Arthritis

Arthritis is the general name for a number of conditions causing problems with the joints between bones. The affected joints get irritated, inflamed and often damaged. This causes pain, stiffness, and other symptoms depending on the kind of arthritis. 

There are many kinds of arthritis. Not all are serious. There is no cure for most forms, but they are manageable conditions. You can get a great deal of relief from symptoms. With the right help and information you can improve your quality of life to a remarkable degree. 

Don’t just accept arthritis pain and limitations as part of ageing. If you have any ongoing pain, stiffness or swelling in joints, talk to your doctor . Do not hesitate. It is absolutely essential to find out which arthritic condition you have. There are other conditions with similar symptoms, and some forms of arthritis must be treated medically without delay. See your doctor as a first step to prevent more serious and unnecessary damage to your joints, general health and happiness. All forms of arthritis are manageable once you know which one you’ve got. 

Arthritis can actually be an opportunity to improve many aspects of your life. Exercise and increased fitness can become a relief and a pleasure, not a chore. Your mobility and functionality can be increased. Your pain can be controlled (and see our pages about “Chronic Pain” for this). You can gain greater peace of mind. Almost every aspect of life can be improved by learning how to deal with arthritic conditions. We hope you’ll find it possible to do these things and more using this site. You may be surprised at how much better things can get. 

The different kinds of Arthritis are mostly caused by: 

• damage, wear and tear of the joint. 
• autoimmune disease (our own protective immune system becoming over-active) 
• an infection 

Osteoarthritis is the “wear and tear” most common form of arthritis. Most of us will have it to some degree as we get older. Damaging wear, stress or injury to a joint is a principal cause, and there may also be hereditary and other factors. The joints most often affected are the knee, hip, great toe, fingers, lower back and neck.

In osteoarthritis the cartilage padding where bones join is worn. There is less padding, space and lubrication for free movement between bones. Scraps of cartilage may break off and clog the joint. As the cartilage wears away the bones may start to change shape from the stress, and eventually bone can grate against bone. These changes all irritate and inflame the joint and prevent it from moving normally. The result can be pain, swelling, stiffness, deformed joints, and other symptoms if nerves or blood vessels are compressed or irritated – especially in the neck and spine. 

With osteoarthritis: 

• joint pain increases as you get tired or when the joint is strained.
• joints stiffen up after a long rest or a night’s sleep.
• getting moving again loosens things up.
• pain and limited movement can make it difficult to function. 

Osteoarthritic joints respond very well to the right forms of exercise. Learning how to use them better and with less strain is important. Improving the muscles around the joints can make all the difference. You can do this whatever your age or state of health. Seeing a physiotherapist is an ideal way to start. Under Self-Help for Arthritis we provide information about exercise, including a wide variety of complementary movement techniques and physical therapies. There are many forms of inflammation and pain relief available for osteoarthritis. Medical treatments from symptom relief through to the replacement of severely damaged joints can be very effective and are always the place to start. That said, Self-Help options which complement the medical approach can work extremely well. Click on our For Arthritis Help list, Complementary Techniques and Therapies Guide and HIT list to find a wide range of options. 

We must take care not to underplay the problems arising with this condition. The symptoms of severe osteoarthritis can be debilitating, chronically painful, and can make it difficult or impossible to carry on life as before. Medical help on the NHS and social care may also not be as good in practice as it is in theory and as we describe it. Nevertheless this is a manageable condition, and we should not be shy about seeking all the help we need to deal with it. 

Rheumatoid Arthritis (RA) is actually an illness, an autoimmune disease. Your immune system becomes overactive. It attacks the lining of joints, causing pain, swelling, and stiffness that lasts for hours. Many joints may be affected at once. Because RA is an illness, you may suffer from fever, tiredness and loss of appetite as well as difficulty in moving. 

RA can affect almost any joint. If the disease becomes severe it can also affect your eyes, skin, lungs and other organs. There is no cure yet, but there are very good drugs to keep the condition under control. The disease has periods of “flare-ups” and periods where symptoms ease off. Getting ill with something else can bring on a flare-up. So can stress. Proper medical treatment can control the flare-ups, and there can be very long periods with far less symptoms. 

The anti-inflammatory drugs and painkillers which help with osteoarthritis are also effective for RA symptoms. Steroids can be very effective. To control the actual disease there are “disease modifying anti-rheumatoid drugs” (DMARDS). Treatment of Rheumatoid Arthritis and the similarly autoimmune Sjögren’s Syndrome has come a long way. With medical help, and using the information and resource links you’ll find on this site, you can stay independent and live a full life. 

Gout is one of the most painful forms of arthritis. It is far more common in men than women, but can affect either sex. An attack can begin when crystals of uric acid form in a joint. Uric acid is produced by the natural breakdown of chemicals called purines which we all have in our cells. Gout sufferers have an inherited tendency to turn purines into a lot of uric acid. Gout attacks usually affect the great toe, but can sometimes also affect other joints, the kidneys and skin (white secreting lumps or ‘tophi’). An attack is extremely painful and anything touching the joint may be unbearable. The good news is that the attack will go away in a matter of a few days up to a week. There may be very long periods between attacks. 

Gout attacks are severe, so we probably won’t need to encourage you to see your doctor. You’ll want to know what’s going on. As with the other arthritic conditions, medical help is effective. Your doctor can supply anti-inflammatory drugs. An old-fashioned drug called Colchicine is also used. Your doctor has to balance treatment against side-effects, but these treatments work. Having them with you in case of an attack can make a big difference. If you have several attacks in a year your doctor may also prescribe a daily tablet to help control the condition. 

Diet may or may not be of some help for other arthritic conditions. For Gout, diet is vitally important. You need to drink lots of water and not get dehydrated. Be moderate with alcohol. Learn which foods have high purine levels and try to avoid them. These include red meat, shellfish, liver and kidneys, dried beans, peas, sardines, anchovies, gravy… Aspirin and some blood pressure medicines must also be avoided. Your doctor will give you clear advice about these things. Start with our For Arthritis help list for any other information you need. 

Other forms of Arthritis: There are over 200 conditions involving inflammation of the joints. Osteoarthritis, Rheumatoid Arthritis and Gout are by far the most common. 

Other forms of arthritis include: 

Spondylosis – arthritic changes in the spine. Almost all of us over 50 have some of this, and it will show on an x-ray. Causes and treatment are pretty much as for osteoarthritis. 

Ankolysing Spondylitis (AS) – If you inherited an unusual tissue type called HLA-B27 you could suffer from this condition. If you have a parent or sibling with Ankolysing Spondylitis you are in a high risk group. Main symptoms are pain and stiffness in the lower back and hips. Symptoms are worst in the morning. If not dealt with, the whole spine can become stiff. Eventually it can curve and lock up. Sometimes the eyes can also become inflamed. This can and must be treated by an ophthalmologist. 

Physiotherapy is the main treatment for AS. Physio is brilliant for all forms of arthritis, but particularly vital for this one. The right daily exercise is vital. As with other forms of arthritis, drugs can also help with the pain and discomfort from stiffness. 

Psoriatic Arthritis can sometimes affect people with the skin condition psoriasis. It’s not a Rheumatoid Arthritis, but it has similar symptoms. An indicator in many people with PA is that their nails become pitted and chalky. Lower back pain can also be a symptom. Like with most forms of arthritis, anti-inflammatory drugs and exercise can make all the difference. If PA is severe it may be treated with many of the same drugs as Rheumatoid Arthritis. 

Polymyalgia Rheumatica is painful and not unusual for those of us over 50. It comes with very painful shoulders and hips, especially in the morning. Moving in bed can be difficult. You may feel depressed, unwell, lose weight, and possibly have a fever. Not nice, but diagnosis and treatment with steroids can stop these problems almost immediately. 

Reactive Arthritis and others:

Reiter’s Syndrome: joints become painful and swollen in reaction to an infection. Can include eye inflammation and a rash on the soles of the feet. Inflammatory Bowel Disease can also cause joint inflammation. In these cases the disease itself must be treated. Symptoms may be controlled 
as with other arthritic conditions. There are a number of reactive conditions. Diseases like Lupus, and bacterial, fungal and viral infections, can also cause arthritic symptom reactions. 

There are many other conditions causing joint pain and problems. Once again, never accept arthritic symptoms. Always go to your doctor to find our what’s causing them. You may have a condition which can and must be cured. 

In general, arthritic conditions are manageable. Your quality of life can be improved. The following texts, our For Arthritis Help and our HIT list, and our pages on Chronic Pain should provide much of what you need to know.