Overview of Arthritis

What is arthritis? Arthritis is a general term for all disorders that affect the structure and function of the joints. This is a common disease that causes many difficulties in daily life and work due to pain. The most common signs of arthritis are limited range of motion of the joint and pain in the joint. Other symptoms may include swelling, heat, redness in the joint and stiffness of the muscles related to the joint. There are about 100 types of arthritis, which can be simple arthritis or arthritis that affects other organs. The two most common types of arthritis are: osteoarthritis (OA) and rheumatoid arthritis (RA).

Osteoarthritis: osteoarthritis is the most common type of arthritis. The main site of damage in osteoarthritis is articular cartilage – cartilage is the tissue that covers the ends of bones and has the role of reducing friction and ensuring that the ends of bones can easily slide over each other when moving the joint. Therefore, osteoarthritis makes it difficult for joints to move, deform, and even cause bones to deviate from their normal position. The joints that are often inflamed are the joints of the hands, spine, knees, and hips. This disease often occurs in middle-aged people, especially those aged 40 and over. However, osteoarthritis can also occur in young people, especially after joint injuries.

Rheumatoid arthritis: This is a disease related to the body’s immune system, the first site of damage in rheumatoid arthritis is the synovial membrane, which then disrupts other components in the joint. The subjects who often suffer from rheumatoid arthritis are women over 40 years old.

Causes of Arthritis

Arthritis includes many different types, each type will have its own cause, but can be divided into the following two groups of causes:

• Joint causes: commonly seen as cartilage inflammation, degeneration, cartilage erosion, joint infection, joint trauma..
• Extra-articular causes: commonly seen due to metabolic disorders (increased uric acid in gout), immune system abnormalities that damage components in the joint (rheumatoid arthritis). These conditions affect the function and structure of the joint, thereby causing arthritis.

Symptoms of Arthritis

Signs of arthritis depend on the location of the inflamed joint and the type of arthritis. Warning signs that you may have arthritis include:

• Joint pain, which can be painful when moving or even when not moving.
• Limited range of motion of the joint, most cases of limitation are accompanied by pain, but there can also be simple limitation.
• Swelling and stiffness of the joint: often seen in acute arthritis.
• Inflammation at the site or around the joint.
• Redness of the skin around the joint.
• Crackling when moving the joints, often in the morning.
• Accompanying extra-articular symptoms may include: fever, rash or itching, shortness of breath, weight loss… these symptoms can also be signs of other diseases.

Risk factors for arthritis

• Age: although arthritis can occur in children, the elderly have a higher rate of arthritis, mostly due to the effects of metabolic disorders and the accumulation of long-term injuries.
• Gender: arthritis affects women more than men.
• Occupation: heavy labor, sitting in one position for a long time, and incorrect movements have a higher rate of arthritis.
• Trauma: injuries to the joints can cause acute arthritis at that time or increase the risk of arthritis later.
• Overweight: increases pressure on the joints, thereby causing arthritis or accelerating the inflammation process that already exists in the joints.
• Metabolic disorders: affect the nutrition of joint components and the appearance of abnormal components in the joints.
• Immune system diseases and some genetic disorders can also increase the risk of arthritis.

Prevention of Arthritis

Arthritis is not always preventable, however, taking the following measures will help reduce the risk and control arthritis better:

• Exercise: different types of exercise can be chosen depending on age and specific conditions.
•  Maintain weight within the allowable limit.
• Ensure safety at work, limit injuries to joints.
• Sit and work in the correct posture.
• Regular check-ups to detect early and promptly treat metabolic disorders of the body.

Diagnosis of Arthritis

Each type of arthritis has different clinical and laboratory diagnostic criteria. Diagnosis of arthritis: in a case of joint pain, the following methods must be performed:

• Examination: ask about functional symptoms and perform an examination to determine the range of motion of the joint, joint deformity, and some tests to determine joint effusion.
• Tests to be performed
• Basic tests: peripheral blood cells, erythrocyte sedimentation rate, C-reactive protein (CRP), liver and kidney function tests, chest X-ray, electrocardiogram.
• Joint X-ray: detects changes in the structure of joints.
• Bone scintigraphy: this is a modern method that not only shows changes in the shape of bones and joints, but can also detect metabolic disorders. It especially helps to detect early cases of cancer and bone and joint tumors. The method has been applied at many large hospitals, especially Vinmec Hospital, with high results.
• Other immunological tests in rheumatoid arthritis such as: quantification of rheumatoid factor (RH), anti CCP…

Treatments for Arthritis

Except for infectious arthritis, most arthritis is considered a chronic disease. Therefore, it is very difficult to completely cure arthritis. Although there are many causes of arthritis, the general treatment goal is to relieve pain, restore joint mobility, limit disease recurrence and prevent joint deformities.

Arthritis treatments include:

Medical treatment: applied in most cases, can be medical treatment with drugs alone or combined with surgical methods. Drugs used depend on each type of arthritis, including anti-inflammatory pain relievers and drugs specific to each cause. Therefore, the use of drugs must be carried out according to the doctor’s instructions.

• Anti-inflammatory pain relievers commonly used to treat arthritis are non-steroidal anti-inflammatory pain relievers (NSAIDs) with brands such as mobic, ibuprofen.
• Corticoids can be used as anti-inflammatory drugs in some cases.

Surgical treatment: surgery is only indicated in the following cases:

• The joint cannot function.
• Prolonged pain that does not respond to medical treatment
• greatly affects the patient’s daily life and appearance.

Surgical methods include:

• arthroplasty to replace the joint.
• articular fusion surgery: the ends of the bones will be locked together until they are healed
• bone reconstruction: the bones will be surgically reconstructed to ensure the function of the joint.

A reasonable lifestyle: in addition to treatment methods, a reasonable lifestyle is also very necessary for arthritis patients. Exercise and diet are two issues that need attention:

• Regular and gentle exercise will help joints become more flexible. Swimming is a good choice for arthritis patients because this sport will reduce pressure on the joints. However, it is necessary to ensure a moderate exercise regimen.
• Diet should reduce starch intake especially in cases of obesity. Increase foods containing antioxidants to reduce inflammation. Maintain a diet full of nutrients to reduce the progression of arthritis.