Introduction

Arthritis is a medical condition which causes pain, redness, swelling and stiffness of the joint. It may due to :

• Wear and tear of the joint
• Infection
• Inherited illness
• or some other cause

The common forms of arthritis in adults are :

• Osteoarthritis (OA)
• Rheumatoid arthritis
• Infectious arthritis
• Gout

OSTEOARTHRITIS (OA)

• Common form of arthritis
• Caused by wear and tear of the joints
• More common in the elderly
• Worsens with activities
• Worsens at the end of the day

RHEUMATOID ARTHRITIS (RA)

• More common in women
• Caused by an abnormal immune reaction whereby the body produces antibodies which fight against its own joints
• Causes stiff joints when you wake up in the mornings
• Stiffness takes more than thirty minutes to go away in the morning
• The joints affected are the fingers, wrists, arms and legs.

INFECTIOUS ARTHRITIS

• This form of arthritis is due to germs
• You usually have fever and chills
• It usually affects only one joint

GOUT

• Caused by deposition of uric acid crystals in the joints
• Common in middle-aged males
• Base of big toe is usually affected

Signs and symptoms

• Joint (arms, wrists, fingers, ankle, knees, hips, lower spine) pain
• Swelling of the joint
• Stiffness of the joint
• Unable to move normally
• Painful movement
• Change in appearance of joint
• Crackling noises in the knee in knee OA
• In knee OA, thigh muscles weaken and become smaller
• Painful on pressing around the joint margins
• Firm swellings around the joint margins

The following may make it more likely for you to have arthritis

• Advancing age
• Overweight:
  • in knee OA
• A member of your family has it:
  • especially generalised OA, familial gout
• Extra-flexible joints (hypermobility)
• Major injury eg. sports injuries:
• Squatting position for knee OA
• Occupational:
  • knee OA in manual worker
  • hip OA in farmers

Treatment

• Treatment involves both drug and non-drug approach with the aim to relieve symptoms and improve joint function.
• In certain cases, surgery is indicated.

Simple steps for healthy joints

• Patients with arthritis should be aware of their disease and empower themselves with knowledge of their condition
• Reduce weight
• Joint exercises
• Participate in an exercise programme to mobilise the joints and strengthen the surrounding muscles.
• Besides joint exercises, you should also do exercises for general fitness such as walking, cycling or swimming.

Joint Protection

• You should protect your joints from further damage
• Avoid activities that put direct pressure on your joints
• Use assistive devices to help reduce stress on joints eg. zipper pullers and devices to help with getting off chairs, toilet seats and beds
• In knee OA, avoid squatting and sitting on the floor. When sitting on a chair, make sure the chair is knee-high and not too low. Use a chair with arm-rest to assist you getting off the chair
• Wear shoes with good shock-absorbing properties.

Pain Relief

Heat therapy may help to reduce pain eg. hot packs but this is not to be used for acutely inflamed joints. Medication can be applied topically or taken by mouth:

• Topical ointment eg. salicylate
• Simple painkillers eg. paracetamol
• Anti-inflammatory drugs are often prescribed to reduce pain and inflammation eg. RA and OA
• In severe cases, injections are given to ease the pain and stiffness of affected joints
• In RA, medications called disease-modifying anti-rheumatic drugs are also used to reduce joint deformities.

Managing stress

Pain is often combined with muscle spasm and other signs of stress. Stress may also affect the amount of pain a person feels.

• Regular rest and relaxation help.
• You may need to reschedule activities to accommodate pain peaks.
• Always balance rest and activity

Surgical Options

• If medical therapy fails i.e. pain remains persistent, then surgical options may be considered.
• A common surgical option is joint replacement.

Prevention

• Lose weight – this takes away stress on joints
• Regular exercise – exercise helps to improve circulation, maintain healthy and strong bones and muscles. It also improves joint flexibility and preserves joint mobility. Balance between rest and exercise and do not overdo exercise if you have pain
• Healthy, well-balanced diet- this is important to maintain a good weight and to obtain adequate nutrition. Avoid purine-rich food eg. seafood, organ meat if you have gout
• Take care of your joints- reduce stress on your joints, use proper body mechanics and maintain a good posture. Respect pain and recognise fatigue.

How safe is alternative medicine?

Be careful in the use of alternative medicine as the active ingredient is not often known. There may be drug interactions with the medication that you are taking and alternative medicine may also be adulterated with other substances.

Be positive

• Maintain a healthy lifestyle and instill a positive attitude.
• Although arthritis is the leading cause of physical disability for those aged 18 and above, it is treatable in many cases and you can take measures to reduce the chance of contracting arthritis.
• Live well and prioritise your activities.
• Joining a support group also helps. Useful support groups are Arthritis Foundation Malaysia and Persatuan SLE Malaysia.