Bone health requires exercise and proper diet

Dr A Mohan Krishna, consultant orthopedic surgeon at Apollo Hospitals explains about arthritis and Rheumatoid arthritis.

What is arthritis?

Arthritis is a common orthopaedic problem. Arthritis is usually a broad term in expressing many joint diseases. There are more than 100 types of arthritis. Arthritis is termed as inflammation of joints in human body. Joint is place where two ends of bone meet to provide movement. 

What are the symptoms of arthritis?

The symptoms of arthritis are Pain, swelling, stiffness in the joints.  Symptoms may vary in intensity from mild, moderate to severe. These complaints vary with day more in early in morning to less severity by end of the day. They may also vary with season with more pain and swellings during winter and less during warm seasons. Symptoms may progress with age gradually damaging the joints resulting in deformity of joints. These changes can be visible in the deformed fingers and bent knees. 

Types of arthritis?

 Degenerative arthritis:  Osteoarthritis is a form of degenerative arthritis. When the cartilage lining between the joints is damaged due to age or due to injury osteoarthritis sets in. This causes pain, swelling and stiffness in the joints. This problem becomes chronic as you age. Risk factors include obesity, family history, age and injury to joint.

  Inflammatory arthritis:  It is usually a defect in immune system. The condition in which bodys own immune system starts damaging the joint lining resulting in arthritis. In some instances other parts of the body like eyes, heart and lungs are involved in inflammatory arthritis. Rheumatoid and psoriatic arthritis are form of inflammatory arthritis.

  Infectious arthritis:  In this type arthritis is caused by infection by bacteria and virus. These type of arthritis are usually treated by antibiotics and sometimes by joint wash.

  Metabolic arthritis: some chemicals in human body which are by products of metabolism can result in joint damage. Gout is a form of metabolic arthritis in which uric acid crystals are deposited in joints resulting in arthritis.

Diagnosing arthritis:

It can usually diagnosed by primary care physician or orthopedician

  Clinical examination

   Blood tests

    X rays

  Specialised blood tests in case of rheumatoid arthritis or other inflammatory arthritis

Preventive measures:

   Exercises

   Range of motion exercises,

  Joint strengthening exercises

   Anti inflammatory drugs in initial stages

   Simple analgesics like paracetmol

  Medications to control uric acid levels in case of metabolic arthritis

What is Rheumatoid arthritis?

Rheumatoid arthritis is most common inflammatory arthritis encountered in orthopaedic practice. Rheumatoid arthritis is condition in which body’s immune system attacks its own tissue like synovial membrane of joints, and some organs of the body.

What are the symptoms of Rheumatoid arthritis?

In the initial period there would be swelling of joints, pain and stiffness in joints.

Typical complaints would be early morning stiffness of small joints of hand and which gradually decreases by end of the day.

Small joints of feet and hand are first to be involved in early stages of rheumatoid arthritis.

As the disease progresses there will be erosions inside the joints resulting in deformity of joints.  In late stages joints get fixed in abnormal position.

In small percentage of patients other organs of body may be involved such as eyes, lungs and blood vessels.

How is rheumatoid arthritis diagnosed:

  Examination by doctor along with typical complaints explained by patients.

   Blood tests like Complete blood picture, ESR, CRP , RA factor , Anti CCP, etc

    X-rays to see the extent of damage

How is rheumatoid arthritis managed?

After diagnosis management is multimodal approach consisting of Medical management, Surgical management, Lifestyle modifications

Medial management:

 Medical management controls the disease severity and helps to reduce joint inflammation and damage. Disease modifying drugs (DMARD’S) are the first line of drugs

 Anti inflammatory medications to control pain

 Immuno modulators are newer drugs introduced to combat Rheumatoid arthritis

Lifestyle medications

  Include physiotherapy, exercises and splints to provide joint mobility, improve muscle strength.

  Splints are used to prevent joint deformity and correction of deformities.

  Physiotherapy modalities include wax bath, heat and cold application, warm and cold pool exercises.

Surgery:

   Surgical aspect in rheumatoid arthritis is done for severly damaged joints like knee and hip.

   Total knee replacement and Total hip replacement are two established procedures for completely damaged knee and hip joints in rheumatoid arthritis.

    Some soft tissue procedures are done for correction of deformities of foot and hand.

What is final outcome of rheumatoid arthritis patient?

Rheumatoid arthritis is a progressive disorder. As explained above with multimodal approach we can try to improve quality of life of patient.  All the explained methods will help to achieve mobility of joints.

For Appointments : Dr A Mohan Krishna, consultant orthopedic surgeon at Apollo Hospitals explains about arthritis and Rheumatoid arthritis.