Arthritis Latest Facts: Causes, Types, Symptoms, Diagnosis, Treatment, and Complications

What is Arthritis?

Arthritis is a term commonly used to describe any inflammation and stiffness in an individual’s joints. Arthritis is a common condition in the elderly population and women. According to the Center Disease for Prevention and Control, between 2013-2015, over 50 million US individuals had arthritis.Arthritis Of The Knee

What are the types of arthritis?

There are many different types of arthritis, but the two most common types are rheumatoid and osteoarthritis.
Rheumatoid Arthritis is an autoimmune disease where the immune system attacks the membrane that surrounds joints, causing inflammation and can lead to the destruction of cartilage. It is mainly located in joints such as hands, wrists, knees, and ankles.

Osteoarthritis, usually caused due to the aging process, involves damage to the cartilage that can result in decreased range of motion and pain. It is mainly located in joints that are involved in increased movements such as knees and hips.

Other less common forms include:

  • Gout: Type of inflammatory Arthritis characterized by swelling and redness of the joint.
  • Juvenile idiopathic Arthritis: Type of childhood arthritis characterized by inflammation but unknown causes.
  • Reactive Arthritis: Type of Arthritis triggered by an infection in the body.
  • Psoriatic Arthritis: Type of Arthritis characterized by the autoimmune disease psoriasis.
  • Septic Arthritis: Type of Arthritis characterized by joint inflammation due to an infectious agent in the joint.
  • Thumb arthritis: Type of Arthritis characterized by pain and decreased range of motion in the thumb.

Signs and Symptoms of Arthritis

Common symptoms of arthritis include:

  • Inflammation
  • Stiffness
  • Redness
  • Fatigue
  • Restricted movement or pain during movement
  • Muscle weakness or pain

Due to arthritis impact on muscle movement, it has become one of the leading causes of disability worldwide. Arthritis can affect the individual’s ability to perform daily tasks, decrease the quality of life, and can eventually lead to long-lasting diseases such as obesity and cardiovascular problems. Arthritis can also lead to increased psychological issues, such as depression and anxiety.

Diagnosis of Arthritis

Diagnosis of Arthritis usually starts with a physical exam and family history. The physician examines the patient for any inflammation or redness. They will also ask the patient to conduct a series of movements to examine if there is any decreased motion in their joints.

Once the physical exam is completed, the physician can confirm the diagnosis through a series of tests that include both imaging and laboratory tests.

Laboratory tests include obtaining a sample and analyzing various types of fluids such as joint fluid, blood, and urine to identify the type of arthritis a patient might have. Imaging tests include x-rays, MRI, CT scan, or ultrasound.

For osteoarthritis, diagnosis usually made radiological changes such as narrowed joint space, local osteosclerosis, and subchondral cysts. In contrast, rheumatoid arthritis is diagnosed usually confirmed by both radiological changes of bone erosions and laboratory findings of anemia and elevated CRP and rheumatoid factor.

Treatment of Arthritis

Treatment of Arthritis depends on the type of arthritis. These treatments can be non-surgical or surgical treatment.

Non-surgical treatment includes medication and therapy; most common treatments include:

Medication: Painkillers, nonsteroidal anti-inflammatory drugs, steroids, disease-modifying antirheumatic drugs, and creams. The first go-to option for the treatment of osteoarthritis includes painkillers such as paracetamol. FDA approved treatment include injectables such as a drug named Zilretta used for knee pain. Currently, in 2020, the FDA has accepted a biologics application for tanezumab as a treatment for pain due to moderate to severe osteoarthritis. The FDA hopes to decide by the end of 2020 whether they will approve this drug. Tanezumab is a monoclonal antibody that targets nerve growth factors that inhibits pain signals from reaching the brain.  Treatment of rheumatoid Arthritis includes corticosteroids and antibodies. The drugs approved for the treatment of rheumatoid arthritis by the FDA include the class named Janus kinase inhibitors. Recently in August 2019, the FDA approved the drug upadacitinib (Rinvoq) that is used for the treatment of moderate to severe RA.

Surgical treatments include:

  • Joint repair: This procedure is minimally invasive, performed arthroscopically, and involves small incisions to realign joints in an attempt to help improve range of motion and reduce symptoms.
  • Joint fusion: This procedure is typically used to fuse smaller joins so they can heal.
  • Joint replacement: This procedure is invasive, used for extreme cases, and requires a long healing process. It involves removing and replacing the damaged joint with an artificial one.

There are other natural remedies that are commonly used but with little evidence to support their success in relieving symptoms. These remedies include:

  • Yoga
  • Acupuncture
  • Massage

Researchers continue to direct their efforts at newer alternative options for the treatment of arthritis. Although yet to fully demonstrate great success, these options include:

  1. Laser therapy: This type of therapy applies a low level of laser to the body as a way to relieve pain and stiffness.
  2. Pulsed electromagnetic field therapy: This type of therapy uses electromagnetic fields to improve the range of motion of joints. The FDA has yet to approve this for the treatment of arthritis; however, Health Canada has approved these devices for the treatment of pain linked to arthritis.
  3. Transcutaneous electrical nerve stimulation: This type of therapy uses electrical stimulation of nerves for pain relief in osteoarthritis.

Risk Factors associated with arthritis

Certain risk factors predispose individuals to arthritis. These include:

  • Age: Increasing age causes deterioration in the cartilage.
  • Sex: Women are at an increased risk compared to men of developing arthritis, specifically rheumatoid arthritis.
  • Increased body mass index: overweight or obese individuals cause increased stress on their joints and are more likely to develop arthritis.
  • Genetics: Family history of certain types of arthritis can predispose individuals to arthritis.

Complications of Arthritis

Generally, arthritis is not associated with life-threatening complications. However, in certain circumstances, severe arthritis can cause restricted movement and inability to perform daily tasks.

My opinion

Arthritis is a debilitating disease that is characterized by swelling, pain, redness, and decreased range of motion. There are many types of arthritis, but the most common are osteoarthritis and rheumatoid arthritis. Diagnosis of Arthritis is made by physical exam and can be confirmed through various laboratory or imaging findings. There are certain risk factors such as increased age, body mass index, previous family history, and sex that can predispose individuals to arthritis. Arthritis can take a toll on an individual’s physical health and mental health. These long term complications can lead to permanent disability. Therefore, it is essential for individuals to seek help when they can.

References

March L, Smith EU, Hoy DG, Cross MJ, Sanchez-Riera L, Blyth F, Buchbinder R, Vos T, Woolf AD (June 2014). “Burden of disability due to musculoskeletal (MSK) disorders”. Best Practice & Research. Clinical Rheumatology. 28 (3): 353–66. doi:10.1016/j.berh.2014.08.002. PMID 25481420.

Pirotta M (September 2010). “Arthritis disease – the use of complementary therapies”. Australian Family Physician. 39 (9): 638–40. PMID 20877766.

Ideguchi H, Ohno S, Hattori H, Senuma A, Ishigatsubo Y (2006). “Bone erosions in rheumatoid arthritis can be repaired through reduction in disease activity with conventional disease-modifying antirheumatic drugs”. Arthritis Research & Therapy. 8(3): R76. doi:10.1186/ar1943. PMC 1526642. PMID 16646983.

Deane, Kevin D.; Demoruelle, M. Kristen; Kelmenson, Lindsay B.; Kuhn, Kristine A.; Norris, Jill M.; Holers, V. Michael (February 2017). “Genetic and environmental risk factors for rheumatoid arthritis”. Best Practice & Research Clinical Rheumatology. 31(1): 3–18. doi:10.1016/j.berh.2017.08.003. PMC 5726551. PMID 29221595.

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