Arthritis is not a single disease, but rather a term used to describe joint inflammation. It encompasses over 100 different conditions that affect joints, surrounding tissues, and connective tissue. With symptoms ranging from pain and stiffness to severe joint deformities, arthritis significantly impacts quality of life.
What Is Arthritis? Definition and Overview
Derived from the Greek words "arthro" (joint) and "itis" (inflammation), arthritis literally means joint inflammation. It may result from degenerative changes, metabolic disturbances, autoimmune conditions, or infections. The most common types include osteoarthritis (OA) and rheumatoid arthritis (RA).
Common Symptoms of Arthritis
- Persistent joint pain
- Morning stiffness
- Swelling and redness
- Decreased range of motion
- Joint deformity (in advanced stages)
- Fatigue and general malaise (especially in autoimmune types)
Major Causes of Arthritis
- Autoimmune reactions (e.g., RA, lupus)
- Degenerative wear and tear (e.g., OA)
- Metabolic disorders (e.g., gout, pseudogout)
- Infections (e.g., septic arthritis)
- Genetic predispositions
- Injury or trauma to joints
Types of Arthritis
1. Rheumatoid Arthritis (RA)
- A chronic systemic autoimmune disease
- Causes symmetrical joint inflammation, commonly in small joints
- Features: pannus formation, ulnar deviation, swan-neck and boutonniere deformities
- Extra-articular symptoms: anemia, nodules, vasculitis
- Treatment: DMARDs, biologics, NSAIDs, corticosteroids
2. Osteoarthritis (OA)
- A degenerative joint disease
- Caused by mechanical stress leading to cartilage breakdown
- Common in elderly and weight-bearing joints
- Radiologic features: joint space narrowing, osteophytes, subchondral cysts
- Treatment: weight loss, physiotherapy, NSAIDs, joint replacement
3. Gout
- Metabolic arthritis due to uric acid crystal deposition
- Affects the big toe (MTP joint) most commonly
- Acute attacks: sudden pain, swelling, redness
- Management: colchicine, NSAIDs, allopurinol, febuxostat
4. Psoriatic Arthritis
- Linked to skin psoriasis
- Affects fingers, toes, and spine
- Can cause joint damage and disability
- Treatment: NSAIDs, DMARDs, immunotherapy for skin
5. Ankylosing Spondylitis
- Affects axial skeleton (spine, sacroiliac joints)
- M>F, presents with back pain and stiffness
- HLA-B27 positive in most patients
- Treatment: NSAIDs, DMARDs, TNF inhibitors, physiotherapy
6. Reactive Arthritis (Reiter’s Syndrome)
- Triggered by infections (e.g., Chlamydia, Salmonella)
- Classic triad: arthritis, conjunctivitis, urethritis
- HLA-B27 positive in 65%
- Treatment: NSAIDs, doxycycline, DMARDs if persistent
7. Haemophilic Arthritis
- Repeated bleeding into joints (haemarthrosis)
- Leads to synovitis and cartilage destruction
- Common in weight-bearing joints
- May need joint replacement
Key Differences Between RA and OA
| Feature | Rheumatoid Arthritis | Osteoarthritis |
|---|---|---|
| Cause | Autoimmune | Mechanical wear and tear |
| Onset | Ages 15-45 | >50 years |
| Joint involvement | Symmetrical, small joints | Asymmetrical, large joints |
| Morning stiffness | >1 hour | <30 minutes |
| Extra-articular | Common | Rare |
How Arthritis Affects the Joints
- Synovial inflammation leads to pannus formation (RA)
- Cartilage breakdown exposes bone (OA)
- Crystals damage synovial membrane (Gout)
- Ligament laxity and fibrosis reduce mobility
Diagnostic Investigations for Arthritis
- Blood tests: ESR, CRP, RF, anti-CCP, ANA
- Joint aspiration for crystal identification
- Imaging: X-rays, MRI, ultrasound
- Bone densitometry in suspected osteoporosis
Stages and Progression of Arthritis
- Early stage: Pain, mild stiffness
- Moderate stage: Joint damage, reduced ROM
- Severe stage: Deformity, disability, joint fusion
Effective Treatments for Arthritis
Non-Pharmacological
- Physiotherapy, hydrotherapy, exercise
- Weight loss, heat/cold therapy
- Splints, braces, ergonomic aids
Pharmacological
- NSAIDs: Pain and inflammation relief
- DMARDs: Slow disease progression (e.g., methotrexate, sulfasalazine)
- Biologics: TNF-alpha inhibitors, IL blockers
- Steroids: Bridging therapy or flares
Surgical
- Arthroscopy: Remove debris, smooth cartilage
- Osteotomy: Realign bones
- Arthroplasty: Joint replacement
- Arthrodesis: Joint fusion
Lifestyle Modifications to Manage Arthritis
- Anti-inflammatory diet (rich in omega-3s)
- Avoid alcohol (especially in gout)
- Stay physically active
- Stress management and sleep hygiene
Prognosis: Can Arthritis Be Cured?
- Most types are chronic and progressive
- With early diagnosis and proper treatment, function can be preserved
- Surgery offers long-term relief in advanced case
FAQs About Arthritis
Q: Can young adults get arthritis?
Yes, types like RA, lupus, or juvenile arthritis affect younger individuals.
Q: Is cracking joints bad for arthritis?
No definitive evidence links joint cracking to arthritis.
Q: What foods worsen arthritis?
Processed foods, sugar, and red meat may worsen inflammation.
