Arthritis (2)

Arthritis

Contrary to popular belief, arthritis is not just one disease. It is actually a complex disorder, comprising more than a hundred different conditions. It can affect any person at any stage of his life, whether he is generally healthy or suffering from some other form of degenerative disorder.

The most common forms of this disorder are osteoarthritis and rheumatoid arthritis, each having very different causes, risk factors, and effects on the body, but the same common symptom: persistent pain in the joints.

Osteoarthritis

Osteoarthritis (OA) or degenerative arthritis, is a condition where pain occurs in the joints due to low grade inflammation. The cause is normally attributed to the wearing and tearing of the cartilage (hence it’s more colloquial name “wear and tear”). The cartilage is that piece of tissue that covers and acts as a cushion inside joints. As the cartilage wears down, the bone surfaces between joints become less well protected, resulting in pain on the patient, particularly upon weight bearing, such as walking and standing.

To avoid the pain, a patient may decrease his movements. However, this (the decreased movements) may indirectly result in certain conditions of the regional muscles, such as atrophy and lax ligaments.

Osteoarthritis is the most common form of arthritis, affecting nearly 21 million people in the United States. That accounts for 25% of visits to primary care physicians and half of an NSAID, or Non Steroidal Anti Inflammatory Drugs, prescriptions.

A Green 2001 health report has revealed that an estimated 80% of the population will have shown signs of osteoarthritis by age 65, evidenced by radiographic test. However, the same report said that only 60% will be symptomatic.

Because the primary problem with osteoarthritis is the degeneration of the cartilage, which cannot ever grow back, there is unfortunately no cure for the condition. Treatment consists of NSAIDs, local glucocorticoid injections, and in severe cases, with joint replacement surgery. The goal is not to cure the disorder, which is irreversible, but to reduce the joint pain, and in that regard, science has no shortage.

Rheumatoid Arthritis

The other form of arthritis, less common than OA, is rheumatoid arthritis or RA. It is a chronic, inflammatory auto immune disorder where the body’s own immune system attacks the joints. Because of pain and joint destruction as a result of this condition, rheumatoid arthritis can lead to substantial loss of mobility as well as affect many extra articular tissues of the body, such as the skin, blood vessels, heart, lungs, and muscles.

The treatment approach for this form of arthritis is different from OA. In osteoarthritis, the goal is to reduce the pain, in rheumatoid arthritis, there is actually a treatment that could halt disease progression.

There are two approaches: one is the disease modifying antirheumatic drugs or DMARDs, and anti inflammatory agents and analgesics. The former is responsible for producing durable remissions and delay or even halting the disease from progressing. The latter only treats the pain resulting from the disorder.

To determine what form of arthritis a patient suffers, X rays and blood tests are often performed on the affected joints. The type can be distinguished by the pace of the onset, the age and sex of the patient, the amount of joints affected, and additional symptoms like psoriasis, iridocyclitis, rheumatoid nodules, and Raynaud’s phenomenon – all of which can be shown through blood testing and X ray.