At Clinica Sandalf, we keep you going

All you need to know about Arthritis

There are more than 100 known types of arthritis. Arthritis as such is not a disease but a symptom. It basically means inflamed joint. It can affect everyone, at any age, any gender and any race. It is the leading cause of disability and affects 1 in 5 adults over the age of 18, rising to 1 in 2 over the age of 65. Women are statistically more often affected than men.

What is Arthritis?

The most common form of arthritis is osteoarthritis, a degenerative disease. Every joint surface is covered with a layer of cartilage, a rubber like material that works like a shock absorber. As cartilage has no blood supply, it cannot grow and does not have any healing potential. This means that any damage done cannot be repaired and will be added to. Over the years the cartilage starts to 'dry' out, gets brittle and eventually wares away. This process, the natural degeneration of cartilage, is usually very slow, but certain risk factors such as obesity, a family history of arthritis, advanced age and previous injuries can speed up the process. Other diseases like diabetes and external factors like smoking or drug abuse are known to accelerate joint degeneration as well. Reduced mobility causing point loading (professional drivers) and excessive overload (roof tilers) also add to faster wear and tear of the joint.

Unfortunately there are no nerve endings inside a joint, so the early stages of arthritis cannot be felt. Hence any minor damages to the joint surface will remain unnoticed. Radiographic images can sometimes show suspicious signs at this stage. In the later stage, when most of the cartilage is worn of and bone 'scratches' on bone, the joint will get inflamed, resulting in swelling, warmth and pain. This is the stage when the patient usually seeks medical advice.

A thorough physical exam, preferably by an orthopedic surgeon, and radiographic images, preferably of both sides for comparison (knees in standing position), can reveal the stage of the arthritis. Based on this, treatment options can be discussed and often initiated immediately.

Treatment Options

Keeping a healthy diet and weight as well as an adequate balance between exercises and rests is indispensible at any stage of arthritis. A physiotherapist can advise on appropriate exercises to keep the affected joint(s) going without overloading them. Massage therapist can reduce the swelling by applying lymph drainage. Gentle sport activities like using an exercise bike, swimming, yoga or Tai Chi can be performed even at a more advanced age. Excessive running (tennis, squash, etc.) should be avoided. Anti-inflammatory medication, as tablet and/ or as creams applied locally, can help to reduce the inflammation and swelling. Painkillers should might be needed if the pain affects even at rest/ night, but caution has to be applied as they mask the symptoms and give the false impression of improvement.

An orthopedic surgeon can also inject the joint with cortisone, which has an almost immediate effect on the inflammation and therefore the pain. The injection of the joint with hyaluronic acid, a joint lubricant, can also help but only in the early to moderate stages. In the later stages, when the cartilage cushion is practically gone, the joint might have to be replaced or, depending on the type of joint, fused.

Prevention

Prevention is the best option. Avoiding repetitive movements especially under additional weight load, avoiding point loading and looking after weight and diet is essential. Staying physically fit and adjusting sports activities to the needs of your joints and not to the desire of your competitive mind is the next. Adding food supplements could slow down the natural joint degeneration. Following these guide lines could help reducing the effect of arthritis, possibly even that much that you might never have to go down the road of artificial joint replacement.

Images