Many people who experience joint pain dismiss this as a side effect of ageing, but if you have painful joints, it is important to establish whether this is caused by arthritis. Arthritis can have a major impact on mobility and lifestyle, and can affect different people in different ways, but early treatment can improve outcomes and reduce the impact the condition has on quality of life, so it is well worth investigating as soon as possible.
What is arthritis?
Arthritis is a condition that affects the joints, and it can take many different forms. The main types of arthritis are osteoarthritis, rheumatoid arthritis and gout. Different types of arthritis are diagnosed depending upon the symptoms seen in the body and the causes of the condition, and the effects on the lifestyle of the patient and treatment will also differ according to these factors.
The main types of arthritis are characterised as follows:
Osteoarthritis is a very common type of arthritis, and the main symptoms are joint pain and stiffness. Patients often experience symptoms such as swelling and tenderness in the joints, or a grating or cracking sound when the affected joints are moved. Symptoms can differ between individuals, and can even manifest differently in the same person in different joints. Whether your symptoms are mild and come in episodes, or severe and continuous, you will benefit from a visit to an expert rheumatologist, who can suggest treatment based on your unique experience of the condition.
Osteoarthritis most commonly affects the knees, the hips and the joints of the hands, but can affect almost any joint in the body. Osteoarthritis causes long term problems in the body since the joints are exposed to constant low level impact, and the body cannot recover itself as it can in those who do not have the condition. In patients with osteoarthritis, the cartilage on the ends of the bones wears down, causing pain and swelling, as well as limited mobility. The affected joints may become red and swollen, and bony growths may develop.
The definitive cause of osteoarthritis is not known, but those at increased risk of developing the condition include people who have had joint injuries or have existing conditions such as rheumatoid arthritis and gout, as well as older people, those who are obese, and those who have a family history of the condition. Women are more likely to be affected by osteoarthritis than men, and mild symptoms may be managed with regular exercise and lifestyle changes. Those with more severe symptoms may require medication to reduce pain and specific physiotherapy interventions. Surgery may be considered in extreme cases.
Rheumatoid arthritis most often occurs in the hands, feet and wrists, and is a long term condition that causes pain, swelling and stiffness in the joints. It usually occurs in episodes, known as flare-ups, and these may be reduced in frequency and severity if treatment is sought in the early stages of the condition developing. Rheumatoid arthritis is an autoimmune disease, which means that the immune system will attack the cells that protect the joints, causing swelling, stiffness and pain. This can lead to long-lasting damage to the joints, cartilage and bones in the affected area, and many people with rheumatoid arthritis also experience symptoms such as fatigue and weight loss.
Rheumatoid arthritis is most likely to affect women and smokers, as well as those with a family history of the condition. The condition is often treated with supportive measures, such as physiotherapy, which aim to improve mobility and reduce the negative impact on your life. Many people choose to take medications that relieve the pain and swelling in the joints and slow the progress of the condition, and surgery may be considered in extreme cases.
Rheumatoid arthritis may lead to complications which can be serious and debilitating, such as carpal tunnel syndrome, inflammation of other areas in the body (including the lungs, heart and eyes) and an increased risk of stroke and heart attack, so learning to manage the condition is very important.
Gout is a specific form of inflammatory arthritis that is caused by high levels of uric acid. This is sometimes due to an excess of foods and drinks containing purines, and sometimes an inability to process uric acid in the body. Excess uric acid can lead to the development of small crystals which form in and around the joints, and this causes swelling, pain and redness. These symptoms often affect the joint of the big toe, but can also affect the fingers, wrists, elbows or knees.
Gout is more common in men, especially those with a family history of the condition, and may also develop after taking certain medications or eating certain foods. Alcohol and sugary drinks can worsen the condition, and it is also more likely to occur in those who are obese or have had certain surgical operations.
Attacks or episodes of gout are usually limited to around ten days, beginning with an intense pain in the affected area. Most people will experience a second attack within a year of their diagnosis, and effective treatment can help to limit the damage to joints and avoid long-lasting harmful effects. It is important to seek help as soon as you have a gout attack, and you may find that applying ice and elevating the affected joint is useful in managing the pain. You should aim to reduce stress in your daily lifestyle and pay attention to your diet and fluid intake in order to decrease the frequency and severity of attacks. A specialist rheumatologist will work with you to create a personalised treatment plan, and this may involve medications to relieve the pain or to reduce the uric acid levels in your body.
Most people with any of the above forms of arthritis will first notice that they have painful, swollen joints, and this may be constant or may come and go in episodes. Consultation with a rheumatologist will help you to make decisions about the treatments you are offered, and give you a long term prognosis for your condition.
If you have been experiencing pain and inflammation in one or more of your joints, you should visit your doctor as soon as possible and ask to be referred for specialist treatment. Working with an experienced specialist will enable you to follow an appropriate plan in order to manage your pain and improve your mobility, depending on the type of arthritis you are experiencing.
Dr Peter is a qualified rheumatologist who sees patients in Tralee and Limerick. To make an appointment, you will need to visit your GP or other healthcare professional, who can refer you to our rheumatology clinic. If you have a query, you can contact us online for more information.