Arthritis

Summary

Arthritis is an inflammatory disease that affects one or more joints and can be acute or chronic. There are various types of arthritis such as psoriatic arthritis, rheumatoid arthritis , osteoarthritis , infectious arthritis, etc. Arthritis affects about 10% of the world’s male population and 15% of women. These numbers increase with age, especially after 70 years of age.

The basic causes of arthritis are inflammations that affect the joints. They may have autoimmune (as in rheumatoid arthritis), infectious (as in septic or infectious arthritis) or mechanical (as in osteoarthritis) causes. People at risk include obese patients, women, and individuals with a family history of arthritis, particularly autoimmune arthritis. The basic symptoms are the same as those of an inflammation: pain, heat, redness and swelling. As the disease progresses, the soft components of the joint deteriorate, with loss of motion and stiffness.

The diagnosis is usually made by imaging or laboratory tests.

Treatment is based on the use of anti-inflammatories, analgesics, immunomodulators and corticosteroids. In some cases, surgery is also indicated.

Medicinal plants and homeopathic medicines with anti-inflammatory action are also useful in controlling arthritis.

As preventive measures, the practice of physical exercises, blood pressure control, healthy eating and weight control are indicated. Always consult your doctor for the best treatment and approaches needed to manage arthritis and its symptoms.

Definition

Arthritis is an inflammatory joint disorder. We speak of monoarthritis when only one joint is affected, and polyarthritis when several joints are affected.

We also highlight acute arthritis, which lasts less than 3 months, and chronic arthritis, which lasts more than 3 months. We can also classify arthritis according to the cause: inflammatory arthritis (autoimmune cause) or infectious (staphylococcus, streptococcus bacteria, after a tick bite, for example).

There are several types of arthritis, the best known of which is rheumatoid arthritis, characterized by symmetrical symptoms (generally both knees and both elbows are affected) and this affects several joints (polyarthritis). The other types of arthritis – polyarthritis are, for example, systemic lupus erythematosus or psoriatic arthritis. In monoarthritis we can find gout or ankylosing spondyloarthritis. Osteoarthritis (or arthrosis) is also a common manifestation of this type of inflammation and is characterized by the degeneration of cartilage and adjacent bone in the joints.

If there is any doubt regarding the diagnosis, consult a general practitioner or a rheumatologist. The rheumatologist is the specialist who takes care of connective tissue diseases: arthritis is one of the many forms of rheumatism and affects the connective tissues of the joints (it is estimated that there are 200 rheumatism diseases).

Epidemiology

Arthritis is a disease that affects more women than men: about 10% of men in the world’s population and 15% of women suffer from some type of arthritis. This number increases as a person ages and about 30% of men over 65 and 50% of women in the same age group suffer from some form of arthritis. Data reveal that in the United States, more than 20 million Americans have osteoarthritis. In Brazil, this number reaches 15 million. With regard to rheumatoid arthritis, Brazil has around 1 million and 500 thousand patients, most of whom are women.

Arthritis is a more prevalent disease in Caucasians (24%) than in Blacks (19%), Latinos (11%) and Orientals (8%). Septic (or infectious) arthritis has a higher incidence in children, adolescents and young adults, and is usually caused by bacteria. However, about 25-40% of cases of infectious arthritis are in patients over 70 years of age. With regard to psoriatic arthritis, there are few studies that talk about its incidence in the population, however, it is known that women are more affected than men.

Causes

Arthritis is a disease that degenerates the joints. In the case of rheumatoid arthritis (which affects 1 to 2% of the western population), the main trigger for inflammation is an autoimmune reaction: the body produces antibodies that attack the joints and inflame the synovial region, causing swelling, redness and pain . This inflammatory reaction causes destruction of the joint and surrounding bone.

Osteoarthritis (arthrosis) is mainly caused by wear and tear of the joints and affects, above all, the elderly population. This wear and tear ends up injuring the joints and causing pain and restriction of movement.

Infectious arthritis is mainly caused by bacterial infections and, to a lesser extent, viral and fungal infections. The most common agent of this type of disease is Staphylococcus aureus, but it can also be caused by agents that cause gonorrhea and tuberculosis.

In gouty arthritis or gout, the main cause is the accumulation of uric acid crystals in the joints that trigger an inflammatory reaction.

Influence of weather on arthritis:
Cold can also have a negative impact on arthritis, as noted in the journal Prevention , January 2020. A study mentioned by the journal estimated that 68% of arthritis patients saw their discomfort increase during changes in weather (e.g. rain, cold). The drop in pressure caused by the cold can promote these tissues to expand and, if inflamed, promote the symptoms of arthritis.

Groups of risk

Some risk groups stand out as more likely to develop arthritis. Among them, we can mention:

– People with a family history of arthritis: This risk factor is particularly important in families with a case of rheumatoid arthritis. It is still not known for sure what makes the human body create antibodies to attack the joints themselves. However, it is believed that genetic factors are involved.

– Obese patients: obesity has been highlighted as a risk factor for the onset of arthritis, especially osteoarthritis, since excess weight puts pressure on the joints, especially the knees, hips and ankles.

– Women: women are more likely to develop rheumatoid arthritis than men, and the ratio can reach 2-3 women for men. However, men have a higher incidence of gouty arthritis.

– Elderly patients: with age, there is natural degeneration of the connective tissue of the joints and, with this, the risk of developing arthritis increases.

– Patients with joint injuries: People who have already had joint injuries, such as athletes, are at increased risk of developing arthritis in the injured joint. Another risk group are those patients who carry a lot of weight or make a lot of physical effort at work or repetitive movements.

Symptoms

Depending on the type of arthritis, the symptoms and especially the location can be different, but in general, the joint has the typical symptoms of inflammation: pain, heat, redness and swelling (swollen joint), sometimes accompanied by fever. The pains are almost always at night and increase when you are at rest (without activity).

Over time, progressive inflammation leads to joint stiffness with a consequent reduction in movement.

The most affected joints are:

– Hands

– Knees

– Feet

– Elbows

– shoulders

– Jaw

– Column

– Hip

Diagnosis

Depending on the type of arthritis presented by the patient, the doctor may request specific tests to find out which form of the disease is presented.

Laboratory tests are based on collecting samples of blood, urine and joint fluid to help the doctor clarify the type of arthritis presented by the patient.

In case of infectious (or septic) arthritis, the doctor will perform a blood culture to identify the causative organism.

Another approach may be imaging tests. In this regard, the following tests are included:

– X ray

– Computed tomography

– Magnetic Resonance

– Ultrasound

Imaging tests allow the joint to be visualized and problems to be detected. Details of the cartilage, tendons, ligaments and bones involved are obtained and the degree of injury is assessed by the physician.

Arthroscopy is a test in which the doctor inserts a thin, flexible tube (called an arthroscope) into the joint and gives an image of how the joint is doing.

Complications

The inflammation of arthritis can evolve and seriously injure the joint, compromising the condition of the ligaments, tendons and cartilage. In addition, the bone that makes up the joint may also be compromised.

When not properly controlled, arthritis progresses and leads to injuries that hinder and atrophy the movement of limbs, especially arms and legs. There may be stiffness, torsion and deformity of the parts involved, which compromises the performance of daily activities, however simple they may be.

The constant wear and tear of the joints can also lead to instability of the cervical spine with postural deformity with loss of locomotor function in some regions.

Treatments

Arthritis drug treatments

Treatments will differ depending on the type of arthritis, so ask your doctor for advice. Here is some purely indicative information:

– In case of inflammatory arthritis, the main treatments will be non-steroidal anti-inflammatory drugs or NSAIDs (diclofenac, ibuprofen, naproxen, etc…).

– In case of infectious arthritis, the main treatments will be anti-infectives (antibiotics), depending on the infectious agent.

To alleviate pain related to arthritis, analgesics are also used, such as paracetamol, or NSAIDs (non-steroidal anti-inflammatory drugs such as diclofenac, naproxen).

Irritant medications also help relieve arthritis pain. Many creams and ointments nowadays contain elements like menthol, capsaicin.

All these medicines are generally used in the form of tablets (to be swallowed), creams or ointments.

Usual treatments for rheumatoid arthritis, only as an indication:

– Antimalarial (hydroxychloroquine and chloroquine), gold salts, methotrexate [see photo, medicine to be taken in general once a week! in injection (better) or tablet] salazopyrine, biological or biotherapeutic TNF-alpha antagonists.

Other biological medicines regulate and modulate the body’s immune response and reduce inflammation. Among them, some used are etanercept and infliximab.

Corticosteroids have recognized anti-inflammatory and immunosuppressive activity. Examples of these medications are prednisone and cortisone. They decrease inflammation and suppress the immune system’s action on the joint.

Attention, all these treatments require a medical prescription, as well as serious medical follow-up (risk of side effects, exact diagnosis)

Other treatments

There are also other treatments such as:

– Physical therapy: This approach ensures that the joints and adjacent muscles are strengthened.

– Surgery: according to the degree of injury to the patient’s joint, the doctor may suggest surgery. In this case, the patient’s joint can be replaced by an artificial one, usually in the knees and hips. Another possibility is the fusion of two joints, usually applied to small bones, such as fingers and ankles.

Treatments are almost always combined, talk to your doctor.

Herbal medicine

The following medicinal plants have demonstrated effectiveness against arthritis. Plants (phytotherapy) should be considered as complementary measures to treat arthritis:

– Devil’s claw , which is usually taken in pill form.

– Arnica , which is usually used topically (gel, cream, ointment)

– White willow , which is generally used in the form of a tablet, capsule…

– Cayenne pepper , which is usually used in the form of a cream or compress.

– The ash tree , which is generally used in capsule form.

Tips

– Practice exercises (walking, sports) without excessive effort (do not lift heavy loads) and avoid sports that are dangerous for joints such as football or squash (especially bad for the knee area). If you still have energy and if the pain is bearable, know that physical exercise remains one of the best “medicines” to treat many rheumatic ailments, such as arthritis. Indispensable complementary treatment, along with medicines.

– Adopt a diet rich in vitamins, minerals, fruits, vegetables, dairy products and fish, especially those containing omega-3. Reduce your meat consumption.

– Make use of specialized appliances if you have arthritis with any restriction or weakness of movement. There are several devices such as walkers that facilitate locomotion and reduce effort.

– Use, with the consent and advice of your doctor, medicines based on medicinal plants to complement your basic treatment.

– Take hot showers (less if you are a heart person)

– Wear comfortable shoes adapted to your feet.

– In case of inflammation (pain, redness) in one or more joints, try to rest for 12 to 24 hours.

– Some alternative methods such as yoga or tai chi seem to have a positive effect on arthritis symptoms.

– Massaging the muscles can help relieve pain.

Prevention

– Exercises and physical activities are advised as it strengthens the ligaments, joints and muscles.

– Weight control is also essential, especially for the prevention of osteoarthritis (osteoarthritis).

– Control your blood pressure, as well as your cholesterol level, as there is a greater risk of cardiovascular complications in patients suffering from rheumatoid arthritis (type of arthritis).

Jeanne Kenney
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I’m a stylist trainer, a content creator, and an entrepreneur passion. Virgo sign and Pisces ascendant, I move easily between my dreams, the crazy world I want, and my feet on the ground to carry out my projects.

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