For people with arthritis, even the simplest everyday action such as standing up or bending over can cause immense pain. While it is widely known that arthritis presents itself more often in older people, believe it or not, people in their 20s can also develop arthritis, with their symptoms only worsening with age.
Arthritis remains a leading cause of pain and disability worldwide, encompassing more than a hundred forms of arthritis and related diseases. According to the Centre for Disease Control and Prevention, more than one-third of adults who have arthritis report that it limits their leisure activities and work, and 25 percent of them say it causes severe pain.
Following the observance of World Arthritis Day, Sunway Medical Centre would like to continue helping you relieve your arthritic pain through different approaches – medically and at home.
Which Arthritis is Which?
There are two main types of arthritis, degenerative and inflammatory, both of which will cause immense pain if left untreated.
Degenerative arthritis is caused by wear and tear in a joint. It is usually non-symmetrical because it only affects a particular joint on one side of the body.
Dr Cheah Chee Ken, Consultant Rheumatologist from Sunway Medical Centre, Sunway City, explains, “When a person overuses their joints, such as their knees or shoulders, they tend to develop degenerative arthritis which will decrease their range of motion.”
Symptoms of degenerative arthritis are more concentrated on the joints with symptoms such as pain, joint stiffness, swelling, and redness. The pain symptom from degenerative arthritis is mechanical in nature, meaning it is worse on movement and relieved with rest. All of which, pain during activities will cause difficulty in performing everyday tasks.
Inflammatory arthritis describes a group of joint diseases with inflammatory joint pain as the main feature. Features of inflammatory joint pain include pain at rest, marked early morning joint stiffness, joint swelling with occasional skin redness. It can be caused by different conditions, ranging from acute injury, infections, or an overactive immune system that attacks the joints (also known as autoimmune diseases). In particular cases of immune mediated arthritis, the immune response does not know how to differentiate oneself from foreign substances, leading to ongoing inflammation and subsequently permanent joint damages.
Unlike Degenerative arthritis, Inflammatory Arthritis may affect multiple joints simultaneously and symmetrically. Systemic symptoms such as fatigue are common.
Taking the Burden Off Your Joints
Treatment principle for arthritis involves identifying the correct diagnosis, arresting inflammation as prolonged inflammations lead to structural damages, controlling pain and symptoms, and preserving joint functions and maintaining quality of life, for appropriate management to be tailored accordingly.
Certain conditions require simple steps such as exercises and physiotherapies, while in some cases surgery may be required.
As for various types of inflammatory arthritis, treatment mainly consists of medical therapy. Therefore, it is advised to seek consultation from a healthcare provider.
The commonest form of arthritis is still degenerative arthritis (Osteoarthritis).
Below are some of the general measures aiming to address different areas of degenerative arthritis:
- Being overweight or obese puts extra weight and strain on joints. It will also contribute to inflammation due to a higher BMI.
- Kickstart an exercise programme such as walking or aerobics. Note that it must be a low-impact activity to lessen the strain on joints.
- Maintain a healthy diet. Specific changes in diet will show benefits of reducing inflammation and stress on joints. For example, the addition of fish oils rich in omega-3 fatty acids and vitamin D3 have modestly improved arthritis pain and joint swelling.
- If exercise or change in lifestyle no longer work, your healthcare provider may recommend surgery. Surgery options include hip resurfacing and hip replacement.
- Hip resurfacing – The surgeon trims away damaged bone and cartilage and replaces them with a metal stem (inserted down into thigh bone), which makes an artificial surface.
- Hip replacement – The surgeon removes the damaged sections of the hip joint and replaces them with an artificial joint.
- Cognitive behavioural therapy (CBT)
- Application of heat pads
- Topical ointments
- Moving and exercising the affected joints can increase hand strength, improve finger, and thumb mobility.
- The key to each exercise is to avoid putting too much stress on the area.
- Alternatively, you may consult a hand therapist to prescribe exercises best suited for your hand.
- The main goal of braces is to support and protect the affected joint.
- Splints or braces will reduce strain and promote proper joint alignment.
- It is not advisable to wear long-term, as it will weaken your muscles.
- Joint fusion – This surgery will limit your flexibility and movement because it uses a plate and screws to keep the bones of your joint together. On the bright side, you’ll have a more stable and pain-free joint.
- Tendon transfer – Inflammatory arthritis can cause tendons to rupture. If this happens, transferring a healthy tendon can restore your hand function.
- “Even after surgery, past sports knee injuries can be lingering; causing damage to both cartilage and bone due to the way a person moves their knee,” Dr Cheah shared.
- Avoid movements such as lunges or squats that could strain joints.
- Remaining physically active is key to managing symptoms and strengthening the knee.
- Specialists will recommend using assistive devices like canes or walkers to provide support.
- Canes can reduce the weight bearing for the arthritic joint, thereby reducing pain.
- Knee replacement – The goal is to resurface the damaged knee joint and relieve the pain. Metal and plastic parts are used to cap the ends of the bones that form the knee joint, along with the kneecap.
- Knee Osteotomy – The surgery re-aligns the joint to shift more pressure onto the better side of the knee joint and reduce wear and tear on the bad side. This surgery can postpone the need for total knee replacement surgery up to 10 years.
- Cartilage Restoration – Bone marrow stimulation. This surgery is to stimulate cartilage growth by making precise microfractures in the surrounding bone.
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