Arthritis

20th February, 2009 - Posted by ross -

X-Ray of an arthritic joint

Arthritis, a common condition affecting many people of all ages, essentially means disease of/or damage to the joints. In the past, however, the word rheumatism was more widely used to describe any pain in or around the bones, muscles and joints. But nowadays, doctors are less likely to use the term rheumatism and are more likely to refer more specifically to the area of symptoms, such as low back pain or hip pain. It is important to note that joints themselves are not the only cause of arthritic-type symptoms and disorders affecting the soft tissues, muscles and tendons may also be symptomatic. The term “musculo-skeletal conditions” or “rheumatic-type disease” is sometimes used to refer to all types of arthritis and other problems with muscles, bones or joints.

There are several different types of joint disorder or arthritis, the most common being osteoarthritis, sometimes referred to as a “wear and tear” or degenerative disease. Essentially osteoarthritis occurs where the cartilage becomes damaged, irregular and thinned and new bone can form at the joint margins as an attempted reparative process. In the X ray diagram above, the right hand side of the knee joint has significantly less space between the bones than the left hand side i.e. the joint space on the right side is markedly narrowed. This space is where the cartilage would normally be found.
The symptoms of osteoarthritis include
• Deep aching joint pain that gets worse after exercise or putting weight on it and is relieved by rest
• Grating of the joint with motion
• Joint pain in rainy weather
• Joint swelling
• Limited movement

One significant cause of osteoarthritis is a result of abnormal stress on the joint, for example, from repetitive and excess use over a prolonged period of time, whilst another cause is injury, which may have seemed innocuous at the time by the patient. Sadly perhaps, osteoarthritis can also occur as a primary joint problem without any known obvious cause. And whilst the joints most commonly affected by osteoarthritis are the hip, the knee and the hands, the disease can occur in any joint.

Another relatively common form of arthritis is inflammatory arthritis, though less common than osteoarthritis. This occurs where the lining of the joint, the synovium, becomes inflamed and can result in damage to the surface of the joint and the underlying bone itself. Many joints are usually involved. Rheumatoid arthritis is the most common but other arthritides falling under this heading include gout, ankylosing spondylitis, arthritis associated with psoriasis, arthritis associated with polymyalgia rheumatica. There are also a number of other inflammatory disorders under this heading.

Interestingly perhaps, pain around joints is not always caused by problems actually within that specific joint. Inflammation, often due to sports related or repetitive stress injuries affecting tendons and ligaments about the joint may result in localised pain. Similarly, there can be referred pain from another arthritic joint, for example, knee pain caused by referral from an arthritic hip joint.

Osteoarthritis and the various forms of inflammatory arthritis can also affect the back(spine).

Treatments and Surgery

Complementary and alternative medicines for arthritis include acupuncture, homoeopathy, manipulation from chiropractors and osteopaths, and hydrotherapy. These therapies work alongside conventional medicine, but are not currently considered part of evidence-based Western medicine.

Currently, there are two main groups of complementary and alternative therapists: those who are legally registered and those who are not. Osteopaths and chiropractors, for example are legally recognized professionals just like doctors. Acupuncturists and herbalists, however, are only just in the process of becoming legally registered. And remember if buying herbal treatments from an online chemist, for example www.sykeschemists.co.uk, always make sure of the quality and provenance of the product, i.e. not poor imitations. Further alternative medical practitioners include occupational therapists and specialist rheumatology nurse practitioners.

The need for surgical intervention depends on multiple factors. Factors to be considered include the nature of the underlying disease process, the severity of symptoms, and the response to conservative (non-surgical) treatments. Joint replacement can be undertaken for almost any joint but currently is most commonly done for severe hip and knee arthritis.

Drug Information

In the early stages of arthritis symptoms may be managed by alteration of lifestyle, avoiding activities that precipitate symptoms. Pain may be controlled by occasional use of analgesics such as Paracetemol. Non-steroidal anti-inflammatory drugs such as Ibuprofen may also be helpful although some people find that these produce stomach upset as a side effect. Most other drugs used for relief of symptoms or for the active management of the arthritic condition will be available on prescription only. These are some of the more common drugs available from your GP, via an online chemist if appropriate, that are used to treat the various forms of arthritis -

Adalimumab; Azathioprine; Cyclosporin; Cyclophosphamide; Etanercept
Gold by intramuscular injection; Hylauronan injections; Hydroxychloroquine; Iloprost; Intravenous immunoglobulin; Infliximab;
Leflunomide; Methotrexate; Mycophenolate

Non-steroidal anti-inflammatory drugs include Pamidronate; Rituximab, plus there are local steroid injections, steroid tablets and Sulfasalazine
available.

Useful addresses include:

The Arthritis Research Campaign (arc)
PO Box 177
Chesterfield
Derbyshire S41 7TQ
Phone: 0870 850 8000
www.arc.org.uk

Arthritis Care
18 Stephenson Way
London NW1 2HD
Phone: 020 7380 6500
www.arthritiscare.org.uk

nras (National Rheumatoid Arthritis Society)
Unit B4 Westacott Business Centre
Westacott Way,
Littlewick Green
Maidenhead SL6 3RT
Phone: 0845 458 3969
Helpline (freephone): 0800 298 7650
www.rheumatoid.org

DialUK (Disability Information and Advice Line)
St Catherine’s
Tickhill Road,
Doncaster
South Yorkshire DN4 8QN
Phone: 01302 310123
www.dialuk.org.uk

RADAR (Royal Association for Disability and Rehabilitation)
12 City Forum,
250 City Road,
London EC1V 8AF
Phone: 020 7250 3222
www.radar.org.uk

Disabled Living Foundation (DLF)
380-384 Harrow Road
London W9 2HU
Phone: 020 7289 6111
Helpline: 0845 130 9177
www.dlf.org.uk