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Arthritis – its causes and management

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By Dr. Shekhar Srivastav, Orthopaedics

Arthritis can be defined as an inflammation of one or more of the joints with symptoms that include decreased range of motion, redness and swelling accompanied by stiffness and joint ache that may worsen with age. Rheumatoid arthritis and osteoarthritis are the most common types of this condition. In case of Rheumatoid arthritis, the immune system of the body initially targets the lining of the joints. Osteoarthritis causes a breakdown of the cartilage (the slippery hard tissue covering the ends of your bones forming a joint).

Causes and risk factors behind Arthritis:

  1. Family History: You could be indisposed to such a condition if arthritis runs in your family. Your genes may make you more vulnerable to those environmental factors that trigger arthritis.
  2. Age: The risk of any type of arthritis increases with age.
  3. Gender: Women are more susceptible to rheumatoid arthritis while men are mostly left vulnerable to gout, another medical condition characterized by sudden and severe soreness in the joints.
  4. Previous joint injury: A previous injury in the joint can make render you susceptible to arthritis of that particular joint. Generally, any injury sustained while taking part in any sporting activity or while lifting heavy weights is the most common type of such an injury.
  5. Obesity: Excessive body weight puts tremendous stress on the spine, knees and hips, thus increasing the possibilities of this condition even further.

Treatments and Management of Arthritis:

  • Medications:
    • Analgesics such as acetaminophen and hydrocodone are effective in easing the pain but not the inflammation.
    • Non-steroidal Anti-inflammatory drugs (NSAIDS) such as ibuprofen is used to control swelling and soreness.
    • Capsaicin or menthol creams are also administered to prevent the pain signals from reaching the brain, thus they work good with easing pain.
    • Disease-modifying anti-rheumatic drugs (DMARDs) cure rheumatoid arthritis by preventing the immune system from attacking the lining of the joint capsule (a tough membrane enclosing all parts of the joint).
  • Surgery: ?Surgeries considered for people who have severe rheumatoid arthritis include:?
    • Arthroplasty, to replace part or all of a joint, such as the hip or knee.
    • Arthroscopy, which uses a small lighted instrument to remove debris or inflamed tissue from a joint.
    • Carpal tunnel release, to relieve pressure on the median nerve in the wrist.
    • Cervical spinal fusion, to treat severe neck pain and nerve problems.
    • Finger and hand surgeries, to correct joint problems in the hand.
    • Foot surgery such as phalangeal head resection.
    • Synovectomy, to remove inflamed joint tissue.

Surgery should be considered if the need arises for a substitution of the affected joint with an artificial one, especially for the knees or the hips. In case of more severe arthritis of the wrists or fingers, doctors may opt for a joint fusion wherein the ends of the bones are locked together until they heal to become one.

  • Physical Therapy: A physical therapist teaches how to work out stiffness without further damaging your joint. Physical therapy also is useful after an injury, such as from a fall, and after joint surgery, especially for artificial joint replacement. The goal of physical therapy is to get a person back to the point where he or she can perform normal, everyday activities without difficulty. Physical therapists provide exercises designed to preserve the strength and use of your joints. They show you the best way to move from one position to another and also teach you how to use walking aids such as crutches, a walker or a cane, if necessary.