Arthritis

Description

Arthritis is a collection of more than 100 disorders that destroys joints, muscles, cartilage, and connective tissue. The degradation causes problems in movement. There are many different types of arthritis; two of the most common are osteoarthritis and rheumatoid arthritis.

Osteoarthritis (OA)

Osteoarthritis is thought to be the most common type of joint disease. It causes the repair process of cartilage to fail. The cartilage breaks down, causing the bones to rub together, which then can lead to discomfort and pain. Osteoarthritis is most common in the knees, hips, and hands.

Rheumatoid Arthritis (RA)

Rheumatoid Arthritis is a type of inflammatory arthritis and is an autoimmune disease. The immune system, which usually protects against foreign cells, starts to attack the body’s own tissue. When the lining of the joints is attacked, fluid builds up. This leads to pain and inflammation. Rheumatoid Arthritis often starts in the hands and feet, but it can spread to other areas of the body making it a multi-system disease.

Causes

Osteoarthritis

Increased mechanical stress on the joints from playing contact sports, obesity, and jobs that require repetitive motions can increase susceptibility to osteoarthritis. Risk factors are genetic bone abnormalities that people inherit, age, and ethnicity. OA has a higher prevalence among women.

Rheumatoid Arthritis

Like many autoimmune diseases, rheumatoid arthritis is not fully understood. Genetic and environmental factors are thought to play a role. Research is being carried out on the role that certain bacteria, viruses, and female hormones have in RA. Smoking is also thought to be a predisposing factor.

Treatment

Osteoarthritis

Osteoarthritis is treated with a combination of therapies, aiming to relieve pain, increase tolerance for activity, and maintain functionality. Often these therapies are a combination of drugs and non-drug management. Surgery is considered a last resort.

• Non-Drug Management
  

  People are encouraged to exercise to increase muscle strength, aerobic ability, and facilitate weight loss. Low impact exercises such as walking, biking, and swimming are encouraged; however, running and aerobics are not, due to their high impact factor. Weight loss using a mix of exercise and diet is encouraged, as excess weight puts extra pressure on joints. Physical therapy and occupational therapy are used when a personal exercise program is not enough.

• Drug Management
  

  Over the counter drugs, such as acetaminophen (Tylenol*), are used to treat pain associated with OA. Non-steroidal anti-inflammatory drugs, NSAIDs, (Anaprox*, Advil*, Voltaren*) are used to treat pain and inflammation in joints. Cox-2 inhibitors (Celebrex*) are newer NSAIDs that provide the same benefit without the gastrointestinal side effects of traditional NSAIDs. When pain is unmanageable with these two groups, opioids are considered. Topical capsaicin (Capzasin*) may also be used as a non-prescription alternative.

Rheumatoid Arthritis

Rheumatoid Arthritis treatment concentrates on drug therapy and exercise to relieve symptoms. To reduce inflammation, NSAIDs and corticosteroids are used. Biologic agents (Remicade*, Enbrel*) are used to modify the disease. A person may be prescribed one or a combination of these drugs to treat RA. Moderate physical activity provides benefits to RA patients by strengthening muscles, decreasing fatigue, and increasing flexibility.