In this Health Hub article, we explore the signs & symptoms, diagnosis, and treatments of arthritis.
Arthritis is the inflammation of one or more of your joints. It is characterised by joint pain and swelling that typically worsens with age. There are two main types of arthritis, Osteoarthritis, and Rheumatoid Arthritis.
Facts & Figures
- Osteoarthritis (OA) is the most common type of arthritis.
- Most people over 55 in Ireland have X-ray evidence of OA at some joint in their body, although it is more common in females (post-menopause) than males.
- OA generally develops over time in people who are over 50 but can develop at any age due to injury or wear and tear of the joints.
- OA causes the cartilage, which is the connective tissue between bones that acts as a cushion, to break down. When the cartilage wears down sufficiently this results in bone grinding directly on bone, causing significant pain, swelling, and immobility.
- Rheumatoid Arthritis (RA) is a more severe but less common form of arthritis.
- It affects around 40,000 people in Ireland.
- RA is an autoimmune disorder which means that there is a fault in the immune system whereby the body attacks itself, namely the lining of the joints. This results in a breakdown of the cartilage and bone in the joints, ultimately destroying them.
- Women are three times more likely to be affected than men.
Signs & Symptoms
Osteoarthritis has no definitive test for diagnosis.Your GP will assess your symptoms along with other risk factors such as age, previous injury, and weight issues. Further tests such as X-rays or blood tests are not usually required but may be used to rule out fractures or rheumatoid arthritis.
Rheumatoid Arthritis is diagnosed by doing a physical examination of the joints to assess swelling, mobility, and appearance. There is also a series of blood tests that will be carried out to measure specific criteria that indicate that you have inflammatory markers in your body such as ESR, CRP and Rheumatoid Factor. Joint imaging is also done using X-rays, ultrasound and magnetic resonance imaging (MRI).
Disease Modifying Anti-Rheumatic Drugs (DMARDs) are also used in rheumatoid arthritis. The auto-immune nature of RA causes antibodies to attack the tissue in the joints and produce chemicals that can cause further damage. DMARDs act by blocking the effect of these chemicals. The earlier treatment with DMARDs is initiated, the more effective they will be. Examples of these are methotrexate, leflunomide, and sulfasalazine. DMARDs do not start working immediately, it can take three to six months to notice an effect so it is important to continue to take the medication. You may also need to try a few different DMARDs to find the one that is the most suitable for you.
Biological’s or ‘High Tech’ medicines are also used in rheumatoid arthritis. They work by blocking the chemicals in your blood that cause the immune system to attack your joints. They are not suitable for everyone and some screening tests will need to be done before they are prescribed for you. Examples of these are etanercept and infliximab.
Advice From The Pharmacist
- If you need to lose weight then try to do so. The extra weight you carry puts extra pressure on your joints. Losing weight also helps to increase mobility and may help prevent injury.
- Take regular exercise. Using your joints helps to keep them mobile. Non-weight bearing exercises such as swimming or aqua aerobics are ideal.
- See an occupational therapist to assess your need for any medical aids that may help eg raised toilet seat, handrails on stairs, walking aids.
- Take your medication as prescribed, and seek advise if you are experiencing any side effects.
- Use hot/cold packs on the joints to provide relief from swelling.
There are many other types of arthritis, if you notice any symptoms involving the joints consult your doctor.