What is Arthritis? - the Types, the Causes, and the Treatments

There are around 200 different conditions that affect the joints and the tissues surrounding the joint. All these conditions often come under the term arthritis.   

While there are many kinds of arthritis, the two most common types of these conditions are: 

  • Rheumatoid arthritis 
  • Osteoarthritis 

Rheumatoid conditions often involve pain, stiffness of the affected joint, aching, and swelling around affected areas. Symptoms of arthritis can be gradual or sudden. Other forms of arthritis involve the immune system and other internal organs. An example of this kind of arthritis is lupus (SLE), which can affect different organs, leading to pervasive symptoms. 

Arthritis is more common among adults over 65 years. However, it can affect younger adults and even teenagers. There have also been cases of arthritis in children. 

What is Arthritis?

Arthritis refers to the swelling and inflammation of the joints and the surrounding tissues. Arthritis can occur in one or more joints. The common symptoms of arthritis are stiffness and pain in the joints. The condition is usually worse in older people and continues to worsen with age. 

Around 54.4 million people have some form of arthritis (according to CDC).  Around 23.7 million people can no longer fully carry out their daily activity as a result of arthritis. 

Quick Facts About Arthritis

  • There are over 200 rheumatic conditions that affect the joints, which are known as arthritis.  They include rheumatoid arthritis and lupus.
  • The symptoms range from mild to severe and limit a person’s ability to achieve daily activities.
  • Engaging in physical activities and exercise can affect arthritis positively. Exercise can reduce pain and improve joint function and mental health. 
  • Some of the factors that lead to the development of arthritis include abnormal metabolism and infection. Genetic factors and dysfunction of the immune system can also be causes of arthritis.
  • Arthritis medication it intended to reduce pain and damage to the joint. It also aims to improve the quality of life of patients. Treatment involves physical therapy, patient education, drugs, and support programs. 

Types of Arthritis: Seven Major Groups of Arthritis

While there are over 200 identifiable types of arthritis, they all fall under seven major groups, which are:

  1. Inflammatory Arthritis
  2. Metabolic arthritis
  3. Degenerative/mechanical arthritis
  4. Infectious arthritis 
  5. Soft tissue musculoskeletal pain
  6. Diseases of connecting tissues
  7. Back pain

Inflammatory Arthritis

Inflammation often occurs in the body as a defense against bacterial and fungal infection. It is a part of the body’s normal healing process in cases of injuries like burns. Inflammatory arthritis, on the other hand, is not a normal inflammation.  It occurs for no reason. 

Inflammatory arthritis can cause severe damage to the surface of the affected joints and the underlying bones. It can also affect several joints of the body. Some examples of inflammatory arthritis include: 

  • Rheumatoid arthritis 
  • Reactive arthritis 
  • Ankylosing spondylitis 
  • psoriatic arthritis or colitis related arthritis
  • Rheumatoid Arthritis 

When the immune system begins to attack the joints, this can result in rheumatoid arthritis.  Rheumatoid arthritis leads to stiffness of the joints and can present different symptoms.

With rheumatoid arthritis, the synovial fluid becomes swollen and tender. Without timely medical attention, the condition can lead to damage of the cartilage and affected bones. 

Rheumatoid Arthritis Symptoms

Some of the commonly reported symptoms of rheumatoid arthritis include:

  • Fever: When rheumatoid arthritis is associated with other symptoms like inflammation and joint pain, one of the early signs may include a low-grade fever. However, a fever higher than 100o may be a sign of other infections or sicknesses.  
  • Morning stiffness: Morning stiffness is also one of the early signs of rheumatoid arthritis. When a symptom persists over a few minutes, it becomes worse if proper treatment is not applied. Stiffness that perseveres for several hours may be likely associated with inflammatory arthritis, especially rheumatoid arthritis.
  • Joint stiffness: One of the main signs of rheumatoid arthritis includes stiffness in smaller joints. Stiffness of the joint can occur at any time of the day, even when you are not active. One of the main parts where you feel the stiffness is the hands. The pain usually begins slowly and progresses gradually. However, the case is not always the same for everybody. Others may feel the pain of rheumatoid arthritis suddenly. Joint stiffness can also be sudden and affect multiple joints within two days.
  • Joint pain: Joint pain often follows joint stiffness. You can feel the pain either in motion or when you are at rest. Rheumatoid arthritis pain usually affects both sides of the body equally. At the inception of rheumatoid arthritis, the pain is around the wrists and the fingers. The pain can also extend to the knees, shoulders, feet, and ankles.
  • Minor joint swelling: Mild inflammation appears early during arthritis and causes the affected joint to appear larger than usual. The bump can cause the joints to feel warm. The swelling is associated with flare-ups that can typically last from a few days to a few weeks. The pattern of outbursts may increase after some time and affect other joints subsequently. 
  • Fatigue: Fatigue usually precedes other symptoms. The unusual feeling of fatigue typically comes a week or a month before the other symptoms. 
  • Symmetrical occurrence: Rheumatoid arthritis usually occurs symmetrically on both sides.
  • Numbness and tingling: Inflammation of the tendons leads to excessive stress on the nerves. Excess pressure in the nerves can lead to numbness and tingling in the hands. It can also lead to carpal tunnel syndrome, a burning sensation that you feel in the hands. In some cases, the joints of the hands and the feet may produce sounds. The sound is a result of damaged cartilage grinding against the joints during movement.  

Other Early Symptoms That May Accompany Rheumatoid Arthritis

At the early stage of arthritis, there are other symptoms that may be experienced. They include:  

  • The feeling of malaise and general body weakness
  • Dryness of the mouth
  • Inflammation of the skin, which can also appear dry and itchy
  • Discharge from the eyes
  • Sleeping difficulty
  • Pleurisy 
  • Weight loss
  • Loss of appetite
  • The feeling of hard lumps of tissue on the arms or under the skin 

Rheumatoid arthritis usually targets several joints at the same time. Consider visiting a physician once you notice one or more of the early signs of rheumatoid arthritis.

Ankylosing Spondylitis

Ankylosing spondylitis is a type of pf arthritis that can cause the fusion of the smaller bones in the spine (vertebrae). Spine fusion reduces the flexibility of the spine and affects a person’s posture. In some cases, the condition can also affect the ribs, making it difficult to breathe. 

Ankylosing spondylitis is more prevalent in men than in women. The signs of ankylosing spondylitis usually begin in early adulthood. The condition does not affect the spine alone. Inflammation can also affect the eyes. Ankylosing spondylitis does not have a cure. However, treatment can help to reduce the symptoms and inhibit the advancement of the disease.  

Symptoms of Ankylosing Spondylitis

The common signs of ankylosing spondylitis are:

  • Stiffness 
  • Pain in the lower back 

People with ankylosing spondylitis, usually experience these symptoms in the morning and after spending long inactive periods. Other symptoms include neck pain and fatigue. The symptoms of ankylosing spondylitis may worsen over time, stop, or improve irregularly. 

The areas where people commonly experience ankylosing spondylitis are: 

  • The joint connecting the base of the spine and the pelvis
  • The lower back vertebrae
  • The connecting points of ligaments to the bones around the spine. Sometimes, patients can also experience the condition behind the heel
  • The condition can also affect the cartilage connecting the ribs to the breastbone
  • The joints of the hips and the shoulders
  • Metabolic Arthritis

Several foods we eat contain purines. The breakdown of purines by the body leads to the formation of uric acid. The body can also produce uric acid naturally. Uric acids dissolve in the blood and pass out of the body with urine. 

However, some people have a high amount of uric acid. There are two main reasons why some people have an excess amount of uric acid in their system. 

  • Their body produces more than the amount they require
  • The inability of their system to clear up the uric acid quickly enough

The build-up of uric acid in the system can lead to the formation of crystals in the joints. The needle-like crystals lead to sudden spikes of severe pain in the affected joints. An example of metabolic arthritis is gout.

Gout

Gout is a painful type of inflammatory arthritis. It occurs as a result of excess uric acid in some parts of the body. The common areas that gout affects are:

Areas affected by gout
  • The big toe
  • The foot joints
  • The elbow
  • The knee
  • The wrist 
  • The fingertips 

Gout can affect a single joint or a collection of small joints. The pain of gout is usually felt at the extremities of the joints. According to one theory, uric acid crystals develop in less active joints. 

Gout can be experienced in episodes. If treatment does not begin in time, it can develop into a chronic condition. 

Symptoms of Gout

  • Swelling and pain on the big toe, ankle joint, or knee
  • Sudden pain occurs mostly during the night. The pain can be excruciating or crushing, or  throbbing  in nature
  • Tender joints that appear swollen and warm
  • Fever can also be a common symptom of gout

Risk Factors Of Gout

The risk factors of gout include: 

  • Hypertension 
  • Obesity 
  • Intake of alcohol 
  • Poor kidney function
  • Excess consumption of meat and seafood
  • The use of diuretics 
  • Some kinds of drugs  

Long-lasting gout can lead to tophi, a condition that causes lumps under the skin. Tophi can appear around the joints, fingertips, and ears.  

Often, tophi can burst and drain out a white chalky substance. In some cases, the patient may require a surgical procedure to drain the tophi. The outbreak of tophi on the skin can lead to osteomyelitis.

Degenerative/Mechanical Arthritis

Degenerative/mechanical arthritis is a group of conditions that lead to the damage of the bone cartilage. The cartilage is the smooth and slippery covering at the end of the bone where it joins with another bone. The work of the cartilage is to allow the joints to glide smoothly.  

Degenerative arthritis leads to the thinning and roughness of the cartilage. Due to thinning out of the cartilage, the body makes modifications to the bone to support stability. However, these modifications can lead to undesirable growth or misshapen bones. Another name for this condition is osteoarthritis. 

Osteoarthritis

Osteoarthritis remains the most common type of arthritis, accounting for the majority of the cases. Osteoarthritis occurs as a result of wear-and-tear on joint cartilage. Damage to the cartilage leads to bones grinding together during movement, causing pain and stiffness. Wear-and-tear of the bone cartilage can be a gradual process and occur over many years. 

Osteoarthritis can also occur from a previous joint injury like a fracture or inflammation in the past.  

Osteoarthritis can affect the entire joint. It can lead to bone changes and the weakening of the tissues and muscles that keep joints together. It also leads to tenderness in the joints.

Infectious Arthritis

Sometimes, fungus, bacteria, and viruses can affect the joints, which can cause inflammation. Different types of organisms can cause inflammation. Some of the common ones include:

  • Hepatitis C, which is a blood-to-blood infection that spreads often through the sharing of needles or other infected instruments
  • Salmonella and shigella can result from food contamination or poisoning 
  • Gonorrhea and chlamydia, which are common STDs 

Treatment is usually with the use of antibiotics or other anti-microbial medications. However, failure to take care of the condition on time can cause it to become chronic. Joint damage as a result of infectious arthritis may become permanent if it persists for a long time. 

Soft Tissue Musculoskeletal Pain

Soft tissue musculoskeletal pain occurs in tissues other than the bones and the joints. Soft tissue musculoskeletal pain can occur as a result of overuse or injury to a particular part of the body. A good example of this kind of arthritis is prevalent in sportsmen and women. The pain usually originates from the soft tissue or muscle that supports the overused joint. 

Soft tissue musculoskeletal pain is also similar to fibromyalgia. However, the latter has other symptoms that are different from that of soft musculoskeletal pain. 

Disease of The Connective Tissues (CTD)

The connecting tissues have different functions, which include binding, providing support, and separating organs from other body tissues. Connective tissues include tendons, cartilage, and ligaments. 

CTD can cause pain and inflammation of the affected areas. Connective tissue disease can also occur in other tissues like the muscles, the lungs, the skin, and the kidneys. CTD can present other symptoms besides pain and inflammation and may require consulting a different specialist. 

Common Examples of CTD include: 

  • Dermatomyositis 
  • Lupus 
  • Scleroderma 

Causes of Arthritis

The function of the joint cartilage is to absorb pressure and shock. When we put stress on the joints, the cartilage absorbs the pressure and keeps the joints safe from damage. A reduction in the amount or normal function of the cartilage can lead to some forms of arthritis. 

One of the main causes of arthritis is wear and tear, and it is linked to osteoarthritis. The breakdown of the cartilage usually occurs as we grow older. However, an injury to the joint can lead to a rapid breakdown of the cartilage. The risk of developing osteoarthritis is higher in people with a family history of arthritis. 

In the case of rheumatoid arthritis, the problem comes from inside the body. in this case, the body’s defense system attacks the tissues of the body. The condition is also known as an autoimmune disorder. In the case of rheumatoid arthritis, the immune system attacks the synovium, and in turn, it destroys the joints. Rheumatoid arthritis can have a more severe damaging effect on the bones and joint cartilage. The exact cause of the autoimmune disorder is not known. However, scientists have identified scientific markers that can increase your risk of developing rheumatoid arthritis. 

Note that, there is no single cause of all the forms of arthritis. The cause of one form of arthritis can differ from the cause of the other types of arthritis. However, the possible causes of different types of arthritis include: 

  • Injury to the joint can cause degenerative arthritis
  • It can also be a result of immune dysfunction in the cases of RA and SLE
  • Arthritis (Osteoarthritis) can be inherited, especially for people with a family history of arthritis
  • Infection can also lead to arthritis, for example, Lyme disease 
  • Diet and metabolism can lead to pseudo-gout and gout 

Risk Factors of Arthritis

Various risk factors are mostly linked to arthritis. The risk factors are classified into modifiable and non-modifiable risk factors of arthritis. 

Modifiable Risk Factors of Arthritis

Obesity and overweight

Being overweight can put a lot of pressure on the joints, which can be a major factor in the onset of arthritis. It can also lead to the rapid progression of the condition, especially in the case of knee osteoarthritis.

Injuries to the joint

The development of osteoarthritis is more common in joints with injuries. People with knee injuries develop osteoarthritis in the knees more easily than people without a history of a knee injury.

Infection

The development of arthritis can be a cause of infection to the joints. Different microorganisms can affect the joints and cause arthritis.

Occupation

Certain occupations can be damaging to the joint. They include jobs that involve repetitive activities like knee bending or squatting. Repetitive bending can lead to osteoarthritis. 

Non-modifiable Arthritis

Age: As we grow older, the risk of developing arthritis increases.

Sex: Being female can put you at a higher of arthritis than your male counterparts. Sixty percent of the people suffering from different forms of arthritis are females. On the other hand, gout is more prevalent in males than in females.

Genetic factor: There are specific genes that are at higher risk of developing some types of arthritis. Genetically induced arthritis include rheumatoid arthritis, ankylosing spondylitis, and lupus erythematosus. 

Diagnosis of Arthritis

The first step of treatment is to visit a physician when you notice any unusual inflammation or joint pain. The physician will carry out a physical examination for fluid around the joints. He will also examine the joints for warm and swollen joints that may appear reddish. The physician also inspects the joints for any limitation in the range of movement. If the situation requires the services of a  specialist, the physician can make a referral.

For those experiencing multiple symptoms, it might be best to see a rheumatologist first before going to a physician. A rheumatologist can help diagnose the problem faster and help begin the treatment as soon as possible. 

Extraction and analysis of the level of inflammation found in the blood and joint fluid is an effective form of diagnosis. It can help the doctor determine the type of arthritis being experienced. Other effective forms of blood tests can help determine the type of arthritis that you may be experiencing. The tests include:

  • Antinuclear antibody (ANA)
  • Rheumatoid factor (RF)
  • Anti-cyclic citrullinated peptide (anti-CCP)

Other times, doctors also rely on different types of imaging scans to have a closer look at the bone. Imaging scans can help the doctor identify the state of the cartilage and the bones. Imaging scans for diagnosis of arthritis are:

  • X-ray scan
  • MRI scan
  • CT scan 

Treatment Of Arthritis

Treatment for arthritis aims to reduce the pain one experiences from the condition. Treatment also aims to reduce further damage to the joints and inhibit the progression of arthritis. Different people rely on different approaches to reduce the pain of arthritis. Heating pads and ice packs may work for some people, while others require mobility assistance.  Devices like walking sticks, canes, and walkers can help to take away pressure from affected joints. 

Exercise can also help to improve joint functions, which can help reduce pain. Treatment of arthritis may involve a combination of different treatment methods. The doctor usually prescribes what works best for different situations. 

Arthritis Medication

Several medications prove effective in the treatment of arthritis.  The treatment may use one or a combination of the following drugs for the treatment of arthritis.

Analgesics

Analgesics such as acetaminophen (Tylenol) and hydrocodone (Vicodin) are effective arthritis pain relievers. However, they are not effective in managing inflammation. Therefore, the doctor might combine analgesics with other forms of medication for the best result.

Non-steroidal Anti-inflammatory Drugs (NSAIDs)

When it comes to controlling inflammation and pain, doctors usually prescribe NSAIDs. The common NSAIDs available for the treatment of arthritis are ibuprofen (Advil) and salicylates. The use of salicylates can cause the blood to thin out. Therefore, it is best to avoid using it with other blood-thinning medications. Caution should also be applied while using salicylates for the treatment of arthritis.

Capsaicin and Menthol Creams

Capsaicin and menthol creams act as pain blockers. The use of these topical applications helps to inhibit the transmission of pain signals from the joint to the brain. Capsaicin and menthol creams are effective ways to control pain.

Immunosuppressant

An immunosuppressant like cortisone is effective for reducing inflammation. Doctors may prescribe immunosuppressants for the treatment of arthritis. 

For people suffering from rheumatoid arthritis, doctors may prescribe corticosteroids. The use of disease-modifying anti-rheumatic drugs (DMARDs) is also an effective way of treating arthritis. DMARDs helps to suppress the immune system. 

There are other types of OTC medications and prescription drugs that are useful for the treatment of arthritis.

Supplements

Research into dietary supplements for the treatment of arthritis is ongoing. While not prescribed by a health care professional, supplements have shown promise in relieving arthritis pain. Other supplements are used for improving joint cartilage. Some of the most popular supplements are:

  • Glucosamine and chondroitin
  • Vitamins
  • Elk velvet antler (EVA)
  • SAM-e
  • Fish Oil
  • Curcumin

Surgery

In severe cases, doctors may suggest a surgical approach to replace the affected joint with an artificial one. Joint replacement is most common in the cases of the hips and the knees. In severe cases of arthritis affecting the fingers and the wrist, the doctor may suggest a joint fusion. The procedure involves locking the end of your bones together until the healing process occurs and they fuse. 

Physical Therapy

Treatment of arthritis often involves physical therapy like exercises. Physical therapy helps to strengthen the muscles around the affected joint. Physical therapy remains one of the main components of the treatment of arthritis. 

Lifestyle Changes And The Treatment of Arthritis

Changes in lifestyle such as losing and maintaining a healthy weight can reduce the risk of osteoarthritis. For those already suffering from osteoarthritis, maintaining a healthy weight can reduce the symptoms of arthritis. 

Eating healthy is essential to maintaining a healthy weight. Also, eating antioxidant rich food can help to reduce inflammation. Eat more fresh fruits and vegetables daily to help maintain a healthy weight or lose weight. Consuming fish and nuts can also help reduce the inflammation of the affected joints.

Avoiding junk food, fried foods, and processed foods is important for arthritis sufferers. Also, avoid excessive intake of dairy products and meat to help reduce the spread of arthritis. According to some research,  there may be gluten antibodies in people with rheumatoid arthritis. Therefore, reducing intake of gluten may help reduce disease progression and improve symptoms. 2015 studies also suggest this when it recommending the reduction of the intake of gluten for people diagnosed with connecting tissue problems. 

Exercising regularly will keep joints flexible. Swimming is a recommended exercise for people with arthritis. Swimming does not put too much pressure on the joints like walking and running. Actively engaging in exercise can be very helpful; however, it is important to rest. Over-exercising can also be dangerous. 

There are simple exercises can be done at home to help patients stay active. They include:

Exercises to help reduce pain in the neck
  • Head tilt 
  • Neck rotation 
  • Neck stretch
  • Shoulder roll
Exercise to reduce pain in the hand
  • Finger bend
  • Thumb bend 
Exercise to reduce pain in the knee
  • Leg raise
  • Hamstring stretches
  • Half squat
  • One leg dip
  • Leg stretch
Long Term Expectation For People With Arthritis

There is no cure for arthritis. However, using the right treatment procedure can help reduce the symptoms of arthritis. Treatments work best in combination with lifestyle changes and exercise.  

Conclusion

Most types of arthritis can occur as a result of various risk factors. Other types of arthritis do not have any causes and they appear suddenly. In such cases, it is difficult to predict their occurrence. Some people may develop certain types of arthritis due to genetic factors. Other factors like smoking, type of occupation, infection, and previous injury can increase the risk of arthritis. Diet can also be a risk factor for arthritis. Additionally, it is not clear whether specific kinds of food can cause arthritis. However, gout is often linked to diet. As previously stated, gout is a result of a high level of uric acid in the body. The excess amount of uric acid in the body can be a result of the intake of foods high in purines. 

Whatever the source of arthritis, there are many treatments available. Depending on the type of arthritis, diet and exercise can have a positive impact on joint health. Severe forms of arthritis may need more extensive treatment, from physical therapy to surgery. One of the primary treatments for arthritis is the use of medications, such as analgesics, NSAIDs, immunosuppressants, DMARDs, etc. Outside of traditional treatments, there is a growing body of evidence to support the use of dietary supplements for treatment of arthritis. Supplements such as glucosamine, chondroitin, fish oil, elk velvet antler, and others can contribute to relief for arthritis patients. 

Whatever a patient’s situation might be, it is important to understand how arthritis might affect you. If possible, avoid joint injuries that may lead to arthritis at a later time. Understand how your own family and genetics can affect your likelihood of developing arthritis. Know that there are options for treating arthritis. As always, consult your physician or any specialists to help you understand your condition.

* The statements and products referred to throughout this article may have not been evaluated by the FDA. They are not intended to diagnose, treat, cure, or prevent any disease or condition. If you have a health condition or concern, please consult a physician.



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