Senior Physiotherapist UO

A better understanding of Arthritis

Ageing causes normal wear and tear of the joints. Overloading, overuse or trauma to the joints can lead to arthritis. Arthritis is predominantly the inflammation of one or multiple joints. It usually presents with pain, stiffness, swelling and tenderness of the joints. The most common types of arthritis are osteoarthritis and rheumatoid arthritis.

Osteoarthritis:
Bone is covered with cartilage that acts as padding between the joints. Early erosion of this padding along with the rubbing of bony ends leads to Osteoarthritis.

Symptoms: People usually present with painful and stiff joints, especially after a period of inactivity, restricted mobility, and visible deformities like a bow or knock knees, deformities of the finger and swelling on the joints are also common.

What causes osteoarthritis?:

In Osteoarthritis, pain is usually caused by the thinning of the cartilage that serves as a protective shock absorber between the joints. Cartilage is important for minimizing the impact of everyday activities on the joints.

There is no single known cause of osteoarthritis, however multifactorial reasons can predispose to OA. The most common factors are as follows;

  • Age- Older age group
  • Obesity- Having a high BMI (Body mass index) is directly proportional to early degeneration of joints
  • Lifestyle- Sedentary individuals who lack in fitness and mobility
  • Family history- Few studies state genetic predisposition (weak bones- osteoporosis)
  • Previous history of trauma or injury

    • Rheumatoid arthritis:

    Rheumatoid arthritis is a type of autoimmune (body’s immune response attacks its own cells) inflammatory arthritis. This means that the nervous system sends errant messages to the immune cells to attack the body’s own joint tissues.

    Symptoms: of rheumatoid arthritis also include painful swelling, stiffness and deformities of the joints, most commonly in the hands, wrists and feet (small joints). It is also associated with morning stiffness, fluctuating joint pain with or without other systemic involvement. Along with X-rays and clinical evaluation, certain blood investigations confirm the presence of Rheumatoid Arthritis.

    What cause Rheumatoid Arthritis?

    Although exact cause of RA is unknown, few studies state that certain groups of people are prone to developing RA based on:

  • Family predisposition
  • Significant hormonal disruption/imbalance
  • Exposure to environmental factors- smoking
  • Infections

    • How do we treat arthritis?:

    Self-care and medical guidance are paramount in treating arthritis. These form the essential domains of treatment.

  • Weight Management- Having an optimal body weight reduces loading on joints, thus reducing inflammation and early degeneration. Few studies have also revealed that for every 1 pound of body weight 4 times more stress is put on the knee joint.
  • Exercises- Mild to moderate levels of aerobic exercises like walking, cycling and swimming help to strengthen the joints. Gentle stretches also help in overcoming stiffness of the muscles and improving the mobility of the joints.
  • Medication- Varieties of oral and topical medication have been proven beneficial in the treatment of arthritis. Medication predominantly comprises of pain killers, anti inflammatory medications, joint and cartilage supplements(collagen based) along with bone nutrition (calcium and vitamin D supplements). In cases of rheumatoid arthritis, steroids, disease-modifying anti-rheumatic drugs(DMARD’s) and biologics are also given
  • Injection- It forms a part of conservative treatment and has multiple variants. The most common injection is a steroid injection (for reducing inflammation) followed by hyaluronic injection (for joint lubrication).
  • Surgery- In severe or advance stages of arthritis (determined both clinically and on X-rays), the choice of surgery is joint replacements or Osteotomy. The most common joint replacement is Knee replacement (total/ partial), followed by hip replacements.

    • Identifying early symptoms and proper diagnosis form the pillar of treatment. A well balanced diet, adequate nutrition, moderate exercises, optimal weight along with medications helps in the prevention and effective treatment of arthritis.

    Dr. Shelly Goshal

    Senior Physiotherapist

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