BENGALURU: Arthritis literally means inflammation of one or more joints. Globally osteoarthritis (OA) ranks eighth in all diseases and covers around 15 per cent of proportions among all musculoskeletal problems. About 80 per cent of the population above 65 years of age suffer from osteoarthritis.
Globally, Knee OA is the fourth most significant cause of incapability or stiffness in women and eighth in men. India has a high proliferative rate of OA in the world and is soon expected to be a top ranker in chronic diseases by 2025.
A study conducted in India showed a significant difference in the prevalence of OA, with 56.6 per cent in rural areas and 32.6 per cent in urban areas.
Osteoarthritis can also affect younger people who suffer from infections, obesity, fracture or dislocation of a joint. There are many different types of arthritis, among which osteoarthritis is the most common form, followed by inflammatory arthritis, metabolic arthritis (gout), post traumatic arthritis, and infectious arthritis. Causes and symptoms vary, and treatment depends mainly on the type and severity of inflammation.
Arthritis is usually a progressive condition. It occurs when there is a damage in the cartilage of joints. With progression of the damage, the underlying bone is exposed. The exposed bones will start rubbing together and this can cause pain, swelling and limitations in movement and in some cases, the person is not able to move at all. The body cannot fully repair this damaged cartilage. Depending on the extent of cartilage damage and thinning (stage of arthritis) it can cause varying levels of the four key warning signs – pain, swelling, stiffness and difficulty in moving the joint.
What causes arthritis? The exact cause is not fully understood. In general arthritis can affect anyone and in any age group, certain factors are shown to be associated with a higher risk of developing arthritis. Some of these are modifiable, while others are not. The non-modifiable risk factors include age. Leaving aside a few exceptions, the risk of arthritis increases with age.
It is more common in women, with exceptions of gout, which is more common in men. Genetic factors are associated with a higher risk of certain types of arthritis like Rheumatoid Arthritis (RA), ankylosing spondylitis and Systemic Lupus Erythematosis (SLE).
Modifiable risk factors: Overweight and obesity are important and common factors that can initiate arthritis and can also cause rapid progression of the disease. Lifestyle factors such as smoking, gaining excessive weight, sedentary lifestyles, having occupations that lead to injury and overuse of joints/muscles, malformed joints or defective cartilage, can increase the risk of osteoarthritis. Certain occupations that involve squatting, sitting cross leg, repetitive bending activities can increase the risk factors. Fractures, ligament injuries or infections involving the joints or bones closer to the joints can increase the risk of developing arthritis.
Symptoms often develop slowly and worsen over time. Osteoarthritis most commonly affects the weight bearing joints and joints that get heavily used like knee, hip, spine, big toe, and hands. Diagnosing rheumatoid arthritis at an early stage and initiating treatment is very important to reduce the impact of the disease.
The author is a senior consultant joint replacement & arthroscopic surgery Aster CMI Hospital
Treatment of arthritis
The principle aim is to control pain, minimise joint damage and improve or maintain the affected person’s quality of life. Management of Arthritis is multi-faceted, and it involves surgical and non-surgical care.
Currently, the process underlying osteoarthritis cannot be reversed, but symptoms can usually be effectively managed, hence awareness among the population about the disease, prevention and management is very important. Some of the commonly preferred types of treatment are simple rest, warm fomentation, use of pain killers, physiotherapy, injections in to the joints like, visco supplementation/steroids/PRP, disease modifying medications for inflammatory arthritis, use of stem cells, muscle gentle strengthening exercises, such as swimming or walking, can be equally effective.
Prevention of arthritis
While earlier and accurate diagnosis can help to prevent irreversible damage caused due to arthritis, adopting a healthy lifestyle is the first step towards this goal. This includes a healthy diet, regular exercise, avoiding obesity, avoiding injuries, following correct body postures at workplace, giving adequate rest to the body, avoiding movements or activities that put extra stress on the joints. Physical activity not only has a positive effect on arthritis also has a positive effect on the mental health and overall wellbeing of an individual. Regular small walk between periods of sitting leads to nutrition of the joints.