BANGALORE: If you find it difficult to climb stairs or if your joints hurt early in the morning, do not take it lightly. You could have arthritis and not consulting experts early could affect your mobility.
Orthopedic specialists say this condition is not something that affects only older people, as is the common notion. Arthritis, especially osteoarthritis, is on the rise and affects women in their early 30s.
"Change in lifestyle, lack of exercise and proper diet and a hectic working pattern increase the chances of getting arthritis, specially in women. Not just osteoarthritis, other forms such as rheumatoid arthritis tend to occur commonly in women," says Dr Basavaraj Kyavater, consultant joint replacement and orthopaedic surgeon at Sagar Hospitals.
Explaining the condition, Dr Ajit Benedict Royan, vice president of HOSMAT said, "Arthritis is a form of joint disorder that involves inflammation of one or more joints. The most common form, osteoarthritis OA (wear and tear arthritis), is a result of trauma to the joint, infection of the joint or age. Other arthritis forms are rheumatoid arthritis, gouty arthritis and related autoimmune diseases."
Regardless of the type of arthritis, the common symptoms for all arthritis disorders include varied levels of pain, swelling, joint stiffness and sometimes a constant ache around the joint. Pain is the main problem and it can range from being mild to being excruciating and constant. Such constant and severe pain may render the activities of daily living difficult.
It also decreases flexibility of the joint and restricts activity and ability to walk. "These factors can create an emotional and social disturbance in an active person's life. Arthritis makes it very difficult for individuals to be physically active and some become home bound, and are exposed to an increased risk of obesity, high cholesterol or vulnerability to heart disease. Individuals with arthritis are also at a risk of depression, which may be related to fear of worsening symptoms," says Dr Kyavater.
Symptoms to watch out for
Doctors say that arthritis is usually 'silent' to begin with, producing virtually no symptoms for many years. The symptoms are generally precipitated by a trivial fall or overuse of the joint. The earliest symptoms are-
- Pain increases by prolonged activity and is relieved by resting.
- Start-up pain and stiffness, particularly following inactivity. For example, pain in the first few steps after prolonged sitting in one position or after getting up in the morning.
- Swelling in and around the joint.
- Decreased range of movement and crunching sound during movement.
- Restricted function of the affected joint. For example, decrease in ability to walk due to affected knees.
- Deformity, for example, bow legs with knee joint osteoarthritis.
Rheumatoid arthritis is a chronic condition affecting many systems in the body, but mainly the bones and joints.
It is three times more common in females. Any age group can be affected. It usually occurs due to the body's response to an unknown stimulus leading to an inflammatory response in the soft tissues (muscles, tendons, ligaments, etc.) and later in the cartilage of joints and surrounding bone. It is found that joint fluid (synovial fluid) in rheumatoid arthritis contains chemical substances that damage the cartilage.
It most commonly involves the small joints of the hand, wrist, feet, neck, but may also involve larger joints like knees, shoulders, elbows, hips, etc. Experts say that many joints of the body can be affected at the same time.
In rheumatoid arthritis one should watch out for painful, swelling and inflammed (red) joints, stiffness in the affected joints particularly in the morning.
Stiffness usually lasts for more than a few minutes and its duration increases with the severity of joint involvement. At a later stage the severely involved joints develop deformity and severe disorganisation of the joint and restrict function.
As multiple joints may be involved a person's activities may be greatly reduced.
'Osteoarthritis and rheumatoid arthritis a big concern'
Osteoarthritis is also a degenerative joint disease. "In this case, the cartilage cushion at the ends of the bones loses its smoothness, becomes rough and wears off. In an advanced case, the cartilage is completely wornout. Thus, bones rub against one another causing pain and stimulating excess bone formation in the form of osteophytes. Although any joint in the body can be affected, the most commonly affected joints are of knees, spine (neck and lower back) and in the hands," says Dr Royan.
There is no cure for either rheumatoid or osteoarthritis.
Treatment is more of prevention than cure.
Treatment options vary depending on the type of arthritis and include physical therapy, lifestyle changes like exercise and weight control and medication. Joint replacement surgery may be required in eroding forms of arthritis.
- Lifestyle Modification - Patients with symptomatic OA of the knee who are overweight should be encouraged to lose weight. A minimum of five per cent of body weight must be lost.They shiuld also maintain their weight with dietary modification and exercise. They should incorporate activity modifications like walking instead of running in their lives.
- Rehabilitation- patients with symptomatic OA of the knee are encouraged to participate in low-impact aerobic fitness exercises. Quadriceps strengthening should be done for the knee.
- Mechanical interve-ntions- using support like kneecap or braces might be helpful in cases of instability to walk. Supports like walking sticks or crutches may also be helpful.
- Medication: Total Knee Replacement (TKR) is recommended in case the initial conservative measures for cure fail and worsens the condition of the joint.