Active Living With Arthritis

Posted: 06. 01. 2018 | Author: admin | Category: Fitness, Health

Arthritis is the inflammation of bones and joints in our body, and is the top cause of disability and immobility affecting a whopping 25% of the global population. Many may not realise that arthritis is just a generic description of not a single disease, but a group that comprises greater than 100 rheumatic diseases and conditions that can cause pain, stiffness, swelling and decreased range of motion in the joints.

Greater than 50 million adults and 300 thousand children are living with some form of arthritis. It occurs more with women, and the likelihood increases with age and for those who are overweight. If left undiagnosed and untreated, arthritis can cause irreparable damage to the joints…

In this modern medical age, arthritis continues to increase in actual volume and symptoms, mainly due to higher longevity and active lifestyles. More than $ 8 billion is spent each year on drug treatment.

Nowadays, arthritis is being more actively treated, as greater emphasis is being placed on improving the treatment of the chronic diseases for better quality of life.

Types, Symptoms And Causes Of Arthritis

Arthritis conditions may affect various parts of the body including muscles, bones, and some internal organs like heart, eyes and lungs, and can result in incapacitating complications. The different types of arthritis range from the commonly known Rheumatism, Osteoporisis, to those which you may not have associated with arthritis like Inflammatory Bowel Disease (enteropathic arthritis) which involve a chronic inflammation of some part of the digestive tract. (1)

Below focuses on the 2 best known forms of Arthritis that afflicts many :

Rheumatoid Arthritis. Rheumatoid arthritis is an immunological disease characterized by inflammatory arthritis of peripheral small and large joints and associated with a number of other symptoms.

Someone with rheumatoid arthritis will experience joint pain, tenderness, swelling or stiffness for six weeks or longer, particularly in small joints (wrist, hands, or feet), where morning stiffness lasts for 30 minutes or longer. The symptoms may come and go, and a flare may last for days or months.

Along with pain, many may feel tired or experience a loss of appetite due to inflammation of the immune system, and may also become anemic (reduction of red blood cell count), or have a low-grade fever.

Rheumatoid arthritis is known to afflict approximately 2% of world’s population, with the common inflammatory arthritis at about 10%. 2 to 3 times more women are affected by rheumatoid arthritis than men, and symptoms can start as early as the childhood years, causing life-long aches and suffering.

The cause of rheumatoid arthritis is not fully understood yet, although doctors do know that it is an abnormal response of the body’s immune system to attack the tissues of the body. It is not known for sure why the immune system goes askew, but there is scientific evidence that genes, hormones and environmental factors are involved. Such immune system attacks will affect the synovium, which is a soft tissue in your joints that produces a fluid that nourishes the cartilage and lubricates the joints. Severe rheumatoid arthritis can lead to joint deformity if it is left untreated.

Osteoarthritis. Osteoarthritis, also known as degenerative joint disease, is the most commonest form of arthritis and is reported to affect greater than 25% of world’s population. It occurs mostly in knees, hips, lower back, neck, small joints of fingers and bases of the big toe and big thumb.

Cartilage covers the end of each bone and provides a smooth, gliding surface for joint motion and acts as a cushion between the bones. Osteoarthritis occurs when this protective cartilage wears down over time.

Initially, osteoarthritis is non-inflammatory and its onset is usually subtle and gradual, and affecting only the joint cartilage of one or only a few joints. Pain is the earliest symptom, and tends to get worse towards end of the day and with activity. Mild stiffness usually sets in when the joints have rested (“gelling”), therefore if you have been sitting still for some time, your hips and knees may feel stiff upon standing again.

As osteoarthritis worsens over time, the bones may break down and develop growths called spurs, and cartilage and bones may also chip off and float around the joint. An inflammation can occur which further damage the cartilage, and in the advanced stage of osteoarthritis, the cartilage wears away and bone rubs against bone leading to joint damage and more pain.

Similar to rheumatoid arthritis, osteoarthritis affects more women than men, and increases in likelihood with weight gain and increasing age. Those with previous joint injuries from accidents or sports have increased risk of osteoarthritis even if the injury has seemingly healed. Risk of developing osteoarthritis may also be increased by a family history of the disease, and those who have repetitive use of certain joints.

Diagnosis Of Arthritis

A great first step is to consult your primary care physician, who will review your condition to screen for various potential causes, to rule out other potential diseases or afflictions which may resemble arthritis. Your primary care physician may then refer you to a specialist or a rheumatologist – a specialist with specific training and skills to diagnose and treat rheumatoid arthritis.

In its early stages, rheumatoid arthritis may resemble other forms of inflammatory arthritis. Since there is no single test that can confirm rheumatoid arthritis, the rheumatologist will ask questions, perform physical examination and perform further diagnostic tests to make their determination.

Diagnostic tests can include blood tests, X-rays, Magnetic Resonance Imaging (MRI)/ultrasound scans, joint aspiration to obtain joint fluid sample to determine the type of arthritis since there are different types of treatments for different types of arthritis.

Blood tests typically include a full blood count, vitamin D level, and checks for specific types of antibodies like anti-CCP (anti-cyclic citrullinated peptide), RF (rheumatoid factor), and ANA (antinuclear antibody).

For osteoarthritis, the degenerative effects on the bones of the joint will show up clearly on the X-ray including cartilage loss, narrowing of space between the joint, subchondral sclerosis, cyst formation and bone spur formation.

Treatment For Arthritis

There is no cure for arthritis, and its damage is irreversible. The main objective of treatment is to reduce the amount of pain and prevent additional damage to the joints. Each individual will have different responses and preference to exercise pain control — some people find that heating pads and ice packs are soothing, others use mobility assistance devices, like canes or walkers, to help take pressure off sore joints.

Strengthening your joint function is also important. Your doctor may provide you a combination of various treatment methods to achieve the best results :

1. Medication – there are several types of medication to treat arthritis:
   • Analgesics – such as acetaminophen (Tylenol), are effective for pain management, but they do not decrease inflammation. Acetaminophen is inexpensive and a safe arthritis pain reliever when taken correctly, but be careful that adults should not take more than 3,000 milligrams of acetaminophen in a day to avoid liver damage. There are stronger types of pain medications called narcotic analgesics, which are available by prescription (include codeine, hydrocodone, and oxycodone). Although narcotics are effective in treating moderate to severe arthritis pain, they have side effects like nausea, constipation, dizziness, and drowsiness. Some people build tolerance to narcotic drugs, leading to the need for an increased dosage, and it can also be habit-forming
   • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) and salicylates, help to control pain and inflammation. NSAIDs are available over the counter and by prescription. Salicylates can thin the blood, so they should be used cautiously especially when used in conjunction with blood thinning medications. NSAIDs can increase the risk of heart attack or stroke, especially in higher doses. They can also cause kidney and liver problems as well as stomach issues in some patients, including ulcers with serious stomach bleeding. Taking the medicine with food is strongly advised.
   • Menthol or capsaicin creams can help to block the transmission of pain signals from your joints.
   • Immunosuppressants like prednisone or cortisone can help reduce inflammation.
   • For rheumatoid arthritis, doctor may put patients on corticosteroids or disease-modifying antirheumatic drugs (DMARDs), which suppress your immune system.
   • There are also many other medications available over the counter or by prescription to treat osteoarthritis. An example of one such supplement that is recommended by my rheumatologist is Artrex. Artrex is a ayurvedic supplement that comprises all natural herbal extracts that is manufactured and patented by a Pharmaceutical company Bioved Pharma, and is clinically validated to be safe and effective in published clinical trials. Many sportsmen have extended several years of their sports life by effectively managing joint pains with Artrex.
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2. Surgery – Joint pain and stiffness may become severe enough to make daily tasks difficult, and some people are no longer able to work. When joint pain is this severe, doctors may suggest joint replacement surgery.
   • Arthroscopy: A quick surgery where the surgeon inserts a pen-sized flexible tube with fibre-optic videocam (arthroscope) inside your joint to smooth rough spots, or remove cysts, damaged cartilage, or bone fragments from inside. Studies have shown that arthroscopic knee surgery has limited uses since procedure seems to be effective only for very specific injuries e.g., if you have a knee that locks up when you try to play a sport, but is less successful for treatment of osteoarthritis.
   • Total joint replacement (arthroplasty): The diseased parts of your bones is replaced with an artificial joint using metal or plastic parts. Total joint replacement usually reduces pain dramatically and is able to improve quality of life. Artificial joints will wear out over time and may need replacement in about 20 years.
   • Osteotomy: Bone near a damaged joint is cut or a wedge of bone is added to realign your leg or arm and remove pressure. It is a difficult surgery and it may not be as effective in relieving pain as joint replacement surgery.
   • Joint fusion: Pins, plates, screws, or rods are used to join two or more bones to make one continuous joint. Over time, the joints will fuse together. This surgery will usually last a lifetime and should reduce your pain. But, it eliminates mobility and flexibility and can put stress on other joints. That can cause osteoarthritis to spread to other parts of your body.
3. Physiotherapy – Most arthritis sufferers reduce their daily movements in response to pain and stiffness, which leads to weakening of the muscles and ligaments around their joints and exacerbation of the problem. Physiotherapy is needed to build up the strength in the surrounding muscles so that they can hokd up the joint better to lessen the strain on the joint. The physiotherapist can provide custom fitted splint for proper rest and maintain joint alignment to prevent deformities from getting any worse. The therapist can also teach you methods of joint protection and energy conservation techniques that can be used daily to prevent excess stress on your joints. Joint protection techniques will require changes in old habits which will take time, patience and dedication. For example :
   • If arthritis occurs in the fingers, you should avoid tight gripping with fingers of a jar cap, and open by either using your palm to press against the cap or use an assisted cap opener, example of a commercially available automatic jar opener.
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   • If arthritis occurs in the hand and it is hard to turn taps, replace with longer tap handles where you can use your arms to turn the taps.

Lifestyle Changes To Improve Quality to Life

Osteoarthritis symptoms can usually be effectively managed with various lifestyle changes even if the underlying damage cannot be reversed. Staying active, maintaining a healthy weight and other treatments may slow progression of the disease and help improve pain and joint function. Various lifestyle changes below can help a lot if applied consistently and patiently.

1. Weight loss and maintaining a healthy weight reduce the risk of developing osteoarthritis and can reduce symptoms if you already have it.
2. Eating a healthy diet is important for weight loss. A diet with lots of antioxidants, such as fresh fruits, vegetables, herbs, fish and nuts can help reduce inflammation. Foods to minimize or avoid if you have arthritis include fried foods, processed foods, dairy products, and high intakes of meat.
3. To soothe achy joints, try a warm paraffin wax bath for sore hands and feet, or a 20 minute heat or cold treatment using a heat pack.
4. Stock your drawers with tools that make it easier to grip and grab objects. Good Grips / Sure Grips Button HookA buttonhook takes the pain out of shirt buttons. Scissors with spring action make it easier to cut.
5. Rearrange cabinets so that the heaviest objects are stored near your waist to prevent bending and adding pressure to your knees if that is where your pain is located.
6. Exercise – It may be hard to believe, but experts agree — exercise can help relieve joint pain from arthritis. Exercise can strengthen the muscles around the joints, which helps take stress off joints, reduces joint stiffness, builds flexibility and endurance. Swimming, biking, walking (with an aid if necessary), tai chi is recommended for people with most forms of arthritis because it does not put so much pressure on your joints the way jogging or running does. Be sure to do sufficient warm-up exercise. At-home exercises you can try include:
   • the head tilt, neck rotation, and other exercises to relieve pain in your neck
   • finger bends and thumb bends to ease pain in your hands
   • leg raises, hamstring stretches, and other easy exercises for knee arthritis

Caution is advised with regards to weight-bearing exercises, which may worsen the cartilage. Consult your physiotherapist on how to protect your joints (e.g. usage of sports medical binding tape) if you must bear weights in your work or play.

Summary

While there is no cure for arthritis and condition is irreversible, there are many medical and physical therapy treatments that can help alleviate its symptoms. Appropriate lifestyle changes can also play a huge part in prolonging and sustaining a good quality of life.

Remember, staying active is important, but you should also ensure sufficient rest when needed to avoid overexerting yourself. Ultimately, with strong awareness and lifestyle changes, you can to strike a good balance to manage arthritis and lead an active healthy life.