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    Arthritis details Arthritis details Document Transcript

    • What is Arthritis? What Causes Arthritis?The word arthritis comes from the Greek arthron meaning "joint" and the Latin itis meaning"inflammation". The plural of arthritis is arthritides. Arthritis affects the musculoskeletal system,specifically the joints. It is the main cause of disability among people over fifty-five years of age inindustrialized countries.Arthritis is not a single disease - it is a term that covers over 100 medical conditions. Osteoarthritis (OA)is the most common form of arthritis and generally affects elderly patients. Some forms of arthritis canaffect people at a very early age.What causes arthritis? In order to better understand what is going on when a person suffers from some form of arthritis, let uslook at how a joint works.Basically, a joint is where one bone moves on another bone. Ligaments hold the two bones together.The ligaments are like elastic bands, while they keep the bones in place your muscles relax or contract tomake the joint move.Cartilage covers the bone surface to stop the two bones from rubbing directly against each other. Thecovering of cartilage allows the joint to work smoothly and painlessly. A capsule surrounds the joint. The space within the joint - the joint cavity - has synovial fluid. Synovialfluid nourishes the joint and the cartilage. The synovial fluid is produced by the synovium (synovialmembrane) which lines the joint cavity.If you have arthritis something goes wrong with the joint(s). What goes wrong depends on what type ofarthritis you have. It could be that the cartilage is wearing away, a lack of fluid, autoimmunity (your bodyattacking itself), infection, or a combination of many factors.
    • Types of arthritis There are over 100 types of arthritis. Here is a description of some common ones, together with thecauses:Osteoarthritis - cartilage loses its elasticity. If the cartilage is stiff it becomes damaged more easily. Thecartilage, which acts as a shock absorber, will gradually wear away in some areas. As the cartilagebecomes damaged tendons and ligaments become stretched, causing pain. Eventually the bones mayrub against each other causing very severe pain.Rheumatoid arthritis - this is an inflammatory form of arthritis. The synovial membrane (synovium) isattacked, resulting in swelling and pain. If left untreated the arthritis can lead to deformity. Rheumatoidarthritis is significantly more common in women than men and generally strikes when the patient isaged between 40 and 60. However, children and much older people may also be affected.Infectious arthritis (septic arthritic) - an infection in the synovial fluid and tissues of a joint. It is usuallycaused by bacteria, but could also be caused by fungi or viruses. Bacteria, fungi or viruses may spreadthrough the bloodstream from infected tissue nearby, and infect a joint. Most susceptible people arethose who already have some form of arthritis and develop an infection that travels in the bloodstream.Juvenile rheumatoid arthritis (JRA) - means arthritis that affects a person aged 16 or less. JRA can bevarious forms of arthritis; it basically means that a child has it. There are three main types:1. Pauciarticular JRA, the most common and mildest. The child experiences pain in up to 4 joints.2. Polyarticular JRA affects more joints and is more severe. As time goes by it tends to get worse.3. Systemic JRA is the least common. Pain is experienced in many joints. It can spread to organs. This canbe the most serious JRA.What are the signs and symptoms of arthritis?The symptoms of arthritis depend on the type of arthritis, for example:Osteoarthritis - The symptoms develop slowly and get worse as time goes by. There is pain in a joint,either during or after use, or after a period of inactivity. There will be tenderness when pressure isapplied to the joint. The joint will be stiff, especially first thing in the morning. The patient may find itharder to use the joint - it loses its flexibility. Some patients experience a grating sensation when theyuse the joint. Hard lumps, or bone spurs may appear around the joint. In some cases the joint mightswell. The most common affected joints are in the hips, hands, knees and spine.
    • Rheumatoid arthritis - The patient often finds the same joints in each side of the body are painfullyswollen, inflamed, and stiff. The fingers, arms, legs and wrists are most commonly affected. Symptomsare usually worst on waking up in the morning and the stiffness can last for 30 minutes at this time. Thejoint is tender when touched. Hands may be red and puffy. There may be rheumatoid nodules (bumps oftissue under the skin of the patients arms). Many patients with rheumatoid arthritis feel tired most ofthe time. Weight loss is common. The smaller joints are usually noticeably affected first. Experts say patients with rheumatoid arthritishave problems with several joints at the same time. As the arthritis progresses it spreads from thesmaller joints in your hands, wrists, ankles and feet to your elbows, knees, hips, neck, shoulders and jaw.Infectious arthritis - The patient has a fever, joint inflammation and swelling. He will feel tendernessand/or a sharp pain. Often these symptoms are linked to an injury or another illness. Most commonlyaffected areas are the knee, shoulder, elbow, wrist and finger. In the majority of cases, just one joint isaffected.Juvenile rheumatoid arthritis - The patient is a child. He will experience intermittent fevers which tendto peak in the evening and then suddenly disappear. His appetite will be poor and he will lose weight.There may be blotchy rashes on his arms and legs. Anemia is also common. The child may limp or have asore wrist, finger, or knee. A joint may suddenly swell and stay larger than it usually is. The child mayexperience a stiff neck, hips or some other joint.How will arthritis affect me?Arthritis affects people in many different ways. How long the patient is affected and how severely it isdepends on the type of arthritis. Arthritis sufferers will find there are good and bad days. Most patientswith arthritis will suffer from discomfort, pain, stiffness and/or fatigue. You may also feel frustrated that you are no longer able to grip things so well or get around like youused to. It is important to remember that if you suffer from arthritis this does not mean you have to giveup having an active lifestyle. With some changes to your way of life there is no reason why you cannotcontinue being active.Physical therapy and occupational therapy for arthritisPhysical therapy and occupational therapy help maintain joint mobility and range of motion. How muchtherapy you need, and what kind of therapy will depend on many factors, such as the severity and type
    • of arthritis you have, your age, and your general state of health. This has to be decided by you with yourphysician and physical or occupational therapist. People with arthritis will often avoid moving the affected joint because of the pain. A physical therapistcan help the patient work out the joint stiffness without damaging it. In order to perform your dailyactivity the physical therapist will help you achieve a good range of motion. This may involve buildingstrength in the muscles that surround the affected joint - stronger muscles help stabilize a weakenedjoint. You will also be taught the best way to move from one position to another, as well as learning howto use such walking aids as crutches, a cane or a walker, if you need one.Occupational therapy can teach you how to reduce the strain on your joints as you go about your dailyactivities. The occupational therapist can help you modify your home and workplace so that yourmovements do not aggravate your arthritis. You may need a splint for your hands or wrists, as well asaids for dressing, housekeeping, work activities, driving and washing/bathing yourself. An occupational and/or physical therapist can make an enormous difference to your quality of life if yousuffer from arthritis. He/she will help you learn more about your arthritis, devise a dietary plan if you areoverweight and overstressing the joints as a result, help you make better decisions about what shoes tobuy if that part of the body is affected. You will learn how and when to rest - rest is crucial for treatinginflammation and pain, especially when many joints are affected and you feel tired. Resting individualjoints is very helpful too - custom splints can be made to rest and support affected joints.Local pain can be relieved with ice packs or heating pads. Ultrasound and hot packs provide deep heatwhich relieves localized pain and relaxes muscle spasm around the affected joint. You may find that awarm bath/shower makes it easier for you to exercise afterwards.Your therapist will most likely devise an exercise program for you. Exercise is a crucial part of effectivearthritis therapy.Medications for arthritisNSAIDs NSAIDs (nonsteroidal anti-inflammatory drugs) are the most commonly prescribed drugs forarthritis patients. These may be either prescription or over-the-counter (OTC). At low doses NSAIDs helpa vast range of ailments, from headaches, muscle aches, to fever and minor pain. At a higher dose -prescription dose - NSAIDs also help reduce joint inflammation. There are three main types of NSAIDsand they all work by blocking prostaglandins - hormone-like substances that trigger pain, inflammation,muscle cramps and fever:
    • Traditional NSAIDs - these are the largest subset of NSAIDs. As is the case with most drugs, they do carrya risk of side-effects, such as stomach upset and gastrointestinal bleeding. The risk of side effects issignificantly higher if the patient is over 60. A patient should take this type of drug at high doses underthe supervision of a doctor.COX-2 inhibitors - these also reduce pain and inflammation. However, they are designed to have fewerstomach and gastrointestinal side-effects. In 22004/2005 Vioxx and Bextra were taken off the marketafter some major studies showed Vioxx carried increased cardiovascular risks, while Bextra triggeredserious skin reactions. Some other COX-2 inhibitors are also being investigated for side-effects. The FDAasked makers of NSAIDs to highlight warnings on their labels in a black box.Salicylates - includes aspirin which continues to be the preferred medication of many doctors andpatients. Patients need to consult their doctor if they plan to take aspirin more than just occasionally.Long term high dosage usage of aspirin carries with it a significant risk of serious undesirable sideeffects, such as kidney problems and gastrointestinal bleeding. For effective control of arthritis pain andinflammation frequent large doses are needed. Nonacetylated salicylate is especially designed to havefewer side effects than aspirin. Some doctors may prescribe nonacetylated salicylate if they feel aspirinis too risky for their patient. However, nonacetylated salicylate does not have the chemical aspirin haswhich protects against cardiovascular disease. Some doctors prescribe low dose aspirin along withnonacetylated salicylate for patients who they feel need cardiovascular protection.Glucocorticoids are anti-inflammatory steroids and are very effective at combating inflammation andcan be extremely helpful when used properly. The patient needs to consider the potential forundesirable side-effects with this type of drug.Anti-malarials, such as hydroxychloroquine and chloroquine are commonly used for treating mildinflammatory arthritis.Minocycline - an antibiotic that is sometimes used as antibiotic therapy for rheumatoid arthritis. Its useis controversial.Sulfasalazine - commonly used for many types of inflammatory arthritis. Sulfasalazine is a sulfaderivative.Methotrexate - works by blocking the metabolism of rapidly dividing cells. It is commonly used fortreating more serious types of inflammatory arthritis.Azathioprine - used for severe forms of inflammatory arthritis. Azathioprine also blocks the metabolismof rapidly dividing cells.
    • Gout medications - some physicians may use gout medications to treat some forms of arthritis.Leflunomide - used to treat rheumatoid arthritis and psoriatic arthritis. It also blocks cell metabolism.However, biologic therapy is gradually taking over.Cyclosporine - an immunosuppressant drug - it makes your immune system less aggressive. Cyclosporineis commonly used by transplant patients so that their bodies do not reject their transplanted organs.Cyclosporine is usually used in combination with methotrexate for arthritis patients. Although effective,this may be limited by its toxicity.Diet and bodyweight impact on arthritis Experts say that eating a well-balanced diet is vital when you have arthritis. Not only will you bereceiving critical nutrients, you will also be either maintaining or arriving more quickly at a healthybodyweight. If you are overweight you will be adding extra pressure on weight-bearing joints. Manypatients have found that losing just a few pounds made a significant difference to their quality of life.Doctors and nutritionists are more frequently advising arthritis patients to keep sugary and/or fattyfoods to a minimum - such as red meat, cream and cheese. You should make sure you are eating plentyof fruit and vegetables, as well as whole grains. Omega-3 essential fatty acids are thought to relieve tosome extent the symptoms of arthritis. A common source of Omega-3 fatty acids is oily fish, such assardines, herring, trout, and salmon.Many of us tend to place large portions on our plate. If you reduce the size of the portions you may loseweight more effectively. Make sure that vegetables and fruit make up a large part of your portion.Living with arthritis Although arthritis can make daily tasks more difficult and exhausting, there are many techniques andtherapies, which added together, can give you a much better quality life, compared to no therapy at all.It is important that people with arthritis seek medical health and treatment. Although there is no curefor arthritis, there is a lot you can do to minimize its overall effects on your everyday life.You may wish or have to continue working, and with the right techniques and help from an occupationaltherapist you may find it is not as daunting as you first thought.There is a lot you can do to minimize the impact your arthritis might have on family life and raising yourchildren. A person with arthritis will need to remember that being there for the child is much moreimportant than being a super active parent. If you pace yourself and prioritize you will be surprised athow much you can achieve successfully. Be open with your family members about your arthritis -explain how it affects you so that they recognize when you may need extra understanding and support.
    • HOME REMEDIES :Home Remedies for Arthritis we recommend.Home remedies for arthritis #1: Eat Alfalfa or take alfalfa capsules. Its very rich in minerals needed forthe formation of bones.Home remedies for arthritis #2: Take chondroitin sulfate 700 mg. a day to strengthening of joints andligaments. Take it in tablet form, click on the sign for Chondroitin Caplets.Home remedies for arthritis #3: Take Vitamin E to protect and improve joint mobility.Home remedies for arthritis #4: Bogbean is an aquatic herb, very powerful herb special forrheumatoid arthritis and Osteoarthritis, anti-inflammatory. Since this herb cleans the urinary tract,drink lots of water.Home remedies for arthritis #5: Boswellia has anti-inflammatory effects similar to Non-steroidal anti-inflammatory drugs (NSAID) (Advil, Aleve, Tylenol etc.) but this herb does not have side effects anddoes not causes gastrointestinal bleeding. It improves circulation to the joints, relieves pain,inflammation and stiffness.Home remedies for arthritis #6: Ginger is the Killer of Arthritis pain, superior to any NASID, it can beapplied directly on the affected area or taken orally ether way it relieves pain, inflammation, stiffness,bursitis, tendinitis.Home remedies for arthritis #7: MSM is rapidly establishing a reputation as a safe, natural effectivesolution for many types of pain and inflammatory conditions including: degenerative (wear-and-tear)arthritis, rheumatoid arthritis, chronic back pain, chronic headaches, muscle pain, fibromyalgia,tendonitis, bursitis, carpal tunnel syndrome, TMJ, post-traumatic pain, inflammation and heartburn.MSM may be the natural solution for pain.