Many people, and not just the elderly, are affected by some form of
arthritis. It can cause temporary discomfort or long-term disability,
but drugs and physiotherapy can do much to relieve the condition.
Arthritis is an inflammation of the joints that may cause pain,
swelling and lack of mobility. Though many people think of it as a
condition which affects mainly older people, it can afflict people of
all ages and is a very common medical complaint. There are many types of
arthritis, and it can be mild or severe, acute (relatively short-lived)
or chronic (long-lasting) and affect just one joint or several.
Arthritis has numerous forms, and is the subject of a well-established
medical specialty, rheumatology.
Sometimes arthritis is brought on by an injury -- when it is known as
traumatic arthritis -- or an infection of the lubricating fluid in the
joint (septic arthritis). The causes of other types, though, are not
always fully understood.
Rheumatoid arthritis, for instance, is a fairly common disease in adults
(it can also attack children, when it is known as Still's disease), but
its cause is unknown. There is a theory that it may be due to a problem
with the body's auto-immune system. Some event -- a severe illness or a
shock -- is thought to trigger a chemical chain reaction in the body
that produces a substance which attacks the synovium, the lining tissue
of the joints, as if it were an intruder.
Rheumatoid arthritis is most common in adults between 20 and 55, and
is three times more likely in women than in men. The usual symptom is a
painful swelling in the knuckles of both hands and the joints of the
toes, though many other joints may eventually be affected. It may be
acute, starting with a fever or rash, or happen more gradually over the
space of several weeks.
Osteoarthritis occurs as
joints age or are put under excessive strain. It mainly affects joints
which have to bear a lot of strain, particularly in the hips, knees and
between the vertebrate in the spine. In women, the hands are also often
It is caused by a degeneration of the cartilage, the tough, elastic
tissue that protects the surface of the joint. As a result, the
underlying bone surface is compressed and the synovium lying over it
becomes inflamed, causing pain and stiffness. Osteoarthritis is most
common in older people, though it can also affect others -- professional
sportsmen, for instance -- who put excessive strains on their joints.
Once a joint has become affected by osteoarthritis, the condition
tends to get worse rather than better, although this process can be
significantly slowed by relieving any strain on the joint and protecting
it from knocks.
RIGID SPINE DISEASE
affects the joints of the spine and the pelvis, and is thought, like
rheumatoid arthritis, to be an auto-immune illness. Thee is a definite
tendency for it to run in families. It's more common in men, affecting
about one in every 200, and usually starts between the ages of 15 and
Calcium is deposited in the ligaments, leading to stiffness. If it is
not treated -- a mixture of drugs and exercises is the usual method --
the vertebrae can fuse together, hence its common name, 'poker back'. It
tends to progress slowly over a few years, often spreading to the whole
spine and hip joints, before gradually petering out.
Forms of arthritis that are rare -- at least in the modern developed
world -- can result from tuberculosis or rubella (German measles). In
recent years, other forms of transient (non-permanent) arthritis have
been associated with infections. Among these is Reiter's disease --
named for the doctor who first described it -- which is associated with
microbes which cause gastro-enteritis and with chlamydia, a
sexually-transmitted disease also known as NSU (non-specific urethritis).
The arthritis clears up when the original infection is properly treated.
'Lyme arthritis', common in parts of the USA, is also caused by an
infection, carried by a tick. Treatment with antibiotics prevents the
development of arthritis.
DIAGNOSIS AND TREATMENT
If you suspect you have some form of arthritis, the worst thing you can
do is to 'just put up with it'. Go and see your doctor. Even if there is
no cure, the condition can sometimes be prevented from getting any
worse. In the case of a child with Still's disease, there is the risk of
permanent deformity without proper hospital care.
Your doctor will ask for a history of your illness and give you an
examination. Blood tests may be needed to test for the presence of
infection or to determine the cause of the pain. There are special tests
to discover the presence of rheumatoid arthritis and ankylosing
Another technique, called arthroscopy, involves the use of an
instrument that is used to look inside the knee joint under local
anaesthetic. Both the cartilage and the synovium can be examined by this
means, and small pieces of tissue can be removed for further microscopic
investigation. You may also need to have X-rays taken to discover the
type of arthritis and the actual amount of damage to the affected
The doctor may prescribe anti-inflammatory drugs and painkillers.
There are specialized treatments for rheumatoid arthritis, which slow
the progression of the disease, but they tend to be associated with
various side-effects and are usually only prescribed in more severe
cases. Perhaps the best known of these treatments is a weekly
intra-muscular injection of gold.
You may have to rest the affected joints or wear a specially made
splint to keep them in the best position and so prevent deformities,
from occurring. A doctor may treat any swollen joints by drawing off
excess fluid under a local anaesthetic or by injecting an
anti-inflammatory drug directly into the affected joint.
Steroid drugs may be used to ease the inflammation, but as they may
have unwelcome side-effects the doctor will only use them when other
forms of treatment have proved unsuccessful.
Possible home treatments include exercises which will be taught by a
hospital physiotherapist and various forms of heat treatment, including
hydrotherapy (exercising in a small pool of very warm water), infra-red
lamps and paraffin wax baths for the hands and feet which can help to
Another possibility is the
surgical replacement of badly-damaged joints with artificial ones made
of metal, plastic or ceramics. This technique is particularly useful in
dealing with arthritic hips, though new artificial joints are constantly
being developed for other parts of the body.
Surgery can also be used to alleviate pain by relieving pressure
around a joint, removing the lining from an excessively inflamed joint,
or fusing the joint. This involves some loss of mobility, though usually
the sufferer finds it a small price to pay for being relieved of