There are an estimated 350 million people living with arthritis worldwide. In Canada, there are more than 4 and a half million people living with some form of the inflammatory disease. There are more than 100 different forms of arthritis, though the most common include osteoarthritis, rheumatoid arthritis, psoriatic arthritis and gout. Even fibromyalgia can cause arthritis-related pain. While all types of arthritis cause pain, they differ based on the nature of the disease. For example, osteoarthritis is a degenerative form of the disease as a result of wear and tear on the joints, while rheumatoid arthritis is considered an autoimmune disorder that results in painful joints throughout the body. Below, Dr. Ghahary breaks down these and other forms of arthritis, including information on different treatment methods that may be beneficial.
First, we’ll start with osteoarthritis (also sometimes referred to as degenerative joint disease.) As mentioned, osteoarthritis is something that develops over time due to normal wear and tear on our joints due to the breakdown of cartilage. This breakdown is what leads to pain. While it can affect any joints, it commonly causes pain in the neck, lower back, knees, hips, and joints in the fingers. In addition to the breakdown of cartilage, bones can also breakdown, and you may also develop something known as bone spurs. Because osteoarthritis takes time to develop, it’s not typically a condition that is seen in younger individuals — though it is possible. However, it is more commonly seen in individuals over the age of 65. Along with age, other risk factors include weight (such as obesity), as well as if you are overusing your joints or have had any previous joint injuries. Genetics can also play a role. In order to determine whether or not a patient has osteoarthritis, Dr. Ghahary, a family physician, will often ask the patient a series of questions pertaining to their medical history, taking note of any medications they may be taking, as well as asking the patient to describe their symptoms and finding out whether or not the symptoms affect their daily lives. To further help in the diagnosis of osteoarthritis, Dr. Ghahary will also perform a physical exam to test range of motion and look for any areas that may be tender or swollen. Diagnostic testing, such as an MRI or X-ray, will also be ordered. When it comes to treating osteoarthritis, one of the best things you can do is stay physically active. Even something as simple as taking a short 20 or 30-minute walk around your neighbourhood has been shown to reduce pain associated with OA. If you are overweight, then weight management also becomes part of the treatment plan. Physical activity is essential for weight loss, as is eating healthy. By losing weight, you will be putting less stress on your joints and prevent further damage. In some cases, Dr. Ghahary may refer patients for physical and occupational therapy. Physical and occupational therapists can teach you the proper ways to use your joints as well as teach you different range of motion and flexibility exercises, and can show you how to use assistive devices (such as scooters, walkers, canes and splints.)
Rheumatoid arthritis is a condition that occurs when the body’s immune system mistakenly attacks the joints. With rheumatoid arthritis, the fluid that normally lubricates joints and gives us the ability to move them — known as the synovium — ends up thickening. This then results in inflammation, swelling and pain. Joints commonly affected by RA include the knees, ankles, feet, wrists, hands and elbows. It’s also considered a symmetrical condition; meaning that if your left wrist is affected, your right wrist usually is too. Rheumatoid arthritis tends to affect more women than men and can begin as early as age 30 all the way through age 60. While genetics can play a role, many people with rheumatoid arthritis do not have a family history of the disease. Other than an abnormal response of the immune system, the exact cause of rheumatoid arthritis is unknown. Along with painful joints, RA can affect other parts of the body, including the eyes, mouth, skin, lungs, blood and blood vessels. Things like dry eyes and dry mouth, gum irritation, lung scarring, and anemia can all occur if there are high levels of inflammation in the body as a result of RA. To diagnose rheumatoid arthritis, you will undergo a complete medical history as well as a physical exam, may require medical imaging tests, and will also need to have blood tests to check for certain antibodies. If it is suspected that you have rheumatoid arthritis, a patient will often then be referred to a Rheumatologist — a type of doctor who specializes in the diagnosis, care and treatment of individuals with RA.
In a recent article, Dr. Ghahary also touched on psoriatic arthritis and its link to psoriasis. In individuals with psoriatic arthritis, common symptoms include pain and stiffness of the joints, as well as possible joint deformity. The joints that are typically affected by psoriatic arthritis include the fingers and spine. Because there is no cure for psoriatic arthritis, treatment is solely based on focusing on reducing the symptoms that the patient is experiencing, such as pain.
Another condition that you may not be familiar with is reactive arthritis — previously referred to as Reiter’s syndrome. It is an inflammatory condition that can affect not just the joints, but also the eyes (causing redness, pain, irritation, and even blurred vision), the skin (causing a rash), the mouth (causing mouth sores), and even the urinary tract (causing things such as painful urination or the urge to urinate more frequently.) In the early stages of reactive arthritis, symptoms can be mild. They can also come and go. Reactive arthritis occurs when bacteria caused by other medical conditions, such as chlamydia (a sexually transmitted disease) or salmonella, enters the blood stream. There is no cure for reactive arthritis, so the goal is to reduce and manage the symptoms that are associated with it.
When it comes to reducing the symptoms (such as pain) that are associated with arthritis, analgesics and non-steroidal anti-inflammatory drugs (also known as NSAIDs) tend to be the go-to treatment. These can include acetaminophen, aspirin, ibuprofen, and naproxen. In severe cases, corticosteroids may also be prescribed, which can either be taken orally or given via injection and is administered directly into the affected joint(s).
For more information on arthritis, visit the Arthritis Society website at arthritis.ca. Patients living in British Columbia can also find more information via ArthritisBC+Me by visiting the website arthritisbcandme.info.
Originally published at alighahary.ca on October 11, 2018.