Arthritis
Reviewed by Dr Badal Pal, consultant rheumatologist

What is arthritis?

© Getty - arthritis
Rheumatoid arthritis (RA) often starts with pain in the joints of the hands, especially in the knuckles and wrists , and often both hands simultaneously.
Arthritis simply means a painful condition of the joints.

There are different types of the disease – many inflammatory, for example rheumatoid arthritis (RA), and others more degenerative in nature, for example osteoarthritis (OA).

How does it feel to have arthritis?

Arthritis may be preceded or accompanied by a period of fatigue and a feeling of stiffness. This appears more in rheumatoid arthritis than in osteoarthritis.

Pain in the joints in rheumatoid arthritis almost always begins in the hands, especially in the knuckles, and often in both hands simultaneously, as one of the commonest types of inflammatory arthritis.

  • Because of the inflammatory reaction, the joints swell and become red, stiff and sore.

  • The problem is worse in the morning than during the day.

  • There can be periods of improvement, which may be followed by a relapse.

Arthritis can affect all joints in the body, and it's impossible to predict which or how many joints will be attacked.

Who is at special risk?

We do not know the cause of arthritis. In rheumatoid arthritis, the theory that it's triggered by an infection has never been proved. It may be partly hereditary, and it occurs three times as often in women as in men.

All age groups can develop arthritis – even children – but usually rheumatoid arthritis appears between the ages of 30 and 35.

How is arthritis treated?

The disease is unpredictable and the treatment difficult. But there are several medical remedies that can both ease the pain and slow down the spread of the disease and the damage it causes.

  • The medicine must be adjusted from time to time, which means it's important to visit your doctor regularly.

  • The treatment of arthritis takes great experience, since it never develops in the same way from one person to the next. It often needs to be treated by a specialist (rheumatologist).

  • Surgery can be offered if permanent deformation of the joints develops, despite medication and physiotherapy treatment.

Future prospects

Some doctors may recommend a diet, but there's no evidence that dietary changes alone can ease or stop the development of arthritis.

Simple painkillers can help. When used with caution, non-steroidal anti-inflammatory drugs (NSAIDs) can provide relief from pain, as well as stiffness. These are prescribed more often in rheumatoid arthritis than in osteoarthritis.

Overweight patients should aim to reduce weight with appropriate diet and exercise.

It's important for patients with arthritis to obtain help to keep the muscles and joints active and to be supported in leading a normal life.

Physiotherapists, who are trained to maintain a patient's physical ability and relieve pain, and occupational therapists, who assess physical ability and provide help and advice including aids, play a large part in making life bearable for arthritis sufferers.

During recent years, there has been great progress in the treatment of arthritis – particularly with the use of artificial joints. Some people still have to live with the discomfort of the disease because not all joints can be replaced surgically.

Research has suggested that the natural treatment glucosamine sulphate, taken at a daily dose of 1500mg, is effective in relieving arthritis symptoms – particularly of the knee joints in patients with osteoarthritis rather than rheumatoid arthritis.

Rheumatoid arthritis patients benefit from disease modifying drugs, such as sulphasalazine and methotrexate, or even the latest biologic treatments in those who fail with routine drugs (anti-TNF drugs and others (rituximab).

NetDoctor shop

Tenscare i-Glove: When used with a recommended TENS or EMS unit gives pain relief to the whole hand with improved mobility. Recommended TENS units are the i-Touch Easy and Plus or the Touch TENS. One size fits all. Fits left and right hands. Treats arthritis in the hand, repetitive strain injury, and other chronic pain conditions.

Multi-Opener: The Multi Purpose Opener is a useful kitchen aid for those with limited dexterity. It has an adjustable steel band which clamps around a jar or bottle top and also incorporates a bottle top opener and ring can pull.

Based on a text by Dr Erik Fangel Poulsen, specialist  and Dr Per Grinsted, GP

Last updated 28.07.2010

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