By Dr. Rachna Pande
In arthritis, joints become swollen and painful, causing suffering and difficulty in working. Typically the pain is induced and or aggravated by physical work or exposure to cold. Some types of arthritis such as rheumatoid arthritis may be intermittent, symptoms waxing and waning. But some like osteoarthritis are chronic, persistent, i.e. pain occurs every day.
Different types of arthritis involve different joints and occur due to various causes.
Rheumatoid arthritis most commonly involves the small joints of the body mostly hands and feet. It is hereditary, common in middle aged women, but can occur in other age groups and gender as well. There is pain and stiffness of joints more so in the morning. It is a multisystem disease, affecting even heart, lungs, eyes, throat, e.t.c. various body parts.
“Rheumatic arthritis,” is caused as a reaction to bacterial infection by Beta hemolytic streptococci. It occurs commonly in young adolescents more in males from poor socio-economic conditions. The involvement of joints is, “flitting”, i.e. joints are affected one after another. The pain and swelling of one joint may subside in a day or 2 followed by involvement of another joint. It mostly affects large joints like knee, elbow and shoulders. The sequel to it is, permanent damage to heart, therefore early therapeutic intervention is must.
Ankylosing spondylitis occurs because of a chromosomal defect during birth. The back bone bears the brunt of the disease. Initially there is pain at the upper back with gradual stiffness, increasing progressively. As the disease progresses it cripples the sufferer.
Gout is a variant of arthritis which involves the great toe earliest, followed by toes, foot, ankle and knee. Severe pain occurs in the night disturbing sleep. Young adults especially men are more affected. It occurs because of increased uric acid levels in the blood. Beer, red meat, excess consumption of foods like tomatoes, spinach tends to cause and aggravate gout by increasing uric acid levels in blood.
Old people suffer from arthritis due to multiple reasons. As age advances stiffness of joints sets in, producing many problems. Softening of the bones augments the suffering. Shoulders become stiff, what is known as, “frozen shoulder syndrome”. It occurs in both genders. It is a degenerative change occurring because of wear and tear in the joint. The stiffness and pain increase gradually to the extent that one finds it difficult to do small things like combing or pulling up the zip at the back of the dress.
Osteoarthritis affects the weight bearing joints of the body mostly the knees, hips and backbone and occurs mostly around 60 years or more. This occurs due to age related wear and tear of the joints and its supporting structures.
Infectious germs can affect the joints, producing pain, swelling and redness of the joint along with high fever. It can occur in any age or gender. This form of arthritis can be acute as with staphylococcal infections. It responds very well to suitable antibiotics. Chronic infections like T.B. can also affect joints, causing pain and destruction.
In any type of arthritis, pain relieving medicines provide temporary relief. Relapses are common. The time interval between relapses is variable depending on various factors, like type and severity of arthritis, nature of physical work being done, nutritional level and osteoporosis, alcoholism, smoking, co-existing diseases like diabetes, amount of exercise and rest.
Any pain killer if taken for long leads to gastric ulcers and even kidney failure. Therefore a person suffering from chronic arthritis should be discouraged from taking pain killers. He should know that these medicines are not curative and not safe if used repeatedly, hence should be taken only in severe pain.
Hot compression and physiotherapy is also useful. Surgical techniques are available to help in case of arthritis, like knee replacement but they do not replace natural flexibility.
Once acute pain is relieved, it is better to take due precautions to avoid exacerbation of pain and inflammation. These include avoiding heavy physical work, correct postures, and etcetera.
Specific exercises of the joints, done regularly, enhance the flexibility of joints and keep the pain and inflammation to minimum.
Dr. Rachna Pande, Specialist-internal medicine. E-mail firstname.lastname@example.org
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