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What is Arthritis?
Ask The Doctor- Edward (Ellie) Bennett, MD
Arthritis is inflammation of one or more joints, which results in pain, swelling, stiffness, and limited movement. There are over 100 different types of arthritis. Arthritis involves the breakdown of cartilage which normally protects the joint, allowing for smooth movement. Cartilage also absorbs shock when pressure is placed on the joint (ie. walking). Without the usual amount of cartilage, the bones rub together, causing pain, stiffness and swelling (inflammation). Persistent inflammation or destruction results in long-term pain and deformity termed chronic arthritis. Osteoarthritis (OA) is the most common type and is more likely to occur as one ages. OA may be felt in any of the joints, but occurs most commonly in the hips, knees or fingers. Risk factors for OA include being overweight or using the affected joint in a repetitive action that puts stress on the joint. Arthritis can occur in men and women of all ages. Over 37 million people in America have arthritis of some kind, or almost 1 out of every 7 people.
Tests for arthritis vary depending on the suspected cause. They usually include blood work and joint x-rays. Often, joint fluid is removed from the joint and examined under a microscope to check for infection and other causes of arthritis (ie. gout caused by crystals).
Treatment of arthritis depends on the particular cause, which joints are affected, severity, and how the condition affects daily activities. If possible, treatment will focus on eliminating the underlying cause of the arthritis. Often, however, the cause is NOT necessarily curable, as with OA and rheumatoid arthritis. Treatment, therefore, aims at reducing pain and discomfort and preventing further disability. The most common medications a physician may prescribe include Tylenol (acetaminophen) or nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, or naproxen. Other possible medications include Biologics, Corticosteroids, COX-2 inhibitors, Immunosuppressants or disease-modifying anti-rheumatic drugs. It is very important to take medications only as directed by your doctor.
It is possible to greatly improve symptoms from OA and other long-term types of arthritis without medications. In fact, lifestyle changes without medication is preferable for OA. Exercise is necessary to maintain healthy joints, relieve stiffness, reduce pain and fatigue, and improve muscle and bone strength. A physical therapist can design individualized programs, which can include low-impact aerobic activity (also called endurance exercise), range of motion exercises for flexibility and strength training for muscle tone. A physical therapist may also consider water therapy, ice massage, or transcutaneous nerve stimulation (TENS).
Vitamin supplements such as glucosamine and chondroitin are available at health food stores or pharmacies. While some studies show such supplements may reduce OA symptoms, others show no benefit. However, since these products are regarded as safe, they are reasonable to try and many patients find improvement in their symptoms.
A few arthritis-related disorders can be completely cured with treatment. Most are chronic (long-term) conditions, however, and the goal of treatment is to control the pain and minimize joint damage. Chronic arthritis frequently goes in and out of remission.
Final word: Osteoarthritis may be more likely to develop in joints that are injured often or with repetitive motions. Excess weight increases the risk for developing osteoarthritis in the knees and possibly in the hips. If arthritis is diagnosed and treated early, joint damage can be prevented.
Dr. Bennett is board certified in both Internal Medicine and Emergency Medicine. He is available in his Kew Gardens Hills office most evenings and weekends and can be reached at 646-623-3350. Send your questions to firstname.lastname@example.org
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