The definition of arthritis is “inflammation of the joints.” Encompassing over 100 different diseases, arthritis is a common crippler of the joints. About 20 percent of the American population has some form of arthritis, with the most common being osteoarthritis and rheumatoid arthritis.
At Advanced Orthopedics and Hand Surgery, we specialize in issues with the joints, and we deal with the damage done by arthritis every day. Here’s some more information on these joint diseases.
What is arthritis?
While some people refer to the term arthritis as if it were a single disease, it can’t be so easily categorized. Arthritis in the broadest sense simply refers to joint pain or joint disease. It is the leading cause of disability in the U.S., with over 50 million adults and 300,000 children suffering from one of the 100+ types of arthritis. It is most common among women and older people. Common joint symptoms are swelling, pain, stiffness, and decreased range of motion. In some people these symptoms come and go; in others the pain is chronic and mobility becomes affected in the joints in question.
What are the common symptoms of arthritis?
Arthritis is based on joint inflammation, no matter what type is involved. Pain in and around the joints is the main symptom. This develops over time in most patients. These are other common symptoms:
- One or more joints that are swollen and stiff
- Joints that appear red and feel warm when touched
- The trouble with mobility in the joint
- Problems with everyday tasks
What causes arthritis?
Causes of the various forms of arthritis are varied, and some causes are not understood. With osteoarthritis, the most common form and what we address the most at Advanced Orthopedics and Hand Surgery, wear and tear breaks down the cartilage that provides the cushioning in our joints. In most cases, the patient simply breaks down cartilage through the use of their joints over time. Sometimes a prior injury to a joint can lead to osteoarthritis later in life. There also seems to be a genetic disposition to developing osteoarthritis.
Rheumatoid arthritis is the second most common form, but it is completely different in the cause. Rheumatoid arthritis is an autoimmune disorder where the body’s immune system attacks the tissues in the body. These attacks affect the synovium, a soft tissue in your joints that produces a fluid that nourishes the cartilage and lubricates the joints. This form of arthritis invades and destroys a joint.
Who is more at risk for developing arthritis?
There are certain risk factors that increase a person’s chances of developing arthritis:
- Family history. If your parents or siblings have a type of arthritis, this makes you more likely to develop certain types of the disease.
- Age. The risk of developing many types of arthritis, including osteoarthritis and rheumatoid arthritis, increases with age.
- Sex. Women are more likely to develop rheumatoid arthritis, while men are more likely to develop gout (another form of arthritis).
- Previous joint injury. An injury, say a knee injury from playing football, is more likely to become arthritic in later years.
- Obesity. The extra weight puts more stress on the joints, which increases the chances of developing arthritis.
What are the types of arthritis?
Arthritis is broken down by four basic categories. Within each category are various forms of the disease. Overall there are over 100 forms of arthritis.
- Degenerative arthritis — Osteoarthritis is colloquially known as “wear and tear” arthritis, as it is simply a result of the wear and tear life takes on our joints. The endless pressure on our joints from something as innocuous as walking over the course of decades eventually affects the cartilage. The cartilage is slick and is the cushioning surface on the ends of our bones. In the joints, where bones come together, as the cartilage wears down, the bones can rub against one another, leading to pain, swelling, and stiffness. Osteoarthritis is the main form of degenerative arthritis, affecting 16 million Americans. It is the form of arthritis we deal with most frequently at Advanced Orthopedics and Hand Surgery.
- Inflammatory arthritis — Our immune system is tasked with fighting off infection and preventing disease. It does this by creating inflammation to activate these defense mechanisms. In inflammatory arthritis, the immune system instead attacks the joints with uncontrolled inflammation. This leads to joint erosion and can damage internal organs, the eyes, and other parts of the body. Rheumatoid arthritis and psoriatic arthritis are examples of inflammatory arthritis.
- Infectious arthritis — If bacteria, a virus, or fungus enter a joint and trigger inflammation that is infectious arthritis. Salmonella, chlamydia, and hepatitis C are examples of organisms that can cause this. Antibiotics can clear the infection, but the inflammation can sometimes become chronic.
- Metabolic arthritis — When the body breaks down purines, a substance found in human cells and in many foods, it produces uric acid. Some people either cannot get rid of the uric acid fast enough, or they create an excessive amount. This can form needle-like crystals in the joints and sudden extreme joint pain. This is a gout attack. Gout is the main form of metabolic arthritis.
How is arthritis diagnosed?
We generally deal with osteoarthritis at Advanced Orthopedics and Hand Surgery and referrals will often come from patients’ primary care physicians. We check your joints for swelling, redness, and warmth. We test the mobility of the joints in question. We may utilize lab tests of blood, urine, and joint fluid. We may perform some imaging tests, such as x-rays, CT scans, MRIs, and ultrasound. These tests may be necessary to rule out other factors, such as bone spurs.
"Dr. Ramin Ghobadi is an amazing surgeon who has worked on both my husband (knee) and me (hand) and is not only skilled but also kind and attentive. I highly recommend him!"
"Dr. DeNoble has a rare knack for making his patients feel right at home in his office. He took the time and patience to answer any and all questions I had. I came to him from the hospital after an accident with four broken fingers. I was in great pain and he knew right away I needed to be operated on to save my hand that was turning black. He operated on me immediately at the hospital and my hand was saved. I have almost full use of it now. I would highly recommend him and his staff."
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What areas of the body are commonly affected by arthritis?
Arthritis predominantly attacks and damages the joints. It can cause permanent changes in a joint, such as the gnarled fingers caused by rheumatoid arthritis. Beyond the joints, it can affect the heart, eyes, lungs, kidneys, and skin.
At Advanced Orthopedics and Hand Surgery, we generally treat arthritis in the shoulders, hips, knees, hands, elbows, and wrists.
How is arthritis treated?
There is no cure for arthritis. The goal is to reduce or remove the pain the patient is experiencing, prevent additional damage to the joints, and return mobility if possible.
There are different types of medications used to treat arthritis:
- Analgesics — Hydrocodone or acetaminophen are used for pain management.
- Nonsteroidal anti-inflammatory drugs — Ibuprofen and salicylates help control both pain and inflammation.
- Menthol or capsaicin — These creams block the transmission of pain signals from your joints.
- Corticosteroids — These can be injected into the inflamed joints for pain relief and to lower inflammation.
- Hormones — Hormones such as prednisone can be used to fight rheumatoid arthritis, as it suppresses the immune response.
Physical therapy and weight management
Exercise can improve range of motion and flexibility. It can strengthen the muscles surrounding the joints to help with the loads. Weight management helps to lower the stress on the joints.
At Advanced Orthopedics and Hand Surgery, surgery is viewed as the last option, except in cases of traumatic injury. Surgery to address arthritis in the joints generally would fall under three areas:
- Joint repair — We can perform various arthroscopic procedures to smooth, realign, or clean out damaged joints, such as removing areas of torn cartilage and bone spurs.
- Joint replacement — When a joint is damaged to the extent that bone is rubbing on bone, joint replacement with an artificial partial or full joint could be necessary.
Joint fusion — In smaller joints with severe arthritis, such as the ankle, wrist, or fingers, fusing two bones in the joint can alleviate pain, although it also decreases mobility.