health

Arthritis: Symptoms, Diagnosis and Treatment

Dr. Nikhil Eric Saldanha

March 14, 2022

Arthritis is the swelling or inflammation of the joints. Arthritis is generally characterised as stiffness or joint pain and usually worsen with age. Statistics suggest that 1 in 4 adults are prone to arthritis. It might affect one or more joints at the same time. In addition, it is also one of the primary reasons for pain, leading to severe disability. The common body parts affected by arthritis and resultant pain are hands, feet, knees, hips and back.

What Causes Arthritis? 

Spongy cartilages cover the bones in your healthy joints, cushioning the bones and muscles. This set-up and synovial fluid allow smooth movement without much friction. However, any injury leads to inflammation or swelling, which are the body’s natural defence mechanisms. But if this inflammation is long-lasting or occurs repeatedly, it can become a case of arthritis. Eventually, it leads to tissue damage. 

Inflammation comes with redness, stiffness, pain and difficulty in movement. Swelling, stiffness, and joint pain are the usual and frequent symptoms. These symptoms might feel worse early in the morning when you get out of your bed and even get up after resting for quite some time.

Common Causes of Arthritis

  • Family history or genetic inheritance
  • Autoimmune disorders
  • Muscle weakness
  • Overuse of a joint, leading to its wear and tear
  • Age (osteoarthritis is more prevalent in individuals over 50 years of age)
  • Overweight and obesity
  • Injuries due to various reasons like accidents

Types of Arthritis and Their Symptoms

There are over a hundred types of this condition, each with different treatments and causes. 

However, some of the most common ones are:

Osteoarthritis

Osteoarthritis happens due to general wear and tear of tissues. It is one of the most commonly known types. It begins with the natural breakdown of cartilage tissues that can be agitated by a joint injury or infection. As a result, it causes excessive friction in the bones. In addition, tiny bones called osteophytes can emerge within joints from the bone ends. 

A flexible yet firm connective tissue known as cartilage protects your joints. It absorbs the shock, and the pressure applied when we move or exert stress on them. A depletion in the usual amounts of these cartilage tissues is known to cause several forms of arthritis. The possibility of developing this condition might be more if one has a family history.

Osteoarthritis, also known as OA, generally occurs after 50 or 60. Yet, research shows radiographic evidence of osteoarthritis developing in women in their 40s. In addition, it is a condition known to be more prevalent in overweight people. OA occurs mainly in the hands, knees and hips.

The common symptoms of osteoarthritis are as follows:

  • Bony hands
  • Clicking and popping sounds while bending
  • Limited range of motion that sometimes goes away after movement
  • Scraping or grating feeling in and around the knees
  • Muscle weakness, especially around the joint
  • Buckling and instability of the joint

Rheumatoid Arthritis

Another commonly known form of arthritis is rheumatoid arthritis (RA). It is an autoimmune disorder. It develops when our body’s immune system attacks our body’s tissues, which results in inflammation of the joints alongside other body vitals. Data shows that RA mainly affects knees, hands and wrists. However, severe cases of RA affect the eyes and nervous system too. 

Furthermore, this inflammatory response in our joints affects the synovium. It is a delicate tissue in the joints that secretes a vital fluid that lubricates the joints and nourishes the cartilages. RA eventually destroys both cartilage and bone within the joint. The precise cause of this attack is still unknown. However, experts have discovered genetic markers that aggravate the possibility of developing rheumatoid arthritis.

Common symptoms of rheumatoid arthritis are as follows:

  • Stiffness in the morning that lasts for about 30 mins or more
  • More than one joint is affected at the same time
  • Fatigue
  • Onset in small joints such as hands and feet
  • Inflammation around the mouth and eyes
  • Similar joints on both sides of our body are affected
  • Mild fever
  • Low RBC count
  • Inflammation of the blood vessels as well as heart muscles

Gout

A common symptom is a severe and sudden pain attack, redness, tenderness and swelling in one or more joints, most often the big toe. This inflammation and pain develop due to too much crystallisation and deposition of uric acid in the joints. Research shows that gout occurs mainly in the knee and wrist. So it is quite a common occurrence. But a complex form of this disease can affect anyone.

The common symptoms of gout are as follows:

  • Redness 
  • Swelling in and around joints, most often the big toe
  • Extreme pain in the joint
  • Sudden attacks, frequent at night

Treatment for Arthritis: Are You Going to be Okay?

The key objective of treatment is to reduce the pain you are experiencing alongside preventing any additional joint damage. Generally, arthritis treatment includes a combination of medications and therapies. Only in severe conditions of arthritis surgery is preferred. Rest, exercise and a few lifestyle changes can reduce arthritis pain effectively.  

Medications

Various types of medications help in treating arthritis:

  • Studies show that Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most prescribed medications for inflammation and pain management. Some of these medicines are salicylates or ibuprofen (Advil). Salicylates help in blood thinning, which is why one should not consume them with any other blood-thinning drugs. NSAIDs are available in different consistencies like gels and creams; you can rub them on the affected areas. However, such medications might affect your heart health. 
  • Some steroids, such as prednisone, are used in arthritis treatment to relieve joint pain and joint damage. In addition, they help reduce inflammation. These steroids are available as injections or tablets. However, you should take them carefully and only for short periods. Steroids have side effects like weight gain and diabetes. Sometimes, these drugs also lead to thinning of bones.
  • Corticosteroid injections are steroids that provide relief from stiffness and joint pains. 
  • Menthol or capsaicin creams contain ingredients that aid in relieving joint pains. In addition, these creams help block pain signal transmissions from the joints due to arthritis. Such medications are called counterirritants.
  • Analgesics like acetaminophen (Tylenol) and hydrocodone (Vicodin) help manage pain. But they do not help in reducing inflammation.
  • Biologics and Immunosuppressants are suitable for conditions like rheumatoid arthritis in which inflammation levels are moderate to severe.
  • If diagnosed with RA, your doctor might suggest disease-modifying antirheumatic drugs (DMARDs). As per a study, they prevent tissue damage due to arthritis.
  • Drugs for rheumatoid arthritis are abatacept, anakinra, etanercept, infliximab, rituximab, etc. 

Physical Therapy

Physical therapy is a core component for treating arthritis. It involves specific exercises which help in strengthening the muscles around the joint. One study states that physiotherapy and rehabilitation can be beneficial for arthritis patients.  

Other than your medical visits, the physical therapist will probably suggest a plan to include daily movement alongside exercises that you can complete quickly at home. In addition, they provide activities and techniques to strengthen the joints and bones. Altogether, this will help build flexibility, strength, and balance to improve mobility alongside preventing falls. 

As per therapists, some standard techniques are:

  • Improve postures and positions that reduce strain on joints
  • Usage of more substantial (stronger) muscles and joints instead of the inflamed ones
  • Aiding oneself with machines to do daily activities like modified doorknobs, walkers, grab bars during a bath, special devices for opening jars, etc. 

Surgery

In severe cases where medications and supplements are not providing enough relief from the pain, surgery is the last option. 

Surgery for joint replacement with a prosthetic one is popular in arthritis treatment. These forms of surgery replace the ankle, shoulders, knees and hips. 

The doctor might perform a joint fusion if the arthritis is severe, mainly in the wrists or fingers. This method fuses the ends of the bones, restricting the movement of joints. As a result, it terminates the inflammation site and reduces joint pains.

Joint repair is another surgical procedure where surgeons smoothen inflamed joints to alleviate pain and inflammation.

Natural Ways to Manage Arthritis Pain

Weight Management

Excess weight puts more pressure on the bones and joints, especially in the back, hips, legs and knees. Losing these extra pounds and maintaining a healthy body weight lowers the possibility of developing conditions like osteoarthritis. It can also help reduce symptoms if you’re already suffering from the disorder. It also improves the mobility of the body. In addition, studies suggest that weight loss ultimately reduces the pain and rules out any future complications. 

Diet Plan

Consuming a healthy, nutrient-rich diet is necessary for losing weight. One research concludes that opting for foods rich in antioxidants like herbs, vegetables, and fresh fruits will help in reducing inflammation. A sound immune system is essential for the proper functioning of the inflammatory responses. Antioxidant-rich fruits and vegetables provide this benefit. Other foods that help in reducing inflammation include nuts and fish. 

Foods to Include in Arthritis Diet

A gluten-free diet might help in improving the symptoms and slow the disease progression. A study suggests opting for a gluten-free diet for individuals with undifferentiated connective tissue disease.

Green leafy vegetables like spinach are rich in antioxidants, namely kaempferol. Data shows that this compound is associated with relieving rheumatoid arthritis and osteoarthritis. Primitive studies of broccoli’s effect on treating arthritis have shown positive results. It is due to sulforaphane, an anti-inflammatory compound. 

Fruits such as grapes and berries are excellent antioxidants like resveratrol and proanthocyanidin. Research shows that this compound can lead to anti-inflammation in rheumatoid arthritis. Quercetin in berries also performs a similar activity. 

Fishes like salmon and sardines are rich in healthy fats that provide anti-inflammatory effects. In addition, studies show that omega-3-fats are beneficial for rheumatoid arthritis. Also, vitamin D in fishes improve bone health.

Spices like ginger, garlic and turmeric have positive effects on the treatment of arthritis. Studies suggest that turmeric plays a considerable role in treating arthritis. Studies conducted on the impact of ginger extract on patients with osteoarthritis revealed improvement in joint pain. 

Another research suggests that garlic has immense anti-inflammatory properties. Hence, people use it as a remedy in cancer treatment. In addition, garlic cloves help improve immune responses. 

Foods to Limit in Arthritis Diet

  • Processed foods with high salt and sugar content
  • Dairy products
  • Fried foods containing saturated fats
  • Meat products
  • Gluten-rich foods
  • Alcohol and nicotine products

Supplements

Very little evidence has supported that herbal supplements may help in alleviating arthritis pain. Some are turmeric, garlic, ginger, devil’s claw, Gingo, etc. 

Regular Exercise 

Exercising regularly will help in keeping the joints flexible. Physical activity also strengthens the muscles. Swimming is a preferred exercise over walking or running for individuals with arthritis. It does not put pressure on the joints. 

Research proves that being in an active state is very important. Nonetheless, paying attention to your body when it is signalling to rest and avoiding overexertion is just as essential. Exercises at home include:

  • Thumb and finger bend that help ease pain in the hands.
  • The neck rotation, head tilt along other exercises help relieve back pain.
  • Hamstring stretches, leg raises, and other easily doable exercises help with knee arthritis.
  • Tai chi and a few yoga poses are good for arthritis. 

Hot and Cold Compress

Hot treatments like hot showers or placing hot packs on the areas of inflammation can relieve the pain to an extent. Similarly, cold treatments like ice packs can reduce sore muscles’ swelling and inflammation. These techniques are used easily at home to relieve the stiffness in the joints. Do not use either method continuously for a very long period. Be careful not to burn yourself. Never put ice directly on the exposed body part. 

Acupuncture and Massage

Acupuncture is an ancient method where therapists insert needles into specific body areas. Similarly, massage is an excellent option for relieving the stiffness of the body. Although there is not enough scientific approach to these techniques, they comfort joint and muscle aches. 

Who Can Get Arthritis? 

Anyone can get it, and various factors like age, sex, heredity, injury history increase the possibility of arthritis. 

Genes 

A genetic inheritance or a family history of any autoimmune disease might increase the risk of rheumatoid arthritis and other related types.

Obesity

Specifically linked to osteoarthritis, obesity adds to additional stress on the joints that bear the weight of our body. These include joints like our hips and knees. Therefore, reducing excess weight will help reduce the possibility of developing arthritis and be beneficial if one is already affected with arthritis.

Age and Gender

The possibility of developing arthritis increases with age in anybody. Also, more women than men are likely to develop the various forms of this condition. The only exception is gout, which is more prevalent in men than women.

Injuries

Injury due to accidents and repeated stress during exercises, weight lifting, physically demanding jobs, or any other activity might increase the chances of developing osteoarthritis in the joints affected later in life.

Infection

Infections caused by microbes like bacteria, viruses and fungi cause inflammation around joints. It triggers the advancement of arthritis. 

Smoking 

Smoking increases the risk of developing RA. It also makes the autoimmune disorder worse.

Diagnosis: What Can You Do to See if You Have Arthritis?

Consulting a general physician should be the first step if you aren’t sure whom to refer for the diagnosis of arthritis. Your healthcare physician will run a quick test to examine any swollen, red or warm joints and fluid accumulation around the joints and document the range of joint motions. The doctor may even refer you to an expert if required.

If you witness any severe signs or symptoms, you can visit a rheumatologist first. It will also help in a better diagnosis as well as treatment. 

Physicians generally use MRI, CT scans and X-rays to produce images of cartilages and bones. It helps them eliminate any other cause of the symptoms, like bone spurs.

Analysing and aspirating any joint fluids that might be present and examining inflammation levels in the blood will help the doctor determine the type of arthritis.

Specific diagnostic blood tests examine antibodies such as an anti-nuclear antibody, rheumatoid factor, and anti-cyclic citrullinated peptide. These factors indicate particular types of arthritis. 

Possible Risk Factors Associated With Arthritis

If left untreated, arthritis symptoms can worsen with time, affecting one’s daily lifestyle. Certain possible complications linked to arthritis are:

Reduction in Mobility

As this condition progresses, individuals might experience uncomfortable movement. It affects your daily lifestyle and might restrict you from socialising and performing certain activities.

Effects on Mental Health

This condition might increase the possibility of experiencing depression or anxiety because of the ongoing inflammation, social isolation and pain.

Physical Instability

Individuals with osteoarthritis have an increased risk of experiencing falls and fractures. It is mainly due to related muscle weakness and dizziness. In addition, pain medications might also lead to instability in the body.

Inflammation 

Suppose the arthritis is due to an autoimmune disease like rheumatoid arthritis. In that case, the inflammation might increase and affect organs like lungs, skin, blood vessels, eyes, etc.

Weight Gain

Weight gain is seen generally in arthritis patients. They tend to move very little because of the decreased mobility and the discomfort that restricts any exercise. 

Decreased Workability

Arthritis affects mobility, and as a result, moving from one place to another, using transportation and such basics get restricted.

Increased Risk of Metabolic Disorders

Gaining weight and having arthritis, an inflammatory condition, might increase the risk of developing heart diseases, type 2 diabetes, high cholesterol, and high blood pressure.

Summary

Arthritis is a condition that brings along complications like reduced mobility, increased risk of fractures, severe pain, inflammation, etc. With early diagnosis, management and treatment of arthritis are more effective and can prevent related complications and other health risks. Although there is no exact cure for this condition, the proper treatment will immensely reduce the symptoms of arthritis.

You can make specific lifestyle changes, such as reducing weight, following a healthy balanced diet, and practising particular postures and techniques to help manage arthritis. Your doctor might also suggest a combination of treatments for best results. In severe cases consorting to surgeries also provide relief from arthritis.

About the Author

Dr. Nikhil did Medicine (MBBS) at St. John’s Medical College and then decided to step away to do a Master’s in Health Psychology at the University of Stirling. On the way to that, he has worked with an NGO, Enfold, on teaching sexual health education in schools and colleges to create a healthy foundation for better sexual health in the nation. He has also worked as a medical content editor with Vinformax. He has now been working with HealthifyMe to bring in a renewed user-centric perspective concerning the users' medical conditions and to support the company with more effective digital tools and devices. He hopes to help improve the healthcare scenario in India.


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