Arthritis is inflammation of one or more of the body’s joints that causes pain and stiffness. Although arthritis is mainly an adult disease, some forms affect children.
There are many types of arthritis. They include osteoarthritis, inflammatory arthritis, post-traumatic arthritis, and septic (infectious) arthritis.
While each of these conditions has different causes, the symptoms and treatment are often the same.
Pain, swelling, and stiffness are the primary symptoms of arthritis. Any joint in the body may be affected by the disease, but it is particularly common in weight-bearing joints such as the knee, hip, and spine.
Although there is no cure for arthritis, there are many treatment options available to help manage pain and keep people active.
Arthritis is a joint disease. A joint exists where the ends of two or more bones meet. The knee joint, for example, is formed between the bones of the lower leg (tibia and fibula) and the thighbone (femur). The hip joint is located where the top of the thighbone (femoral head) meets the cup portion of the pelvis (acetabulum).
Cartilage. A smooth layer of cartilage covers the ends of bones in a joint. Cartilage cushions the bone and allows the joint to move easily without the friction that would occur with bone-on-bone contact.
Synovium. A joint is enclosed by a fibrous capsule that is lined with a tissue called the synovium, which produces a fluid that also helps to reduce friction and wear in a joint.
Muscles, tendons, and ligaments. Ligaments connect the bones and keep the joint stable. Muscles and tendons power the joint and enable it to move.
Arthritis may be caused by wear and tear on the articular cartilage through the natural aging process (osteoarthritis), or it may develop following an injury (post-traumatic arthritis).
Inflammatory arthritis, such as rheumatoid arthritis or lupus arthritis, is the result of a systemic disease throughout the body.
Regardless of whether arthritis is caused by injury, normal wear and tear, or systemic disease, the affected joint becomes inflamed, causing swelling, pain, and stiffness. Inflammation is one of the body’s normal reactions to injury or disease. In arthritic joints, however, inflammation may cause long-lasting or permanent disability when it destroys the joint’s cartilage.
Arthritis is diagnosed through a careful evaluation of symptoms and a physical examination. X-rays are important to show the extent of any damage to the joint. Occasionally, advanced imaging such as magnetic resonance imaging (MRI) is used to diagnose arthritis. Blood tests and other laboratory tests may help to determine the type of arthritis. Fluid from the joint must be analyzed to diagnose crystalline or septic arthritis.
There is no cure for arthritis, but there are many treatments to help relieve the pain and disability that it can cause. Treatment depends on the type of arthritis.
Medications. Over-the-counter medications can be used to control pain and inflammation in the joints. These medications, called non-steroidal anti-inflammatory drugs (NSAIDs), include aspirin, ibuprofen, and naproxen. Acetaminophen can also be effective in controlling pain.
Prescription medications also are available. A doctor will take into account the type of arthritis, its severity, and the patient’s general physical health before prescribing a medication. Patients with stomach ulcers, asthma, kidney disease, or liver disease, for example, may not be able to safely take anti-inflammatory medications. For patients with inflammatory arthritis, the doctor (typically a rheumatologist) may prescribe medications that modify the body’s immune response.
Injections of cortisone into the joint may temporarily help to relieve pain and swelling. It is important to know that repeated, frequent injections into the same joint may cause damage and undesirable side effects.
Viscosupplementation (injection of hyaluronic acid preparations) can also be used. This is typically performed in the knee. There is, however, a lack of strong evidence that viscosupplementation is an effective treatment for arthritis.
Exercise and therapy. Canes, crutches, walkers, or splints may help relieve the stress and strain on arthritic joints. It may also be helpful to learn methods of performing daily activities that are less stressful to painful joints.
Certain exercises and physical therapy may be used to decrease stiffness and to strengthen the weakened muscles around the joint.