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Tuesday, December 3, 2019

Arthritis: Myths and Facts

Arthritis: Myths and Facts, By:Dr.Firoz

There are more than 100 different forms of arthritis and related diseases. The most common types include osteoarthritis (OA), rheumatoid arthritis (RA), psoriatic arthritis (PsA), fibromyalgia and gout. All of them cause pain in different ways.Arthritis and related diseases can cause debilitating, life-changing pain. According to the Centers for Disease Control and Prevention, more than one-third of the adults who have arthritis report that it limits their leisure activities and work. And 25 percent of them say it causes severe pain (seven or higher on a zero to 10-point scale).

In osteoarthritis (OA), the protective cartilage inside the joint breaks down. This makes movement of affected joints more difficult and painful. In time, bones of the joint may rub directly against one another, causing severe pain. Pain can also come from parts of your joint other than the cartilage, such as bone, synovium and ligaments. The intensity of OA pain varies from person to person and can range from mild to severe. These changes cause pain, swelling and problems moving the joint. Because of pain and decreased physical activity, the muscles that support the joints can weaken. Your family history, being overweight, past joint injury and joint overuse can make you more likely to develop OA.

Rheumatoid Arthritis
In rheumatoid arthritis (RA), the joints and other organs are attacked by the body’s own immune system. The immune system normally protects a person from viruses, bacteria and other invaders. In people with autoimmune diseases like RA, it becomes overactive and attacks healthy tissue. In the case of RA, the immune system primarily goes after the lining of the joints, called the synovium. Over time, the persistent inflammation breaks down the joint and damages it permanently.Pain in RA can come from other parts of your joint besides the synovium, such as bone and ligaments.
Lifestyle Factors
These are some common risk factors for developing RA that also fuel ongoing inflammation.
·      Smoking. Smokers are far more likely than nonsmokers to have disease progression and treatment failures. Some researchers believe that smoking not only makes RA worse, it may cause it in the first place. The theory is that smoking triggers anti-CCP autoantibodies (against citrullinated proteins) in people who have a genetic propensity to RA. This, in turn, sets the autoimmune process in motion. Anti-CCPs show up in the bloodstream long before patients develop RA symptoms.
·      Gum disease. Many studies have linked gum disease-causing bacteria to RA. In 2016, for example, Johns Hopkins researchers reported that a type of bacteria found in severe periodontal disease damages immune system cells called neutrophils by punching holes in them. This drives the production of citrullinated proteins, which, as with smoking, triggers an autoimmune response.

Psoriatic Arthritis
Psoriatic arthritis (PsA) is an autoimmune inflammatory disease in which the immune system attacks the body, causing inflammation and pain. PsA affects the joints, causing arthritis; the connective tissue where tendons or ligaments attach to bones, causing enthesitis; and the skin, causing psoriasis.

Fibromyalgia is considered a central pain syndrome. This means that the brain and spinal cord process pain signals differently. A touch or movement that doesn’t cause pain for others may feel painful to you (this is called allodynia). Something that is mildly painful to someone without fibromyalgia may hurt you even more (this is called hyperalgesia).Fibromyalgia is characterized by widespread pain. It may come and go or be constant. Besides pain, fibromyalgia is associated with other symptoms, such as fatigue, sleep problems, inability to concentrate and mood troubles.

Gout is a form of inflammatory arthritis, but it does not cause body-wide inflammation like RA or PsA does. In gout, uric acid crystals are the problem. If your body produces too much uric acid or if you are unable to remove the excess fast enough, it can build up in the blood (called hyperuricemia). Excess uric acid can form crystals in your joints. This results in extremely painful joint inflammation. Gout usually strikes in the large joint of the big toe, but can also affect other joints. With a gout flare, you can go to bed feeling fine and wake up with excruciating pain.

Other Musculoskeletal Pain
Soft-tissue rheumatic conditions can also cause pain. In these conditions, muscles, connective tissues such as tendons and ligaments, and bursae become inflamed and painful. Read more about musculoskeletal pain and its treatments in
Your approach to arthritis pain management may include some or all of the following treatment options:
Lifestyle Modifications
Reaching and maintaining a healthy weight, moving your body regularly and eating nutritious, anti-inflammatory foods can help ease your arthritis pain.

Medications to Treat Arthritis
To successfully manage your pain, you need to treat your underlying arthritis or related disease.
Medications to Treat Pain
Over-the-counter and prescription medicines are available to treat your pain and other symptoms that contribute to your pain.
Natural Therapies
From dietary supplements to acupuncture to yoga, there are many complementary and alternative pain relief options that can augment your medication regimen.
Physical Therapies and Assistive Devices
Physical therapy, occupational therapy, braces and self-help devices can help protect your joints and ease pain.
In some cases, joints are so badly damaged by arthritis that surgery becomes necessary as a final remaining option to relieve pain and restore function

Dr. Feroz Khan
M.N.A.M.S(Ortho), D.N.B. ORTHO, D.Ortho, F.C.P.S.Ortho
Consultant Orthopedic Surgeon, Aadhar Hospital, Rukhmini Nagar, Near new bus stand Akola