What is Arthritis?
Arthritis, in its simplest terms, refers to inflammation of a joint and joint space. It is a very common, yet misunderstood diagnosis, due in part to there being over 100 different types of arthritis, with different causes and treatments. However, today, we are going to talk about the two most common forms: osteoarthritis (OA) and rheumatoid arthritis (RA).
What is OA?
Osteoarthritis, or OA for short, is sometimes referred to as “wear and tear” arthritis. In normal joints, cartilage, a firm and rubbery material, covers each bone. Cartilage acts as a cushion between bones and provides a smooth gliding surface for joint motion. Over time, the cartilage can break down, which causes pain, swelling, and difficulty moving the joint. As this worsens, the bones may start to rub against one another, resulting in their breakdown, and development of growths called bone spurs can also form. The joints most commonly affected are knees, hips, lower back and neck, and the small joints of the fingers.
Symptoms of OA
The first symptom of OA is stiffness in the joint, usually occurring in the morning or after prolonged periods of rest. Over time, there can be limitations in the movement of the joint, clicking or cracking when the joint bends, mild swelling around the joint, and pain, which is worse after activity or at the end of the day.
Causes of OA
Contributing factors to the development of OA include:
- Repetitive movement and heavy lifting
- Sports-related injuries
- Studies have shown certain metabolic disorders, such as hemochromatosis can also increase the likelihood of developing OA (www.arthritis.org)
Treatment of OA
Depending on the location of the joint, your physician may refer you for conservative treatment with a physical or an occupational therapist. They can provide you with pain management advice, strengthening and stretching to reduce joint inflammation, and light strengthening and home and activity modifications to reduce re-injury risk. For more information, contact your primary care physician, or your physical or occupational therapist at Virginia Gay Hospital.
What is RA?
Rheumatoid Arthritis, or RA for short, is an autoimmune disease. The body’s immune system, which normally protects your body from disease, begins to treat the areas in the joints as if it is also a disease. OA affects the cartilage that surrounds the bones that make up the joint. But, RA affects the lining of the joints, which can cause painful swelling that can lead to bone erosion and joint deformity. The most straightforward example of joint deformity caused by RA is often seen in hands, as shown in the picture below:
Symptoms of RA
Symptoms of RA can include painful, tender, and stiffness in the joints that lasts for up to 30 minutes or longer in the morning for up to six weeks, fatigue, loss of appetite, and even low-grade fevers. Symptoms usually start in the smaller joints, such as in the hands and feet, but progressively get worse and affect the knees, wrists, ankles, elbows, hips, and shoulders. In most cases, RA affects both sides of your body.
As RA is considered a systemic and autoimmune disease, around 40% of individuals with RA experience signs and symptoms that don’t involve the joints at all. These can include dry, red eyes with increased light sensitivity, dry mouth, and gum irritation or increased gum infections, scarring, and inflammation of the lungs and can lead to shortness of breath, anemia, and inflammation of blood vessels (www.arthritis.org).
Treatment of RA
Treatment of RA involves reducing as much inflammation as possible. Less malformation of the joint occurs with earlier treatment. Your physician may recommend nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation. Other drugs that your physician may recommend which can assist with slowing the process of RA include corticosteroids, DMARDs, and JAK inhibitors. Your doctor may refer you to a physical or occupational therapist to discuss different pain management techniques. Examples include the use of heat or ice for pain, joint protection techniques to reduce pain and increase the ease of daily tasks, and light exercises and stretches. Other options when the joint has permanent, irreparable damage can include joint replacement surgery, which involves the replacement of damaged joints with metal or plastic parts. Hips and knees are most commonly seen, both in the hospital and in our therapy clinic, but elbows, shoulders, and thumbs are also frequently seen in the clinic. For more information about Osteoarthritis or Rheumatoid Arthritis, please discuss with your primary care physician, a physical or occupational therapist at Virginia Gay Hospital.