What does arthritis mean?
Arthritis is
derived from the Greek words "Arthros" meaning joint & "itis"
meaning inflammation. Any inflammation/ irritation/wear & tear of
the joint is called arthritis. In the initial stages arthritis results
in pain & stiffness of the joint. Later on the muscles around the
joint weaken & become smaller in size. Towards the end, the joint
loses most of its useful movement & the bone develops deformities.
What are the causes of arthritis?
Broadly
speaking arthritis is of two main types; inflammatory arthritis &
non inflammatory arthritis. The more common non-inflammatory arthritis
is also known as osteoarthritis is due to the age related wear &
tear of the joint cartilage. The less common inflammatory arthritis is
due to the body producing antibodies to the joint cartilage. The body
reacts against its own tissue & causes widespread damage to the
joints.
Common types of Arthritis
- Osteoarthritis
- Rheumatoid Arthritis
What are the symptoms of osteoarthritis?
lt depends on
the joint affected. If knee is affected, it causes pain in the knee,
with decreased ability to walk & run. Stiffness of the knees makes
simple things like getting into a chair or getting out of it difficult.
Stair climbing also becomes increasingly difficult. In the spine, pain
is brought on by bending. Sometimes the tiny nerve endings that branch
off from the spinal cord & travel in various directions can get
pinched by excess bone formation that is seen with arthritis. This
results in numbness & tingling in the arms & legs depending on
the area affected (neck vs low back). Hip arthritis makes sitting
difficult &there is pain especially in the night. Finger arthritis
makes down fine things difficult like turning a key, holding a pen or a
spoon to eat.
What is osteoarthritis?
It is the most
common form of arthritis affecting our joints. Really speaking it is
not a disease at all ! It is simply a manifestation of ageing. As me
grow older our joints undergo wear & tear. Normally each of our
joints has a cushion of variable thickness at its ends called, the
cartilage. As we age, the thickness of the cartilage decreases, forcing
raw bone to come in contact with raw bone, thereby leading to pain. Our
joints have another protective mechanism called the "synovial fluid”. In
our youth, healthy thick viscous synovial fluid is produced which adds
to this Iubrication. As we age, our joints produce copious amounts of
less viscous watery synocial fluid that is Iess efficient in lubricating
the joint.The reason why we develop arthritis is not fully known.
Almost any joint can be effected, the commonest being the knees, hips,
neck, lower back & the fingers.
Usually
through a good clinical history & detailed examination, one can
diagnose osteoarthritis. Sometimes blood tests may be required to
distinguish if from the more serious inflammatory arthritis. X rays will
be required in all instances to assess the stage of the disease.Very
rarely MRl may also be required in addition to study the soft tissues
around the joint.
How is osteoarthritis treated?
Once the
smooth cartilage of the joint is destroyed, it cannot be replaced by any
known modern treatment. However, if one keeps the muscles around a
joint strong through exercise, the ill effects of the lost cartilage can
be minimised.
Physiotherapy
is the cornerstone of treatment of osteoarthritis. In the knee it means
doing what we call the quadriceps & hamstring exercises, for the
hip the muscle on the side & back or the hip (abdurtors and gluteus
maximus) need to be strengthened, in
the spine the muscles on either side of the centre (paraspinal muscles)
are strengthened & for the fingers, handgrip exercises are
prescribed, Water based exercise (swimming) are far superior to land
based exercises for osteoarthritis of almost any joint. Immersion in
water makes our body lighter & restores the lost flexibility to our
muscles and tendons. Light resistance training with weights/ theraband
is also recommended to increase muscle strength. Weight loss helps
immensely by offloading the sore joints. Applying hot packs helps soothe
the muscles around the joint. For acute onset pains, Ice packs are
recommended.
Application of an ointment or a spray always helps, The physical
therapist also use ultrasound, tiny pulses of electric current (TENS)
and a special form of deep heat to further help heal the pain. You
should take simple precautions like not doing activities like squatting
& cross legged sitting. Using a stick for knee and hip arthritis is
also very helpful
Anti-nfIammatory
medicines (loosely called pain killers) are also prescribed judiciously
for a short period to help relieve the pain & inflammation of the
sore joints. Prolonged intake of these medicines is harmful for the
heart, stomach & kidneys. In case you feel the need to take these
medicines on a daily basis, you may be suffering from an advanced stage
of the disease & might benefit from a joint replacement, Collagen
powders are increasingly being used for the treatment of osteoarthritis
of the knee. They are contained in a sachet & are meant to be
dissolved in a cup of lukewarm water & gulped down on a daily basis
for 3-6 months. They have a role to play in early arthritis, once the
disease is advanced, they have little to no therapeutic effect.
Newer
therapies like willow bark extract are about to enter the market &
will usher in an exciting phase of naturally occurring plant based pain
relief medications. These medicines relieve pain & unlike the
mainstream painkillers, they are virtually devoid of all major side
effects.
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