Despite what most people think, arthritis is not a single disease. It is mostly accompanied by several discomforts or health conditions such as severe pain, inability to walk, fatigue, weight loss etc. It is commonly seen in adults over the age of 65, but research found that it can also develop in children, teens, and younger adults.
Types of Arthritis
There are more than 100 different types of arthritis, with different causes and treatment methods. According to Wikipedia, two of the most common types are osteoarthritis and rheumatoid arthritis.A) Osteoarthritis
Osteoarthritis is the most common form of arthritis. It can affect both the larger and the smaller joints of the body, including the hands, wrists, feet, back, hip, and knee. The disease is essentially one acquired from daily wear and tear of the joint; however, osteoarthritis can also occur as a result of injuries.In recent years, some joint or limb deformities, such as knock-knee or acetabular over coverage or dysplasia, have also been considered as a predisposing factor for knee or hip osteoarthritis. Osteoarthritis begins in the cartilage and eventually causes the two opposing bones to erode into each other.
The condition starts with minor pain during physical activity, but soon the pain can be continuous and even occur while in a state of rest. The pain can be debilitating and prevent one from doing some activities. Osteoarthritis typically affects the weight-bearing joints, such as the back, knee and hip. Unlike rheumatoid arthritis, osteoarthritis is most commonly a disease of the elderly. More than 30 percent of women have some degree of osteoarthritis by age 65.
Risk factors for osteoarthritis include prior joint trauma, obesity, and a sedentary lifestyle.
B) Rheumatoid arthritis
Rheumatoid arthritis (RA) is a disorder in which the body's own immune system begin to attack the body tissues. The attack is not only directed at the joint but to many other parts of the body. In rheumatoid arthritis, most damage occurs to the joint lining and cartilage which eventually results in erosion of two opposing bones.RA often affects joints in the fingers, wrists, knees and elbows, is symmetrical (appears on both sides of the body), and can lead to severe deformity in a few years if not treated. RA occurs mostly in people aged 20 and above. In children, the disorder can present with a skin rash, fever, pain, disability, and limitations in daily activities.
With earlier diagnosis and aggressive treatment, many individuals can lead a better quality of life than if going undiagnosed for long after RA's onset. The drugs to treat RA range from corticosteroids to monoclonal antibodies given intravenously. Treatments also include analgesics such as NSAIDs and disease-modifying antirheumatic drugs (DMARDs), while in rare cases, surgery may be required to replace joints, but there is no cure for the disease.
Treatment with DMARDs is designed to initiate an adaptive immune response, in part by CD4+ T helper (Th) cells, specifically Th17 cells. Th17 cells are present in higher quantities at the site of bone destruction in joints and produce inflammatory cytokines associated with inflammation, such as interleukin-17 (IL-17).
Bone erosion is a central feature of rheumatoid arthritis. Bone continuously undergoes remodeling by actions of bone resorbing osteoclasts and bone forming osteoblasts. One of the main triggers of bone erosion in the joints in rheumatoid arthritis is inflammation of the synovium, caused in part by the production of pro-inflammatory cytokines and receptor activator of nuclear factor kappa B ligand (RANKL), a cell surface protein present in Th17 cells and osteoblasts. Osteoclast activity can be directly induced by osteoblasts through the RANK/RANKL mechanism.
According to NHS, other types of arthritis and related conditions include:
- Ankylosing spondylitis – a long-term inflammatory condition that mainly affects the bones, muscles and ligaments of the spine, leading to stiffness and joints fusing together. Other problems can include the swelling of tendons, eyes and large joints.
- Cervical spondylosis – also known as degenerative osteoarthritis, cervical spondylitis affects the joints and bones in the neck, which can lead to pain and stiffness.
- Fibromyalgia – causes pain in the body's muscles, ligaments and tendons.
- Lupus – an autoimmune condition that can affect many different organs and the body's tissues.
- Gout – a type of arthritis caused by too much uric acid in the body. This can be left in joints (usually affecting the big toe) but can develop in any joint. It causes intense pain, redness and swelling.
- Psoriatic arthritis – an inflammatory joint condition that can affect people with psoriasis.
- Enteropathic arthritis – a form of chronic, inflammatory arthritis associated with inflammatory bowel disease (IBD), the two best-known types being ulcerative colitis and Crohn's disease. About one in five people with Crohn's or ulcerative colitis will develop enteropathic arthritis. The most common areas affected by inflammation are the peripheral (limb) joints and the spine.
- Reactive arthritis – this can cause inflammation of the joints, eyes and urethra (the tube that urine passes through). It develops shortly after an infection of the bowel, genital tract or, less frequently, after a throat infection.
- Secondary arthritis – a type of arthritis that can develop after a joint injury and sometimes occurs many years afterwards.
- Polymyalgia rheumatica – a condition that almost always affects people over 50 years of age, where the immune system causes muscle pain and stiffness, usually across the shoulders and tops of the legs. It can also cause joint inflammation.
Treatment of Arthritis
There's no cure for arthritis, but there are many treatments that can help slow down the condition.1) For osteoarthritis, medications are often prescribed, including:
In severe cases, the following surgical procedures may be recommended:
- arthroplasty (joint replacement)
- arthodesis (joint fusion)
- osteotomy (where a bone is cut and re-aligned)
- analgesics (painkillers)
- disease modifying anti-rheumatic drugs (DMARDs) – a combination of treatments is often recommended
- physiotherapy
- regular exercise
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