Rheumatoid arthritis is an autoimmune condition where the bodys’ own immune system attacks itself. Our body immune system will usually produces anti-bodies for attacking foreign viruses and bacteria, and thus protects our body against any infection. But in those affected by Rheumatoid arthritis, the body-immune system will send antibodies to the joint lining, which actually attack the surrounding tissues and the synovium of the joint. The synovium of the joint is a thin layers of cells that cover our joints, but as the antibodies attack this membrane and synovium, they become inflamed and sore.
The inflammation process releases chemicals which both thickens the synovium and damages the cartilage, tendons, ligaments and bones. Repetitive flare ups eventually causes the joint to loose its normal alignment, congruency and shape.
Symptoms of rheumatoid arthritis
It is a progressive disease, initially starting in the smaller joints like toes and fingers and moving to larger joints bilaterally such knees and shoulders. Joints will feel hot, swollen, stif and appear red and may be the most painful in the mornings. A person will also complain of muscle tightness with symptoms varying from patient to patient. Often an individual will report flare ups in symptoms rather than a permanent pain, with flare ups becoming more frequent an intense as per the deterioration of the condition. The other symptoms include lining of blood vessels, lungs and heart, salivary and tear glands.
Rheumatoid arthritis is found more commonly amongst women because of the estrogen (a female hormone). Although not conclusively proven, research has shown estrogen to be a key hormone responsible for the progression and development of this disease. Genetic or hereditary transportation of the problem is also another cause.
Certain lifestyle habits such as smoking and excessive alcohol consumption may make an individual more prone to the disease.
Treatment and care:
The main treatment of this Rheumatoid arthritis is to give patients relief from pain, reduce the inflammation in the joints and finally slow down & prevent damages to the joints. Different patients respond in different ways to these treatments. One of the best known drugs used for the treatment is Disease-modifying anti-rheumatic drugs (DMARDs). The drug is very helpful in easing the symptoms and slowing down the damage caused with the disease. The drug blocks the effects of the chemicals that damage the bones, cartilage, ligaments and tissues. Leflunomide, methotrexate, sulfasalazine and hydroxychloroquine are the different conventional DMARDS.
Osteoarthritis is a very common progressive disease caused by excessive wear and tear of our joints. It usually affects people the latter half of their lives affecting most commonly the spine, hips, knees and hands.
Signs and symptoms:
In this condition, the cushioning structures of our joints i.e the cartilage which normally functions to allow our bones to glide smoothly over one another becomes worn with time.
Unfortunately with the lack of cushioning, the bones begin to rub together, causing inflammation at the joint surfaces swelling, pain and ultimately stiffness. This has a direct impact on the range of motion of the joints. In some severe cases, joint deformity can occur leading to poor alignment or Herberden’s node forming.
The eitiology of this condition is not conclusively known; but it is associated with aging. Although more commonly found in older populations, osteoarthritis can affect younger people as a result of a genetics (juvenile arthiritis) or as a result of previous trauma to a joint, i.e a fracture. Experts deem that mechanical, chemical and metabolic factors may also play a considerable role in this process. Another important consideration is an individual weight; as many of the joint such as the knees and hips are weight bearing joints, excessive loading with obesity can speed up this degenerative process.
Work ergonomics and hazards may also cause excessive stress on joints leading to an acceleration of arthiritis of such joints.
What may be the preventive cares:-
- Try to avoid repetitive motions which may stress and wear joints down
- Exercising often will keep joints supple and lubricated
- Maintain a healthy weight and diet
- Gentle and regular range of motion exercises can definitely increase your flexibility and reduce stiffness at joints
There are many medications available, but among the most prominent:
1) Anti-inflammatory and non-steroidal drugs that can relieve you from your pain, swelling and inflammation. Although it is a good reliever of all these symptoms, its long term use can cause stomach problems, in the form of ulcers and bleeding and heart problems.
2) Acetaminophen (Tylenol) for reducing only pain, not inflammation. This also has some side effects including liver damage in alcoholic patients.
Advice from a medical practitioner should always be taken before taking any medication.
Knee arthritis or Knee OA is a major cause of disability, affecting a person’s mobility and quality of life drastically. In the most severe conditions the cartilage can be completely worn away and damaged leading to excessive joint irritation. In such instances joint replacement may be the only solution for these patients.
Conservative management and treatment of Knee OA
If the problem is not severe, Appropriate medication can be utilised to treat and manage the symptoms of arthiritis. Ongoing research is looking for methods to re-grow cartilage, but it is still not in its application stage.
It is one of the best known therapeutic management of this problem. Under the supervision of a professional therapist, a patient can improve the motion and strength of the joints.
Exercise therapy, massage, electrotherapy, mechanical aids like splints and braces, joint mobilisation techniques, hot/ice therapy, hydrotherapy and gait re-education are all useful and effective methods available to help sufferers of knee pain.
Complimentary/ holistic therapy
Indian Yoga, Chinese Tai Chi, Homeopathic medicines, acupuncture, mind-body medicines and the traditional treatment balneotherapy and many more holistic treatments are becoming increasing popular for pain sufferers.
Surgery and other invasive procedures
Visco-supplimentation is a type of treatment, in which ‘hyaluronic acid’ or artificial joint fluid is injected to the knee, so that it can act as a cushion the joint. Unfortunaly this treatment gives the patient only short term relief of about 6 months or so.
Since severity of the knee OA is the main criteria for surgery, total or partial replacement of knee (joint replacement or arthroplasty) can be recommended in severe cases of osteoarthirits. In this scenario an artificial joint is implanted to replace the inflammed joint.
A less invasive option of surgery is known as an arthroscopy where the damaged or torn cartilage is removed or fixed from the joint.
Osteotomy is another type of treatment in which bone is realigned to ease stress on the affected joints or bones.
SingHealth and Singapore General Hospital (SGH) have launched a new mobile phone application to help patients suffering from rheumatoid arthritis.
Before you know it, you may already have arthritis. Arthritis symptoms are sometimes common, recurring and can be easily ignored.
Arthritis can be under its way if you experience progressive stiffness and pain in the joints even without the chills, swelling and fever. Inflammation, pain swelling and stiffness in the arms, fingers, legs and wrists should already alarm you as these are common signs of arthritis.