causes damage in the affected joints, resulting in pain, stiffness and swelling.
Inflammatory arthritis can affect several joints, and the inflammation can damage the surface of the joints and also the underlying bone.
Examples of inflammatory arthritis include:
Rheumatoid arthritis (RA)
Reactive arthritis
Ankylosing spondylitis
Arthritis associated with colitis or psoriasis
The word “arthritis” means “joint inflammation,” but inflammation may also affect the tendons and ligaments surrounding the joint.
Degenerative or mechanical arthritis
Degenerative or mechanical arthritis refers to a group of conditions that mainly involve damage to the cartilage that covers the ends of the bones.
The main job of the smooth, slippery cartilage is to help the joints glide and move smoothly. This type of arthritis causes the cartilage to become thinner and rougher.
To compensate for the loss of cartilage and changes in joint function, the body begins to remodel the bone in an attempt to restore stability. This can cause undesirable bony growths to develop, called osteophytes. The joint can become misshapen. This condition is commonly called osteoarthritis.
Osteoarthritis can also result from previous damage to the joint such as a fracture or previous inflammation in the joint.
Soft tissue musculoskeletal pain
Soft tissue musculoskeletal pain is felt in tissues other than the joints and bones. The pain often affects a part of the body following injury or overuse, such as tennis elbow, and originates from the muscles or soft tissues supporting the joints.
Pain that is more widespread and associated with other symptoms may indicate fibromyalgia.
Back pain
Back pain can arise from the muscles, discs, nerves, ligaments, bones, or joints. Back pain may stem from problems with organs inside the body. It can also be a result of referred pain, for example, when a problem elsewhere in the body leads to pain in the back.
There may be a specific cause, such as osteoarthritis. This is often called spondylosis when it occurs in the spine. Imaging tests or a physical examination may detect this.
A “slipped” disc is another cause of back pain, as is osteoporosis, or thinning of the bones.
If a doctor cannot identify the exact cause of back pain, it is often described as “non-specific” pain.
Connective tissue disease (CTD)
Connective tissues support, bind together, or separate other body tissues and organs. They include tendons, ligaments, and cartilage.
CTD involves joint pain and inflammation. The inflammation may also occur in other tissues, including the skin, muscles, lungs, and kidneys. This can result in various symptoms besides painful joints, and it may require consultation with a number of different specialists.
Examples of CTD include:
SLE, or lupus
scleroderma, or systemic sclerosis
dermatomyositis
Infectious arthritis
A bacterium, virus, or fungus that enters a joint can sometimes cause inflammation.
Organisms that can infect joints include:
Salmonella and Shigella, spread through food poisoning or contamination
chlamydia and gonorrhea, which are sexually transmitted diseases (STDs)
hepatitis C, a blood-to-blood infection that may be spread through shared needles or transfusions
A joint infection can often be cleared with antibiotics or other antimicrobial medication. However, the arthritis can sometimes become chronic, and joint damage may be irreversible if the infection has persisted for some time.
Metabolic arthritis
Uric acid is a chemical created when the body breaks down substances called purines. Purines are found in human cells and several foods.
Most uric acid dissolves in blood and travels to the kidneys. From there, it passes out in urine. Some people have high levels of uric, acid because they either naturally produce more than they need or their body cannot clear the uric acid quickly enough.
Uric acid builds up and accumulates in some people and forms needle-like crystals in the joint, resulting in sudden spikes of extreme joint pain or a gout attack.
Gout can either come and go in episodes or become chronic if uric acid levels are not reduced.
It commonly affects a single joint or a small number of joints, such as the big toe and hands. It usually affects the extremities. One theory is that uric acid crystals form in cooler joints, away from the main warmth of the body.
Some of the more common types of arthritis are discussed below.
Rheumatoid arthritis
Rheumatoid arthritis and osteoarthritis share some characteristics, but they are different conditions.
Rheumatoid arthritis (RA) occurs when the body’s immune system attacks the tissues of the body, specifically connective tissue, leading to joint inflammation, pain, and degeneration of the joint tissue.
Cartilage is a flexible, connective tissue in joints that absorb the pressure and shock created by movement like running and walking. It also protects the joints and allows for smooth movement.
Persistent inflammation in the synovia leads to the degeneration of cartilage and bone. This can then lead to joint deformity, pain, swelling, and redness.
RA can appear at any age and is associated with fatigue and prolonged stiffness after rest.
RA causes premature mortality and disability and it can compromise quality of life. Conditions it is linked to include cardiovascular diseases, such as ischemic heart disease and stroke.
Diagnosing RA early gives a better chance of learning how to manage symptoms successfully. This can reduce the impact of the disease on quality of life.
Osteoarthritis
Osteoarthritis is caused by a reduction in the normal amount of cartilage tissue through wear and tear throughout life.
Osteoarthritis is a common degenerative joint disease that affects the cartilage, joint lining and ligaments, and underlying bone of a joint.
The breakdown of these tissues eventually leads to pain and joint stiffness.
The joints most often affected by osteoarthritis are those that get heavy use, such as hips, knees, hands, the spine, the base of the thumb, and the big toe joint.
And Also:
Arthritis, Symptoms, Causes, Diagnosis, Treatments, Diet and exercise, Outlook
What is arthritis?
Arthritis is an inflammation of the joints. It can affect one joint or multiple joints. There are more than 100 different types of arthritis, with different causes and treatment methods. Two of the most common types are osteoarthritis (OA) and rheumatoid arthritis (RA).
The symptoms of arthritis usually develop over time, but they may also appear suddenly. Arthritis is most commonly seen in adults over the age of 65, but it can also develop in children, teens, and younger adults. Arthritis is more common in women than men and in people who are overweight.
What are the symptoms of arthritis?
Joint pain, stiffness, and swelling are the most common symptoms of arthritis. Your range of motion may also decrease, and you may experience redness of the skin around the joint. Many people with arthritis notice their symptoms are worse in the morning.
In the case of RA, you may feel tired or experience a loss of appetite due to the inflammation the immune system’s activity causes. You may also become anemic — meaning your red blood cell count decreases — or have a slight fever. Severe RA can cause joint deformity if left untreated.
What causes arthritis?
Cartilage is a firm but flexible connective tissue in your joints. It protects the joints by absorbing the pressure and shock created when you move and put stress on them. A reduction in the normal amount of this cartilage tissue cause some forms of arthritis.
Normal wear and tear causes OA, one of the most common forms of arthritis. An infection or injury to the joints can exacerbate this natural breakdown of cartilage tissue. Your risk of developing OA may be higher if you have a family history of the disease.
Another common form of arthritis, RA, is an autoimmune disorder. It occurs when your body’s immune system attacks the tissues of the body. These attacks affect the synovium, a soft tissue in your joints that produces a fluid that nourishes the cartilage and lubricates the joints.
RA is a disease of the synovium that will invade and destroy a joint. It can eventually lead to the destruction of both bone and cartilage inside the joint.
The exact cause of the immune system’s attacks is unknown. But scientists have discovered genetic markers that increase your risk of developing RA fivefold.
How is arthritis diagnosed?
Seeing your primary care physician is a good first step if you’re unsure who to see for an arthritis diagnosis. They will perform a physical exam to check for fluid around the joints, warm or red joints, and limited range of motion in the joints. Your doctor can refer you to a specialist if needed.
If you’re experiencing severe symptoms, you may choose to schedule an appointment with a rheumatologist first. This may lead to a faster diagnosis and treatment.
Extracting and analyzing inflammation levels in your blood and joint fluids can help your doctor determine what kind of arthritis you have. Blood tests that check for specific types of antibodies like anti-CCP (anti-cyclic citrullinated peptide), RF (rheumatoid factor), and ANA (antinuclear antibody) are also common diagnostic tests.
Doctors commonly use imaging scans such as X-ray, MRI, and CT scans to produce an image of your bones and cartilage. This is so they can rule out other causes of your symptoms, such as bone spurs.
How is arthritis treated?
The main goal of treatment is to reduce the amount of pain you’re experiencing and prevent additional damage to the joints. You’ll learn what works best for you in terms of controlling pain. Some people find heating pads and ice packs to be soothing. Others use mobility assistance devices, like canes or walkers, to help take pressure off sore joints.
Improving your joint function is also important. Your doctor may prescribe you a combination of treatment methods to achieve the best results.
Shop heating pads for pain relief.
Medication
A number of different types of medication treat arthritis:
Analgesics, such as hydrocodone (Vicodin) or acetaminophen (Tylenol), are effective for pain management, but don’t help decrease inflammation.
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) and salicylates, help control pain and inflammation. Salicylates can thin the blood, so they should be used very cautiously with additional blood thinning medications.
Menthol or capsaicin creams block the transmission of pain signals from your joints.
Immunosuppressants like prednisone or cortisone help reduce inflammation.
If you have RA, your doctor may put you on corticosteroids or disease-modifying antirheumatic drugs (DMARDs), which suppress your immune system. There are also many medications to treat OA available over the counter or by prescription.
Shop capsaicin creams for pain relief.
Surgery
Surgery to replace your joint with an artificial one may be an option. This form of surgery is most commonly performed to replace hips and knees.
If your arthritis is most severe in your fingers or wrists, your doctor may perform a joint fusion. In this procedure, the ends of your bones are locked together until they heal and become one.
Physical therapy
Physical therapy involving exercises that help strengthen the muscles around the affected joint is a core component of arthritis treatment.
What lifestyle changes can help people with arthritis?
Weight loss and maintaining a healthy weight reduce the risk of developing OA and can reduce symptoms if you already have it.
Eating a healthy diet is important for weight loss. Choosing a diet with lots of antioxidants, such as fresh fruits, vegetables, and herbs, can help reduce inflammation. Other inflammation-reducing foods include fish and nuts.
Foods to minimize or avoid if you have arthritis include fried foods, processed foods, dairy products, and high intakes of meat.
Some research also suggests that gluten antibodies may be present in people with RA. A gluten-free diet may improve symptoms and disease progression. A 2015 study also recommends a gluten-free diet for all people who receive a diagnosis of undifferentiated connective tissue disease.
Regular exercise will keep your joints flexible. Swimming is often a good form of exercise for people with arthritis because it doesn’t put pressure on your joints the way running and walking do. Staying active is important, but you should also be sure to rest when you need to and avoid overexerting yourself.
At-home exercises you can try include:
the head tilt, neck rotation, and other exercises to relieve pain in your neck
finger bends and thumb bends to ease pain in your hands
leg raises, hamstring stretches, and other easy exercises for knee arthritis
What is the long-term outlook for people with arthritis?
While there’s no cure for arthritis, the right treatment can greatly reduce your symptoms.
In addition to the treatments your doctor recommends, you can make a number of lifestyle changes that may help you manage your arthritis.