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All pains are painful, but only a few immobilize.
Arthritis, a disease of the joints, bones and
muscles, is one of them. Its symptoms can range
from pain and stiffness in a few joints to serious
and severe damage to many joints and internal
organs.
The
word ‘arthritis’ literally means ‘inflamed joint’
(‘arthro’ comes from the Greek word meaning
joints, ‘itis’ means inflammation).
Normal
Synovial Joint
To have a better understanding of arthritis,
it would be helpful to understand the structure
of a joint. Joints are the meeting place of
two bones and allow movement with stability.
Joints are made up of a number of parts of which
the most important are the cartilage (the firm
tissue that cushions and protects the end of
each bone) and the specialized tissue lining
called the synovium.
The
synovium is the joint lining membrane which
surrounds the joint cavity. It produces the
joint fluid which lubricates the joint and allows
for smooth movement.
The
Most Common :
Arthritis
is the generic name given to more than 100 diseases
of the joints, bones and muscles. Some of the
most common amongst them are:
 OSTEOARTHRITIS:
Normally,
a disease caused by the general ‘wear and tear’
of the cushioning cartilage in the joints. It
is the most common arthritis. As a matter of
fact, everyone over fifty has had enough wear
and tear on his weight bearing joints to give
him/her at least some arthritis. This is why
it is also called the ‘disease of the old age’.
RHEUMATOID
ARTHRITIS (RA)
It is the most common and mast severe chronic
inflammatory arthritis, affecting nearly one
in every 100 adults.
Who
gets RA
It typically occurs between the ages of 25 and
50, however, it is reported in people of all
ages including infants and children. Women are
nearly three times as likely as men to have
RA. The disease affects people of all races
and has been medically identified for about
200 years.
RA is believed to cause the most significant
joint damage within the first two years after
onset – a strong reason why early diagnosis
and appropriate treatment are critical.
 Effects
of RA on a joint
In RA, the synovium or joint lining becomes
inflamed and thickened producing large volume
of fluid. This large volume of fluid causes
pain, stiffness and swelling. The increased
blood flow that is a feature of inflammation
also makes the joint warm.
When this process becomes chronic (longstanding)
and severe, the thickened and inflamed (membrane
called the pannus) releases proteins that damage
the nearby bone and cartilage causing ‘erosions’
of the bone. This process results in joint damage,
instability and deformity.
The other structures of the joint can also be
involved in the process. Muscles, tendons and
ligaments may whither from lack of use due to
pain and inflammation. The bursae, which are
fluid filled sacks that lubricate the movement
of muscles, can become inflamed, producing further
pain and swelling in a condition known as ‘bursitis’.
Untreated RA can irreversibly damage joints
leading to pain, stiffness, deformity, loss
of function and long - term disability.
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What
causes RA?
The
precise cause of RA is still unknown.
However, research is making enormous
progress towards increased understanding
and better treatment of the disease.
It
is now known that RA is an
autoimmune
disease.
The body’s immune system (usually
responsible for defending the
body against infection) produces
chemicals that circulate and attack
the synovium.
In
addition, circulating antibodies
(protein substances) can clump
together and block small blood
vessels causing tissue damage.
It is not known what causes the
normally protective immune system
to start attacking the body’s
normal tissues.
The
current theories suggest that
people born with specific genes
(described as having the DR4 gene
type) develop RA if they come
across the right trigger.
The
right trigger to set off the development
of RA has not been identified
but researchers suspect that it
is a different trigger in different
people. These triggers may include
infections (with virus, bacteria),
trauma and stress but no one knows
for sure.
Is
RA inherited?
Rheumatoid
Arthritis is not inherited in
the in the usual sense i.e. it
is not passed directly from parents
to children. However, a susceptibility
to develop RA can be inherited,
but other factors are also important.
The gene that influences the likelihood
or a tendency to develop RA is
one of the genes that controls
the function of the immune system.
However, not everyone who inherits
this gene will develop the disease.
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SYMPTOMS
OF RA
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Pain
and aching in and around
joints, particularly the hands,
feet and knees. |
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Joint
stiffness, most noticeable
in the morning. |
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Swelling
of joints, particularly of
hands, feet and knees. |
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Persistent
fatigue and feeling 'run-down'. |
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Muscle
weakness associated with stiff
joints and decreased physical
activity. |
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Inability
to sleep well at night due
to painful joints. |
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MANAGING RHEUMATOID ARTHRITIS
Modern
treatment methods can relieve
the pain, reduce inflammation,
slow the rate of joint damage,
improve physical function and
induce remission. As the major
damage to joints occurs in the
first two years of developing
the disease, early diagnosis and
‘appropriate’ treatment are of
utmost importance. Left untreated,
RA can cause serious permanent
damage, such as joint destruction,
bone deformities and osteoporosis.
It
can even lead to early death (though
rare) if internal organ inflammation,
such as in the lungs or heart,
occurs or as a result of chronic
disability and immobilization.
Treatment of RA most often involves
some combination of medication
with education, exercise, rest,
joint protection, physical and
occupational therapy, and surgery
when necessary. There is no single
standard treatment that applies
to all people with RA. The disease
can be very different in different
people. Instead, a treatment program
needs to be designed to best meet
individual needs, taking into
account the severity of the arthritis,
other medical problems and lifestyle.
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FIBROMYALGIA
: It
is a disease that causes
fatigue, sleep disturbances,
and widespread pain in the
muscles and tendons, particularly
in the neck, spine, shoulders
and hips.
GOUT
: It is a strange condition,
which is not in any way
related to other forms of
bone disease. In fact it
is a metabolic disorder
causing a very painful type
of arthritis that is usually
associated with it. In all
cases of gout, there is
too much uric acid in the
blood. This excess uric
acid is deposited in some
of the soft tissues of the
body and also around certain
joints. This results in
painful swellings, known
as tophi.
A
Sane Advise
As
has already been stated
earlier, Arthritis is the
generic name given to some
more than hundred types
of pains caused by the diseases
of the joints, bones, and
muscles. Out of these, which
disease is causing the pain
is, at times, even difficult
for the specialists to diagnose
what to speak of the patients.
It is therefore advised
that if one has any or all
of the following symptoms,
he/she must immediately
consult a specialist–preferably
a Rheumatologist:
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Swelling
in one or more joints, especially
with warmth and redness.
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Stiffness
around the joints that lasts for
at least one hour after getting
up in the morning
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Constant
or recurring pain or tenderness
in a joint.
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Sudden
difficulty in using or moving
a joint.
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The
Ball Is Also In
Your Court, Dear Patient
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Remember that most kind of arthritis
are chronic and can’t be cured
unless treatment is initiated
at the earliest. However, you
can do a lot to lessen its pain.
The list of your Do’s and Don’ts
is short and simple. Observe it
religiously to lead a life as
pain-free as possible.
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| Do’s |
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Once
your physician has diagnosed your
ailment and prescribed you the
medicines, take them as per his/her
advice
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Obesity
is one of the greatest enemies
of arthritis. It overtaxes the
weight-bearing joints such as
the hips, knees, and ankles and
thus aggravates the disease. In
case you are overweight, take
a resolve to reduce it. The section
on:
Obesity:
The
Mother of Many Ills may help you
in your endeavour.
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Self-help
programmes can give you
Coping-Skills.
The
first step in this direction is
to understand that a perpetual
psychological state of fear, anxiety,
insecurity, depression or for
that matter any negative feeling
may do no good to you but certainly
would aggravate your problem.
Some
Yogic
Exercises can
improve your body and mind balance,
muscle strength, and energy level.
However, consult a competent Yoga
teacher before undertaking the
yogic exercises. For developing
a positive attitude in life, the
section
Can We Be Healthy Without Being
Happy will
may go a long way in helping you.
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Studies
from the Touch Research Institute
at the University of Miami show
that massage relieves stress and
can relax tense muscles and ease
pain.
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Physical
Exercise :
It is stating the obvious that
people who are physically active
are healthier and live longer
than people who are inactive.
This is particularly true for
people with arthritis. Yet it
is the people with arthritis who
use their disease as an excuse
for limiting their physical activities.
They forget that being inactive
may increase their problems. No
doubt that pain, stiffness, and
fatigue make it difficult for
arthritic patients to be active
in the normal sense, but there
are exercises that are specially
designed for them and they must
not have any fear or unwillingness
in doing them. Given below is
a demonstration of one of such
specially designed Arthritis
Home Exercise Programme
for
the arthritic patients.
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| DON’TS |
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Don’t
be a victim of quacks. They may
promise a cure for this incurable
disease, eventually aggravating
your problems.
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Never
take very strong drugs without
consulting your doctor. They may
give you relief at the cost of
many side effects.
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Avoid
prolonged positions and activities.
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