Arthritis: The Disease and Its Treatments

There are two types of arthritis which will be both discussed here. They are osteoarthritis (OA) and rheumatoid arthritis (RA). We will begin discussing osteoarthritis which is also known as degenerative joint disease. It is a slowly progressive disorder of articulating joints, and it is characterized of the articular cartilage. The symptoms of OA are joint pain, stiffness, and limited range of motion. The disease can have a wide range of severity, ranging from annoying and uncomfortable symptoms to significantly disabling disease. It is estimated that nearly one third of all adults over 60 years of age, have X-ray evidence of degenerative joint disease.

The primary cause of OA is basically unknown. But it is considered to be influenced by multiple factors such as metabolic, mechanical, genetical, and chemical factors. Also previous trauma, fractures, infection, or deformities can predispose a person to degenerative changes at a later age. The deterioration of cartilage in a joint that leads to OA is an active process that occurs over the span of several years. An enzyme found in the joint fluid may be responsible for eating away cartilage that has been cracked by an injury. Also inadequate supply of nutrients to the joint and particularly cartilage may result in cartilage degeneration. Specific predisposing factors such as excessive use or stress on a joint have been identified as accelerating OA, e.g., the knees of football players, and the feet and ankles of ballet dancers. The person normally experiences pain in a particular joint, pain occurs on motion and weight bearing, and is generally relieved by rest.

There is no specific treatment for osteoarthritis. The purpose of therapy is to reduce pain, prevent the progression of the disease, and restore if possible joint function. Acetaminophen is one of the most common choices of treatment. Topical creams containing capsaicin is sometimes used in combination with acetaminophen. Capsaicin is a substance found in chilli peppers, which has been found to block pain signals to the brain and thus decreasing the sensation of pain. These creams can be found in different strengths and must be used regularly for maximal effect. The second choice of treatment for OA, consist of non-steroidal anti-inflammatory drugs (NSAIDs). The long term use of NSAIDs is discouraged as they may produce negative side effects. So it is better to use them under the supervision of a medical professional. Osteoarthritis cannot be prevented, but reducing or eliminating stress on the joints and reducing body weight can greatly improve the symptoms.

Rheumatoid Arthritis (RA) is a chronic, systemic disease characterized by recurrent inflammation of a joint and its related structures. Sometimes a person develops rheumatoid nodules, experience nerve pain, and other symptoms. The person may experience periods of being free from pain and inflammation, and periods when the symptoms become worse. RA may occur at any age, it most often occurs in women of child bearing age. In the USA is considered a significant health problem because it affects close to 6 million people and also for its potential to cause chronic disability.

The cause of rheumatoid arthritis is unknown. It is also not clear if a single of multiple factors are involved in triggering the disease. Scientists continue to investigate the possibility of specific pathogens triggering the process. There is the strong possibility of autoimmune factors triggering the process. An abnormal change in the joint may trigger the body to attack itself (e.g., the joint tissue), as it is the case in some people with diabetes genetic factors have been linked to may diseases and may well influence the expression of RA. It has also been speculated that metabolic and biochemical abnormalities, nutritional and environmental factors may play a role in the cause of the disease.

Rheumatoid arthritis is known to progress through four stages. In the first stage, the unknown agent causes inflammation of the joint. The swelling of the membrane inside the joint causes the production of excess fluid within the joint. In the second stage inflammatory granulation tissue is formed at the juncture of the bone and cartilage within the joint. At the third stage, the granulation tissue becomes to be replaced by tough fibrous tissue. There is also a significant decrease in joint motion, and deformity of the joint also occurs. At the final stage of the disease, the tough fibrous tissue becomes calcified, almost bone like and total joint immobilization may occur. The initial symptoms of RA are nonspecific such as fatigue, poor appetite, weight loss, and some generalized discomfort and stiffness may occur. The stiffness eventually becomes more localized after weeks to months. The individual characteristically has joint stiffness on arising in the morning, and after periods of inactivity. The stiffness usually begins to disappear 30 minutes or more once the person begins moving again.

The treatment of choice of RA has been high doses of aspirin and Non steroidal Anti-inflammatory drugs (NSAIDS). It is believe that the erosive destructive process of the disease begins within the first two years of the illness. Recently many rheumatologists have begun using a disease-modifying agent such as methotrexate. A disease modifying agent is a drug that has the potential to lessen the permanent effects of RA such as joint deformity. The damaging effects of the disease may be prevented, or postponed. The exact time to introduce the disease-modifying agent varies amongst health professionals. Some patients may not respond to methotrexate, so they may be started on Gold Therapy. Gold has anti-inflammatory action. It is usually given in weekly injection for up to 5 months, then once or twice a month to maintain its therapeutic effects. Gold therapy often causes minor side effects, such as skin rashes, mouth sores, and diarrhea. There is no special diet for RA. However, a well balanced diet is always recommended.

There are many alternative treatments and techniques available to relieve the symptoms of arthritis. At this time there is no cure for either type of arthritis. Some of the alternative treatments for arthritis include; cold therapy, acupuncture, exercise therapy, heat therapy, imagery and meditation. Cold therapy has been known to relieve the pain associated with arthritis flare-ups. Some doctors believe that cold can be such a powerful pain killer that it reduces the need for painkilling drugs. Patients who place cold packs on arthritic joints at intervals throughout the day seem to have less pain and may rely less on pain killing medications. On the other hand; heat therapy can be used to relieve painful muscle spasms and stiff joints. Applying heat to a stiff joint helps to relax muscles and joint tissue and brings a rush of healing blood to damaged tissue. A warmed-up muscle can also help thaw out joint stiffness, helping arthritis sufferers move more freely. "Heat increase the flexibility of the muscles and soft connective tissue around joints and it also relieves nerve sensitivity," says John Arbruzzo, M.D., director of the Division of Rheumatology at Thomas Jefferson Hospital in Philadelphia. Studies show that by widening the blood vessels, heat draws a greater volume of blood to inflamed or infected tissues. In acupuncture 10 - 20 needles may be inserted at a time. Traditional Chinese acupuncturists believe that acupuncture helps facilitate the flow of energy of the body. This helps relax muscles and increase circulation. Many acupuncturists estimate that acupuncture brings 50 to 70 percent improvement in many cases of chronic pain such as in arthritis.

Balm of Gilead, a resinous, sweet smelling herbal remedy was well known for its healing powers in the Middle East for thousands of years, it's been used for rheumatic arthritis and muscle soreness. The topical balm helps improve circulation, as the circulation increases the area gets warm, bringing a feeling of pain improvement. In India ginger has a reputation as an anti-arthritis spice. Researchers speculate that ginger consumption may reduce the amount of prostaglandins, substances that play a role in joint inflammation. In the West ginger is better known for its ability to help settle an upset stomach and relieve dizziness, so use with caution or ask a health professional. Oil of wintergreen has the unique ability to feel your skin hot and cold at the same time. Deep-penetrating rubs with oil of wintergreen, are used for temporary relief of arthritis and minor aches and pains. Music therapy, deep breathing and meditation are alternatives methods that when used in conjunction with other treatments can help reduce stress and pain associated with arthritis or other ailments. These methods help your mind focus on other things besides your aches muscles and joints.

As we have learned here arthritis can range from annoying aches and pains to a highly debilitating disease. There are several measures you can take to relive the symptoms. In case of severe illness, splints at night might be useful to help support and protect a joint with active disease. Ask your doctor for more advice. Some people use gloves at night to retain heat and thus minimize joint stiffness and pain. Relieve pain with heat, including hot soaks, heat pads, heat lamps, or whirlpool, use electric blankets with caution as they may pose a fire hazard. Remain as active as you possibly can, but include daily rest periods. Sleep for eight to ten hours each night, don't become overtired. When able, exercise actively to preserve strength and joint mobility. Build slowly to the amount suggested by your doctor. Exercise disabled joints passively to help prevent contractures. Eat a normal balanced diet. Avoid arthritis diet fads, which are common. Try to lose weight if you are overweight, obesity stresses the joints. Always ask your doctor before trying any new products or treatments.