Management of arthritis

Rotimi Adesanya

A patient who came for consultation last week was surprised to hear from me that arthritis has no cure and that medical scientists are still researching into a possible cure for the disease. But, she told me about practitioners (orthodox, herbal and alternative practitioners alike) who said that it was curable.

The fact is that there is no cure yet for arthritis. But there is a certain treatment for the disease that can help to slow down the inflammation and its symptoms.

Arthritis is a common condition that causes pain and inflammation in a joint. It affects people of all ages, but it is quite common among older people. Most types of childhood arthritis are known as juvenile arthritis, which causes pain and inflammation in one or more joints for at least six weeks.

Although the exact cause of juvenile arthritis is unknown, the symptoms often improve as the child gets older, which means he can live a normal life.

Signs and symptoms of arthritis

Pain in the knee, wrist, hip, neck, elbow, shoulder and ankles are some of the obvious signs of the disease, in addition to tenderness, stiffness, swelling and inflammation around the joints.

These symptoms can lead to joint weakness, instability and deformities that can interfere with the most basic daily tasks, such as walking, driving etc

 Types of arthritis

Degenerative arthritis: Osteoarthritis is the most common type of arthritis. When the cartilage – the cushioning surface on the ends of bones – wears away, then bone will rub against bone. This causes pain, swelling and stiffness. Over time, joints can lose strength and pain may become chronic. The risk factors include excess weight, family history, age and previous injury.

Inflammatory arthritis: A healthy immune system is protective. It generates internal inflammation to get rid of infection and prevent disease. But the immune system can go awry, mistakenly attacking the joints with uncontrolled inflammation and potentially causing joint erosion. This may damage internal organs, eyes and other parts of the body.

Rheumatoid arthritis is an example of inflammatory arthritis and smoking is an example of an environmental risk factor that can trigger rheumatoid arthritis in people with certain genes.

 Infectious arthritis (septic arthritis): A bacterium, virus or fungus can enter the joint and trigger inflammation. Examples of organisms that can infect joints are salmonella and shigella, chlamydia and gonorrhea (sexually transmitted diseases) and hepatitis C. Observed in people afflicted with sickle cell disorder, it could also be due to tuberculosis. In many cases, timely treatment with antibiotics may clear the joint infection, but sometimes the arthritis becomes chronic.

Metabolic arthritis: Uric acid is formed as the body breaks down purines, a substance found in human cells and in many foods. Some people have high levels of uric acid because they naturally produce more than is needed. Since the body can’t get rid of the uric acid quickly enough, leading to gout attack; it can become chronic, thereby causing pain and disability.

 Diagnosing arthritis

Arthritis diagnosis often begins with a primary care physician, who performs a physical exam, may also do blood tests for full blood count, blood uric acid, ESR, X-rays, ultrasound scans, CT scans, MRI of affected joints and rheumatoid factors in order to determine the type of arthritis and confirm diagnosis.

An arthritis specialist, or rheumatologist, should be involved if the diagnosis is uncertain or if the arthritis may be inflammatory. Rheumatologists typically manage ongoing treatment for inflammatory arthritis, gout and other complicated cases. Orthopaedic surgeons do joint surgery, including joint replacements. When the arthritis affects other body systems or parts, other specialists, such as ophthalmologists, dermatologists or dentists, may also be included in the health care team.

Treatment

Arthritis invariably impacts on a patient’s quality of life and includes varying degrees of discomfort and pain. There is no cure for arthritis, but a certain treatment can help to slow down the condition. The drugs for the treatment of the disease are often prescribed. They include painkillers, corticosteroids, antibiotics, exercise, physiotherapy and the use of cold/hot compress.

In severe cases, the following surgical procedures may be recommended by the orthopaedic surgeons: arthroplasty (joint replacement), arthodesis (joint fusion) and osteotomy (where a bone is cut and re-aligned).