Arthritis (from Greek arthro-, joint + itis, inflammation; plural: arthritides) is a group of conditions where there is damage caused to the joints of the body. Arthritis is the leading cause of disability in people over the ages of 55.
There are many different forms of arthritis, each of which has a different cause. The most common form of arthritis, osteoarthritis (also known as degenerative joint disease) occurs following trauma to the joint, following an infection of the joint or simply as a result of ageing. Other forms of arthritis are rheumatoid arthritis and psoriatic arthritis, which are autoimmune diseases in which the body is attacking itself. Septic arthritis is caused by joint infection. Gouty arthritis is caused by deposition of uric acid crystals in the joint that results in subsequent inflammation.
We often employ terms like arthritis and rheumatism as these are common joint disorders. We spoke to Dr. B. Rajasekar, Senior Consultant Rheumatologist, Apollo Hospitals Chennai and asked him to explain the basic facts about these disorders.
What do the terms Arthritis and Rheumatism mean?
People are often confused about the meaning of the two words – arthritis and rheumatism. Arthritis means disease of or damage to the joints. The term rheumatic disease is used to refer to all types of arthritis and rheumatism.
What are the common types of arthritis?
Arthritis actually is an umbrella term covering more than 100 different diseases. Osteoarthritis and Rheumatoid Arthritis are the two most common conditions we come across.
Osteoarthritis is a condition, in which the cartilage surface that lines the joints becomes damaged and eventually deteriorates, often affecting the hands, hips, knee and spine. Most people over 60 have some degree of osteoarthritis, although not all experience its most painful symptoms.
Another common but very different type is Rheumatoid Arthritis, in which the immune system goes after healthy joint tissue, leading to inflammation and damage to the joints. Rheumatoid arthritis, which afflicts about one crore people in India and affects the young and the old alike, is not merely a physical disability but also affects the person’s life span.
What are the different types of Rheumatic diseases?
Rheumatic diseases fall into four main groups:
- Inflammatory arthritis for which Rheumatoid arthritis is an example. But there are many other forms of inflammatory arthritis, including gout, reactive arthritis and arthritis associated with colitis and psoriasis. There are other rarer disorders that can affect many parts of the body called connective tissue diseases such as Systematic Lupus Erythematosis (SLE).
- Soft tissue rheumatism where rheumatic pain arises from damage to areas around joints, such as ligaments and tendons. Minor injury or overuse can result in localized pain which often lasts only for a short period. Tennis elbow or housemaid’s knee are examples.
- Back pain – this can be caused by any one of a number of problems, including stresses on the spine, damage to or degeneration of the muscles, discs, ligaments and joints, and some specific rheumatic diseases. Osteoarthritis can also affect the back, in which case it is usually referred to simply as spondylosis.
Do Rheumatic diseases affect any particular group people?
Arthritis and rheumatism do not affect according to age, sex, race, class or country. It is a common worldwide problem.
How do these disorders manifest in affected individuals?
People with arthritis are often confronted with pain every day and it limits their ability to lead a full and active life. It is one of the leading causes of disability in this country, but it is not, as many people think, an inevitable part of growing older. Research has offered a better understanding of arthritis and the effective ways to prevent it and its complications. The earlier a diagnosis can be made and the earlier therapy can be started, greater the chance of minimizing discomfort and minimizing the risk of disability.
Who should be consulted first if one has joint pains?
Rheumatologists specialize in medical aspects of arthritis and orthopedic surgeons specialize in surgical aspects of arthritis. Ideally patients must first visit the rheumatologists as most rheumatic diseases do not require surgery. It is preferable to try medical interventions long before there is a need for surgery.
Are there any risk factors for common musculoskeletal disorders?
Activities in the home, at the office, in industry and agriculture and in other areas almost inevitably bring with them the problem of musculoskeletal disorders (MSD).
In most cases, these basic facts – inadequate education, poverty and lack of awareness – hinder attempts to deal with the MSD problem. Poor working conditions and non-enforcement of statutory norms are additional factors.
There is a great deal of ignorance concerning MSD in most Indian industries. Unsuitable tools, bad work posture and improper work height or reach are the major causes of MSD.
What is the treatment strategy?
We now think of four different types of treatment strategy –
- Effective treatment or control of established disease
- Containment or salvage.
Treatment is getting better all the time. New drugs (like biologic therapy) and operations are safer and more effective than before and there is also greater recognition of what can be achieve through self-help and caring. The best of old is being combined with modern therapy to improve a lot of the person with rheumatic diseases – providing a more rounded, holistic approach to treatment
Is anything being done globally about such a disabling but common problem?
The World Health Organization (WHO) has declared 2001-2010 as the decade of ‘Bone and Joint’ diseases. There is no better time for health professionals to work hard to crate awareness of arthritis among people and provide appropriate advice.