Arthritis is a leading cause of pain and disability. There are more than 100 types of arthritis and related conditions. Common symptoms of arthritis include pain, stiffness, swelling and reduced mobility of joints.
A rheumatologist is a specialist who is qualified by additional training (5-6 years after medical school) and dedicated to treatment of arthritis and other diseases of the joints, muscles and bones.
Different forms of arthritis have different symptoms. Accurate and early diagnosis is very important in minimizing joint damage and helping preserve joint function.
Types of Arthritis
The common forms of arthritis in adults include osteoarthritis, rheumatoid arthritis, osteoporosis, ankylosing spondylitis, gout, tendinitis, and bursitis.
Osteoarthritis (OA) is the most common form of arthritis affecting over 27 million Americans. OA primarily affects the cartilage, causing breakdown and eventually bone rubbing on bone. This causes pain and stiffness in the affected joints. Osteoarthritis commonly affects the knees, hips, and hands, although other joints can also be affected. It usually appears after age 45. Increased body weight is a well established factor in the development of osteoarthritis. Other factors include injury and genetics. Treatment includes medications including non-steroidal anti inflammatory drugs, analgesics, topical pain relievers, and surgery as needed.
Rheumatoid Arthritis (RA)
Rheumatoid arthritis (RA) is a form of inflammatory arthritis and an autoimmune disease. It is a chronic disease that causes pain, swelling, stiffness, and loss of function in joints. It can affect many joints, but commonly affects the hands, wrists, and feet. The cause of rheumatoid arthritis is not yet known, but can be a combination of genetic and environmental factors. Rheumatoid arthritis is diagnosed by clinical evaluation, lab testing, and x-rays. Medications used to treat rheumatoid arthritis include non-steroidal anti-inflammatory drugs (NSAIDS) and corticosteroids which help to reduce pain and inflammation. Medications that can modify the disease or put it in remission include various disease modifying agents (DMARDs) and biologic agents. Early treatment of rheumatoid arthritis helps to preserve joint function before the onset of permanent joint damage and joint deformities.
Osteoporosis is often called the “silent disease” since bone loss occurs without any symptoms. It is a major cause of hip, spine and wrist fractures and can cause a stooped posture (kyphosis). Risk factors include advanced age, family history, female sex, low weight, previous fracture, and smoking.
At the Center for Arthritis and Osteoporosis, we use a DEXA or Bone Density test to scan the hip, spine or forearm to detect osteoporosis and early bone loss. The DEXA test has a very low radiation exposure, approximately 1/10th of a Chest X-ray. Bone density test results are reported as a T-score:
- -0.00 to -1.0 - Normal bones – low risk for fractures
- -1.0 to -2.4 - Osteopenia – medium risk for fractures
- -2.5 or lower - Osteoporosis – high risk for fractures
A bone density test can:
- detect osteoporosis before a fracture occurs
- predict your chances of fracturing a bone in the future
- determine the rate of bone loss and/or monitor the effects of medications
Treatment options include a balanced diet rich in calcium and Vitamin D and weight bearing exercise. Prescription medications including oral as well as injectable medications are available to treat osteoporosis and to reduce risk of future fractures.
Ankylosing Spondylitis is a form of arthritis that predominantly affects the spine and sacroiliac joints, but can affect the hips, shoulders and knees. X-rays including CT Scans and Bone Scans help in making an accurate diagnosis. Treatment includes prescription medications, range of motion and strengthening exercises.
Gout is a form of inflammatory arthropathy caused by deposits of uric acid crystals in joints. It can cause sudden onset of severe pain, swelling, redness, and tenderness - most often in the big toe, but can occur in the ankle or knees. Prompt medical attention can help to resolve the gout symptoms quicker. Multiple gout attacks can result in long-term damage to the joints. Treatment of gout is initial relief of pain an inflammation during the acute attack. Long term treatment includes lowering uric acid levels, prevention of future attacks, and avoiding long-term damage to the joints.
Tendinitis refers to inflammation of tendons (tough cords of tissue that connect muscle to bone) caused by various factors. Tendinitis causes pain and tenderness and may cause restricted movement of joints.
Bursitis involves inflammation of the bursae, small fluid-filled sacs that help reduce friction between bones and other surrounding structures in joints. Bursitis can cause pain and tenderness of the affected joints.