Arthritis

Stiff painful joints?
That'll be your Arthritis.

Another of those middle age men health issues

Osteoarthritis

Symptoms of Osteoarthritis

Diagnosis of Osteoarthritis

Osteoarthritis Treatment

Osteoarthritis Surgery

Rheumatoid Arthritis

Living with Arthritis


What is Arthritis

Its a catch all name for a number of conditions. But we'll just concentrate on the ones that we mainly face as middle aged men.

The two main types that are likely to affect you as a middle aged man are:

  • Osteoarthritis
  • Rheumatoid Arthritis




  • Osteoarthritis
    Is basically wear and tear on the joints.
    It has been with us since man first walked on the earth.Dinosuars even had it.
    It can also be the result of injury, disease, or... (Ready for it) Obesity.

    the main cause is that over time the cartilage in between the ends of your bones either wears, or becomes brittle, and breaks down.
    Leaving the ends of the bones to rub together.
    This causes damage and pain, either directly from the abrasive effects of the rubbing, or it can cause swelling of the lining of the joints.
    this produces enzymes which break down more cartilage.

    The ends of the bones can develop calcified 'nodes' which which make the joint surfaces rough, worsening the abrasive action.

    These 'nodes' can also break off and float around in the joint as can bits of cartilage, periodically getting trapped, and causing more damage and pain.

    All this can affect the way the joint works, and the way we move.

    The joints most commonly affected by Osteo Arthritis are...
    The knees, hips, fingers, neck and lower back.

    Whilst the elbows, knuckles, wrists, ankles, and shoulders are affected less often.

    American physician Dr David S. Pisetsky.
    Has a theory about this, which he examines in his excellent book;
    The Duke University Medical Center Book of Arthritis.

    “If OA was caused by simple wear and tear, you would expect these body parts to be affected more often,”
    He says.

    The symptoms of Osteo Arthritis

    Tend to develop gradually over a number of years beginning with soreness.
    How many of us have heard a relative or friend complain of joint pain, saying "I must be getting old".
    For many people thats how it stays.

    But for others, the symptoms of arthritis can become so painful that it interferes with there lives to the extent that they cant walk, climb stairs, etc.

    The main Osteo Arthritis symptoms are...

  • Soreness in joints (Arthralgia), especially after exercise or periods of inactivity
  • Stiffness in the morning, which goes away once you start 'moving around'
  • weakness of muscles around a joint (caused by lessened activity due to pain.)
  • Posture and gait become affected due to pain
  • If you have Osteo Arthritis of the knee, you will prbably notice...

  • Pain when moving the knee
  • Grating, or locking, when you bend or straighten your knee.
  • Pain when walking especially when you climb up and down stairs, or getting up after sitting in a chair.
  • Pain that stops you from exercising your leg muscles.
  • Hip Arthritis.
    Can produce Pain in your groin and the side of your thighs and knees which will affect how you walk

    If you develop Arthritis of the Spine.
    It can produce a breakdown of the discs that separate the bones of your spine which can cause an abnormal growth of the bones
    Back Arthritis, can also effect the nerves of your spine, giving rise to weakness, numbness, and pain

    Neck Arthritis,
    Can affect your arms, and lower back.

    Osteo Arthritis in Hands and Feet.
    Manifests itself in painful and sometimes swollen joints in the fingers and toes. Bony growths can become visible at the knuckles.
    This can result in difficulty in walking, and in picking up small objects.

    Diagnosis of Osteo Arthritis

    The first stage in the diagnosis is to look at your medical history to see if you have anything that will predispose you to the condition.
    Then your Doctor will probably have the affected part x rayed.
    An x ray will show up any reduced space in a joint, due to wear on the cartilage, and may show up bony spurs, that might have appeared.

    If this proves inconclusive, he/she might order an MRI scan, which gives a much clearer picture of the condition of a joint, it also shows up cartilage which an x ray doesn't.

    Another test that might be ordered is called Arthrocentesis.

    This procedure involves inserting a needle under local anasthetic, into the joint, and taking a small sample of liquid from it.
    This is sent for analysis to eliminate some causes of the condition such as the formation of excess enzymes which promote cartilage deterioration.

    Osteo Arthritis Treatment

    Because Osteo Arthritis is a progressive disease. Early diagnosis and treatment, have a large bearing on how it will affect your life.

    The main aims of Arthritis care are...

  • Controlling pain and other symptoms
  • maintaining and improving your ability to carry out your normal activities.
  • Prevent or slow further degeneration.
  • In the early stages there is a lot you can do for yourself with simple lifestyle changes.

    Take gentle exercise and Lose weight if you need to.
    This will relieve stress on lower body joints

    Eating healthy is important in the care of Arthritis diet can play a big part in your wellbeing, eating well with lots of citrous fruit, and Omega three oils.
    Both of which are thought to help with managing Arthritis pain.

    The pages on this site are here to help you achieve this.

    To supplement these lifestyle changes you may need medication:

    Initially, in the treatment of Arthralgia,(Arthritis pain) pain medication such as analgesics are used.
    These range from asprin and paracetamol to morphine.

    Or, your doctor might prescribe Nonsteroidal Anti-Inflammatory Drugs, which as well as being pain killers have an anti inflamatory effect.
    But they have a drawback. Long term use of NAID's can lead to stomach bleeding, and ulcers.

    Where there is a risk of this. Doctors can use drugs called Cox-2 Inhibitors, which dont cause stomach irritation.

    In cases of moderate to severe pain your Doctor can inject you with a steroid, which usually give good results in pain relief and swelling reduction.
    The drawback here is you can only have these three or four times a year.

    Hylauronic acid Injections, can help in knee Arthralgia, by replacing some lost lubrication to the joint.



    Surgical options...

    Arthroscopy

    In this procedure a tiny video camera is inserted into the joint through a small incision. This enables the surgeon to see on a monitor the inside of the joint.
    Instruments are then inserted through a second incision to carry out a range of options, such as removing debris, cutting away diseased tissue, and washing out the joint.

    This video is an animation of a hip arthroscopy


    If you have the stomach for it, this video is the real deal



    Osteotomy

    This litarally means to cut bone. The surgeon cuts and re-aligns the joint to get a better bearing surface.

    Again this is a quick animation to illustrate the procedure.



    And for you Bloodthirsty ghouls the real one...



    And in the last rsort...


    Joint Replacement Surgery.

    When there is literally nowhere else to go, and the patient is either in, or heading for a wheelchair.

    Its time for Joint Replacement Surgery.

    This involves cutting out all or part of the diseased joint, and replacing it with a man made componant. At present this is usually only offered to people over fifty, as the componants only last between eight and fifteen years.

    Here's an animation of a knee replacement.



    And again for all you horror fans, is an High definition video of an actual knee replacement.

    Caution:
    This isn't for the faint hearted. This video almost made me faint.






    Rheumatoid Arthritis

    Is a different animal.

    It's thought to be an immune problem, where your bodies immune system attacks your joints.

    It firstly attacks the lining of your joints, which swell and thicken.
    These, then produces enzymes which destroy bone and cartilage, causing pain and deformity.

    Its a chronic disease, meaning that it's a long term thing which can flare up, or be dormant for periods.

    It usually starts in a joint, with fingers, toes, ankles, and wrists being most common.

    If you get it in a joint on one side of your body, you usually get in in the corrosponding joint on the other side, right thumb, left thumb.

    Because Rheumatoid Arthritis is a disease of the immune system it can produce symtoms elsewhere in the body...

    Apart from swollen painful joints Rheumatoid Arthritis symptoms can include...

    Stiffness
    Particularly in the morning and when sitting for long periods of time. The longer this stiffness lasts, the more active your disease is.
    Weakness
    Flu-like symptoms
    Pain associated with prolonged sitting
    Muscle pain
    Loss of appetite
    Depression
    Weight loss
    Anemia
    Cold and/or sweaty hands and feet
    The effects of Rheumatoid Arthritis can vary from person to person. Which has led to some scientists thinking it may actually be more than one disease.

    Treatment

    Treatment of Rhumatoid arthritis is usually tailor made to the patients particular needs, because there are so many ways in which the disease attacks the sufferer.

    They usually center around relieving pain, reducing inflamation, preventing further joint damage.

    Medicinal treatment of Rheumatoid Arthritis...

    Rheumatoid Arthritis Medications The main categories of drugs used to treat Rheumatoid Arthritis are:

    Analgesic Drugs
    These drugs relieve pain, but don’t necessarily have an effect on inflammation. Examples of these medications are acetaminophen, propoxyphene, mepeidine and morphine.
    Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
    such as ibuprofen. Although NSAIDs work well, long-term use can cause stomach ulcers, and bleeding. These drugs are used to reduce inflammation, and relieve pain. They include medications such as aspirin, ibuprofen, indomethacin and COX-2 inhibitors such as valdecoxib and celecoxib.
    Glucocorticoids or Prednisone
    Are prescribed in low maintenance doses to slow joint damage caused by inflammation.
    Disease Modifying Antirheumatic Drugs (DMARDs
    Are used with NSAIDs and/or prednisone to slow joint destruction caused by RA over time. Methotrexate, injectable gold, penicillamine, azathioprine, chloroquine, hydroxychloroquine, sulfasalazine and oral gold. Are all commonly used.
    Biologic Response Modifiers
    These drugs directly modify the immune system by inhibiting proteins called cytokines, which contribute to inflammation. Examples of these are abatacept, etanercept, infliximab, adaliumumab and anakinra.

    For more information on US and UK licenced drugs :

    US Licenced Drugs UK Licenced Drugs

    In the event the disease isn't controllable by medication. There is...

    Protein-A Immuoadsorption Therapy

    This is a therapy that filters your blood, to remove antibodies that cause inflammation.

    Then there are the surgical options...

    Arthroscopy see above.

    Synovectomy

    In this operation the surgeon cuts or scrapes away damaged tissue from the joint lining., using kehole surgery.

    Arthrodesis or fusion

    This procedure fuses two bones together. Although movement becomes limited, it results in a less painful joint.

    Its usually performed on the ankles, wrists, fingers, toes and spine.

    THIS VIDEO AGAIN, IS NOT FOR THE SQUEAMISH,

    In the last resort you can have a joint replacement.



    Living with Arthritis.

    With the exception of joint replacement there are no miracle arthritis cures.

    But you can self-help to a certain degree...

    Take a moderate amount of exercise
    I know I keep banging on in these pages about exercise but it really is important especially at our time of life.
    If you do some exercise keeping our muscles strong, it will stabilise, and protect your joints.
    You've also got to keep moving the affected joint, despite the pain, to stop it from seizing up.
    You will find that if you dont keep mobile, the pain from arthritic joints restricts you movements bit by bit over time. Until your hardly moving at all.
    Keep your weight down.
    Especially if you have arthritis in your load bearing joints. You will be absolutely astonished at the difference losing a few pounds will make. (I speak from experience here.)
    Eat a healthy Diet.
    Fruit and vegtables contain vitamins and minerals, (Especially vitamin C.) which help to keep joints healthy and flexible as do Omega-3 oils found in fish.
    Avoid pain and damage by listening to your body.
    Take time to study what makes your pain worse, balance activity with rest. (You can have too much of both).
    Dont sit or stand for too long. If, for instance, your job involves sitting at a computer, get up every half an hour and move around for a couple of minutes.
    Work smart.
    Use your large muscles to lift and carry.
    Use a backpack to carry your stuff, rather than a bag/briefcase.
    Always lift with your legs, and use your palms rather than your fingers.
    Use tools /aids to help you open jars, cans etc.
    There are a million of these on the market (We'll look into maybe doing a few pages on some of them in the future.)
    Dont think that these things are just for the old, and disabled. They're there for SMART PEOPLE.



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