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Arthritis

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Arthritis

Arthritis is a common condition that causes inflammation and pain in one or multiple joints and can affect people of all ages, including children.

More than ten million people in the UK have arthritis or other, similar conditions that affect the joints. The two most common types of arthritis are osteoarthritis and rheumatoid arthritis.

There is currently no cure for arthritis, but there are many treatments that can help to slow it down and improve quality of life.

Osteoarthritis

Osteoarthritis affects nearly nine million people and is the most common type of arthritis in the UK. It most commonly affects the joints in the spine, hands, hips, and knees.

It usually develops in adults who are in their mid-40s or older and is more common in women and people with a family history of the condition.

However, osteoarthritis can occur at any age and can occur as a result of an injury or be associated with other joint-related conditions, such as rheumatoid arthritis or gout.

This type of arthritis initially affects the smooth cartilage lining of the joint, which makes movement more difficult than usual and leads to pain and stiffness.

Once the cartilage lining starts to thin out and become rough, the ligaments and tendons have to work harder.

This strain on the ligaments and tendons can cause swelling and the formation of bony spurs called osteophytes.

Severe loss of cartilage can lead to bone rubbing on bone and forcing the bone out of its normal position, which can be extremely painful and alters the shape of the joint.

Rheumatoid arthritis

Rheumatoid arthritis affects more than 40,000 people in the UK. It often starts when a person is between the ages of 40 and 50 years old and is three times more likely to occur in women than men.

Rheumatoid arthritis causes the body’s immune system to target affected joints, which leads to pain and swelling. The synovium (outer covering) of the joint is the first place affected. This can then spread across the joint, leading to further swelling, a change in the joint’s shape, and even cartilage and bone break down.

People with this type of arthritis can also develop problems with other organs and connective tissues in the body.

Other types of arthritis and related conditions

  • Ankylosing spondylitis
    a chronic (long-term) inflammatory condition that typically affects the bones, muscles, and ligaments of the spine. Ankylosing spondylitis can lead to stiffness and fusing of the joints. It can also cause other problems including swelling of the tendons, eyes, and large joints.
  • Cervical spondylosis
    also referred to as degenerative osteoarthritis, cervical spondylitis affects the bones and joints in the neck, which can cause stiffness and pain. It is often seen in people over 50, and is caused by ‘wear and tear’ to the muscles and bones as the body gets older
  • Cervical spondylosis
    also referred to as degenerative osteoarthritis, cervical spondylitis affects the bones and joints in the neck, which can cause stiffness and pain. It is often seen in people over 50, and is caused by ‘wear and tear’ to the muscles and bones as the body gets older
  • Fibromyalgia
    is a chronic (long-term) condition that causes pain all over the body and can also cause: increased sensitivity to pain, muscle stiffness, difficulty sleeping, fatigue (extreme tiredness), and other problems. It causes pain in the body’s ligaments, muscles, and tendons.
  • Lupus
    is a chronic (long-term) autoimmune condition that causes inflammation to the joints, skin, and other organs. It can cause joint pain and stiffness, extreme fatigue, skin rashes, weight loss, and other symptoms. Lupus can affect many different organs and tissues in the body.
  • Gout
    : is a type of arthritis caused by too much uric acid in the body and causes sudden and severe joint pain, redness, and swelling. The uric acid can be left in the joints (commonly in the big toe) but can develop in any joint.
  • Psoriatic arthritis
    is an inflammatory joint condition that can affect people with psoriasis. It can cause inflammation, pain, and stiffness in any joint of the body, but typically affects the hands, feet, knees, neck, spine, and elbows.
  • Enteropathic arthritis
    is a form of chronic inflammatory arthritis associated with inflammatory bowel disease (IBD). The two main types of IBD are ulcerative colitis (UC) and Crohn’s disease. One in five people on average with UC or Crohn’s disease will develop enteropathic arthritis and will usually be affected in their peripheral (limb) joints and or spine.
  • Reactive Arthritis
    reactive arthritis can cause inflammation of the joints, eyes, and the urethra (the tube that passes urine). It can develop shortly after an infection of the bowel, bladder, or genital tract. Less frequently, it can occur after a throat infection.
  • Secondary Arthritis
    is a type of arthritis that can develop after a joint injury, sometimes occurring many years after the initial injury.
  • Polymyalgia Rheumatica
    is a condition that almost always affects people over the age of 50. It causes pain, stiffness, and inflammation in the muscles around the neck, shoulders, and hips. The immune system causes muscle pain and stiffness and can also cause joint inflammation.

Arthritis in children

Arthritis is usually associated with old age, but can also affect children. About 15,000 children and young people in the UK are affected by the condition.

Most types of childhood arthritis are known as Juvenile Idiopathic Arthritis (JIA). JIA causes inflammation and pain in one or more joints for at least six weeks.

The main types of JIA are Oligo-articular JIA, Polyarticular JIA (polyarthritis), Systemic onset JIA, and Enthesitis-related arthritis.

The exact cause of JIA is unknown, but the symptoms often improve as the child gets older, meaning they can live a normal life.

  • Oligo-articular JIA:
    is the most common type of JIA and often goes away without causing long-term joint damage. It affects up to four joints in the body, most commonly the knees, wrists, and ankles. Oligo-articular JIA can cause a risk of developing eye problems, so regular eye tests with an ophthalmologist (eye care specialist) are recommended
  • Polyarticular JIA (polyarthritis):
    is the second most common type of JIA and affects five or more joints. The symptoms of this type of arthritis are similar to symptoms of adult rheumatoid arthritis. Polyarticular JIA can affect children of any age and can develop both gradually and suddenly in different cases. A child with the condition may also feel unwell and occasionally experience a high temperature (38C or above)
  • Systemic onset JIA:
    begins with symptoms such as a rash, fever, fatigue, and enlarged glands. Later, the joints can become swollen and inflamed. Similar to polyarticular JIA, this type of JIA can affect children of all ages
  • Enthesitis-related arthritis:
    enthesitis-related arthritis is a type of juvenile arthritis that causes inflammation where the tendons attach to the bone. It can cause stiffness in the lower back and neck in teenage years and is also linked to a painful eye condition called acute uveitis (an inflammation of the middle layer of the eye, that can cause pain and changes to your vision)

When to see an expert at Ahmeys?

If you are experiencing the symptoms above and think that you or your child may have arthritis, we recommend that you call Ahmeys to book an appointment.

One of our experts can check your symptoms and conduct tests to confirm a diagnosis and rule out any other problems.

Call to make an appointment or speak to an expert at Ahmeys if:

  • You are experiencing stiffness and pain that has come on gradually (you may be experiencing the onset of osteoarthritis, rheumatoid arthritis, or another related arthritic condition)
  • You notice pain and stiffness in your legs, arms, or back after sitting for short periods or after sleeping at night (you may be experiencing the onset of osteoarthritis, rheumatoid arthritis, or another related arthritic condition)
  • The pain has come on quickly and you also have a fever (you may have infectious arthritis)
  • You have sharp and severe pain in concentrated joint areas, especially the big toe, (you may be developing gout)
  • Your child has developed a rash or pain in the knees, wrists, and ankles, has a fever, poor appetite, or is experiencing fatigue (your child may have a type of JIA)

Causes

There are more than 100 different types of arthritis that can affect one or multiple joints.

The most common cause of arthritis is normal wear and tear of the cartilage due to age. Other causes of cartilage breakdown can be infection, an injury, or a family history of the disease.

Rheumatoid arthritis is an autoimmune disorder, which is caused by your immune system attacking the soft tissue in your joints that nourishes cartilage and lubricates the joint.

The exact cause of this type of immune reaction is unknown, but scientists have discovered genetic markers that increase your risk of developing this type of arthritis.

Diagnosis

If you are concerned that you may have arthritis, call Ahmeys to book an appointment with one of our experts to discuss your symptoms and potential treatments.

An expert at Ahmeys will review your symptoms and potentially perform the following diagnostic tests:
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  • A physical exam to check for fluid around the joints, red or warm joints, and to test the range of motion of the affected joints
  • Blood tests to check for specific types of antibodies and for inflammatory markers
  • Blood tests to check for anti-CCP (anti-cyclic citrullinated peptide), RF (rheumatoid factor), and ANA (antinuclear antibody)
  • Conduct or refer you to a hospital for imaging scans such as MRI, X-Ray, and CT scans to produce an image of your cartilage and bones. This can also rule out other causes of symptoms and identify bone spurs

Treatment

Once one of our experts has assessed you, they will discuss treatment options with you. Treatment may also depend on the results of any potential diagnostic tests.

The main goal of arthritis treatment is to reduce the amount of pain experienced and prevent further damage to the joints.

Treatment may be dependent on your age, weight, other medical history factors and will certainly be dependent on what type of arthritis you have been diagnosed with.

One of our experts may combine a combination of treatment methods to improve pain relief, joint function and to help take pressure off sore joints.

Below are the common treatments that one of our experts may use to treat your arthritis symptoms:

Medication

  • Analgesics:
    such as hydrocodone or acetaminophen for pain relief
  • Nonsteroidal anti-inflammatory drugs (NSAIDs):
    such as ibuprofen, to help control pain and reduce inflammation
  • Menthol or capsaicin creams:
    to apply topically to the affected area and block the pain signals from your joints
  • Immunosuppressants: like prednisone or cortisone to help reduce inflammation
  • Opioids:
    can be used to relieve severe pain
  • Steroid injections:
    Steroids contain manmade versions of the hormone cortisol and can be used to treat painful musculoskeletal problems. Patients with osteoarthritis may be offered steroid injections when other treatments haven’t worked. The injection is made directly into the affected area (usually after a local anesthetic is used to numb the area and reduce pain)
  • PPR injections:
    PPR is a newer treatment that may be offered to treat osteoarthritis. PPR is blood plasma containing concentrated platelets that get injected into the affected area so that your body can use it to repair damaged tissue
  • Corticosteroids or disease-modifying antirheumatic drugs (DMARDs):
    if you have RA, your doctor might prescribe either of these two types of drugs, which suppress your immune system in order to stop it from attacking your connective tissues

Surgery

In some cases, despite medication and physiotherapy, continued damage to the joint can occur. In such cases, you may need surgery to help restore the ability to use the joint.

Surgery may also be recommended to correct deformities or reduce pain.

  • Carpal tunnel release:
    the cutting of a ligament in the wrist to relieve pressure on a nerve and reduce pain
  • Release of tendons:
    release of tendons in the fingers to treat abnormal bending
  • Removal of inflamed tissue:
    removal of inflamed tissue lining the finger joints to reduce pain and increase mobility
  • Arthroscopy:
    removal of inflamed joint tissue through a small cut in the skin using a thin tube with a light source and camera called an arthroscope. This is a relatively non-invasive procedure and typically does not require an overnight stay in hospital
  • Joint replacement or arthroplasty:
    surgery to replace a severely damaged joint with an artificial one may be suggested. This surgery is most commonly used to replace hips and knees. This is a major operation that involves several days in the hospital, followed by months of rehabilitation and physiotherapy. The latest joints have a lifespan of ten to 20 years
  • Joint fusion:
    if you are experiencing severe arthritis in your wrist or fingers, joint fusion may be suggested to you. In this procedure, the ends of your bones are locked together until they heal and become one

Supportive treatments

  • Physiotherapy Therapy Physiotherapy is a core component of arthritis treatment and involves exercises that help to strengthen the muscle around the affected joint. It helps to restore movement and function when someone is affected by injury, illness, or disability and considers the body as a whole, rather than just focusing on the individual aspects of an injury or illness
  • Transcutaneous electrical nerve stimulation (TENS)TENS is a machine that sends electrical impulses through electrodes (sticky patches) attached to the skin. This can help to ease pain by numbing the nerve endings of your spinal cord
  • Assistance Devices
    • You may be prescribed or recommended mobility assistance devices, such as canes or walkers, to help take pressure off sore joints
    • If you have osteoarthritis in your lower limbs, you may be recommended to wear special footwear or insoles in your shoes to absorb shock and spread your weight more evenly
    • A splint or brace can be used to rest a painful joint
    • If your hands are affected by osteoarthritis, you may be given or recommended assistance devices such as a tap-turner, that can aid with hand-operated tasks

Complimentary and alternative therapies

  • Acupuncture:
    is a treatment derived from ancient Chinese medicine in which fine needles are inserted into certain sites in the body for preventative and therapeutic purposes
  • Chiropractic:
    is a treatment where a practitioner (Chiropractor) uses their hands to help relieve problems with the muscles, bones, and joints
  • Osteopathy:
    physical manipulation, stretching, and massaging the muscles and joints to prevent and relieve health problems and pain  

Nutritional supplements and dietary changes

While there is no strong evidence to suggest that specific dietary changes can improve rheumatoid arthritis, some people feel as though their symptoms get worse after eating certain foods.

It is important to ensure that your diet is healthy and balanced. Some people have found it useful to take vitamin supplements to prevent side effects of medications they are taking related to arthritis.

Calcium and Vitamin D may help to prevent osteoporosis if you are taking steroids and folic acid supplements may help to prevent some of the side effects of methotrexate.

There is also some evidence to suggest that taking fish oil supplements may help reduce joint pain and stiffness caused by arthritis.

How to manage your symptoms

  • If you are overweight, weight loss and maintaining a healthy weight can reduce symptoms if you have Osteoarthritis
  • Eat a healthy and balanced diet with fresh fruits, vegetables, and herbs
  • Experiment with ‘inflammation reducing’ foods such as fish and nuts and try taking fish oil supplements to help reduce joint pain and stiffness
  • Apply hot or cold packs to joints to relieve pain
  • Use stretching techniques provided by one of our experts at Ahmeys or a physiotherapist
  • Take painkillers to reduce pain, but make sure that you follow the recommended dose and that the medication does not conflict with any other medication you are currently taking
  • Exercise regularly to keep joints flexible, but avoid overexerting yourself or putting too much pressure on your joints. Swimming is a good non-weight bearing activity
  • Look after your joints and try to avoid further damage
  • Practical tips for those incapacitated or severely troubled by mobility problems relating to arthritis are:
    • Keep things within easy reach
    • Install and use a handrail on the stairs to help you get up and down
    • Use long-handled tools to pick things up or clean
    • As previously mentioned, fit levers to taps to make them easier to turn
    • Use electric kitchen equipment, such as tin openers, when preparing food
Faheem Ahmed

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Providing NHS services

How to Find Us

Visit us at:
158 Oxford Road
Cowley, Oxford, OX4 2LA
Contact us at:
info@ahmeysclinic.com
01865 689 149

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