By Dr. Kesavan A R
Arthritis is an inflammation of joint(s), commonly seen as joint pain, swelling, stiffness and deformity. It is not a single disease, and it’s a way of referring to any joint pain or joint disease. There are more than 100 different type of arthritis.
However all joint pains are NOT arthritis. Pain around the joint MAY be arthritis if:
1. Pain is present for more than 6weeks
2. Swelling is present around the joint
3. Early morning stiffness (> 30 minutes) of the joint, which eases out with movement.
If someone has the above symptoms, they have to get it checked by the doctor and tests such as blood tests and xrays may be done to confirm or negate arthritis.
Types of Arthritis:
1. The commonest is Osteoarthritis (colloquially referred to as “Arthritis of old age”). In India, it is found to affect the knees more often, although other joints like terminal joints of fingers, hips also can be affected
2. Inflammatory arthritis like Rheumatoid Arthritis, Psoriatic arthritis, Ankylosing Spondylitis etc, form a major chunk
3. Trauma- Fractures around joints can lead to arthritis. Long standing deficiency or dysfunction of ligaments around joints and direct cartilage damage may result in Osteoarthritis
4. Infections causing arthritis can lead to long term damage. May be related Bacteria causing pus (Pyogenic) or Tubercular; Fungi or other micro-organisms
5. Miscellaneous – Crystal deposition (eg: Increase in uric acid levels)
Stages of arthritis
1. Stage of Synovitis – pain and swelling of joints, normal cartilage
2. Stage of Early arthritis- mild cartilage damage
3. Stage of advanced arthritis- marked cartilage damage
4. Stage of Ankylosis or Dislocation/ Displacement of joint
Treatment of Arthritis: (Depends on the underlying cause of arthritis, stage of arthritis, age and activity needs of patient)
1. Exercises – almost all joint problems will require some form of exercises. It may involve moving the joints through their normal action ( RANGE of MOVEMENT Exercises), Muscle Strengthening Exercises, Heat or Cold Therapy
2. Medicines –
a. Anti- inflammatory (”Pain-killers”) are used to reduce acute joint inflammation, pain and swelling. Steroids are also used in severe conditions to reduce inflammation
b. For inflammatory arthritis- Disease modifying Anti Rheumatic Drugs (DMARDs) have revolutionized treatment of these problems and their use has avoided the need for surgery in a vast majority.
c. Antibiotics and anti-microbials are used in infectious arthritis
3. Orthoses- splints, braces, belts and bandages are used as needed in specific areas to correct or prevent deformity and to aid in normalization of joint function.
4. Surgery – Joint replacement – Hip, knee, shoulder, elbow replacement have been a boon for advanced arthritis. Advances in Surgery have made surgery extremely effective and have benefited millions. These include, Multi-modal paint control, Uncemented Implants, Ceramics in replacement, usage of large head Hips, Minimally invasive surgery
Dr. Kesavan A R is Senior Consultant – Institute of Orthopedics & Joint Replacement, Gleneagles Global Health City, Chennai
Co-author Dr. Sham S is Consultant – Department of Rheumatology, Gleneagles Global Health City, Chennai