Arthritis is derived from a Greek term disease of joints. It is defined as acute or chronic joint inflammation that often co-exists with pain and structural damage. Arthritis can refer to over 150 different conditions that affect muscles, bones and joints. These include;
· Auto-immune or auto-inflammatory processes (rheumatoid arthritis and ankylosing spondylitis)
· Crystal deposition (gout and pseudogout)
· Infection (septic arthritis)
· Idiopathic (juvenile idiopathic arthritis)
Many factors contribute to the etiology of arthritis like;
· Wear-and-tear associated with day-to-day weight bearing.
· A prior history of trauma / injury to the joint(s).
· Prior infection
· Prior surgery
· Deposition of monosodium urate or calcium pyrophosphate dihydrate crystals.
· Autoimmune processes.
Regardless of the type of arthritis, the common symptoms of all arthritis include;
· Varied levels of pain and swelling.
· Joint stiffness and sometimes a constant ache around the joint(s).
· Arthritic disorders like rheumatoid and lupus can affect other organs in the body with a variety of symptoms like;
· Inability to use the hand or walk.
· Malaise or a feeling of tiredness.
· Poor sleep.
· Muscle aches and pains.
· Difficulty moving the joint.
In advanced arthritis, significant secondary changes are common. For example, in someone who has limited their physical activity;
· Muscle weakness.
· Loss of flexibility.
· Decreased aerobic fitness
Diagnosis is made by clinical examination from an appropriate health professional, and may be supported by other tests such as radiology and blood tests;
· Medical history – finding out about symptoms, family history, other health problems in the past.
· Physical examination – look for redness and swelling in and around the joint, check out the range of movement of your joints. Depending on the type of arthritis also look for rashes, check your eyes and throat, and measure your temperature.
· Scans and other tests – again depending on the type of arthritis test may include: blood tests to check for levels inflammation in blood; x-rays; ultrasound; CT (computed tomography) or MRI (magnetic resonance imaging)
· Referral to specialist – if appropriate, your doctor will refer you to a specialist, often a rheumatologist, for diagnosis and specialized management of your condition.
Treatment and management options vary with the type of arthritis, its severity and the parts of body affected. There is no cure for arthritis. Treatment options include medications, physical therapy, lifestyle changes, orthopedic bracing. Joint replacement surgery may be required in eroding forms of arthritis.
MEDICATIONS; Treatment typically begins with medications that have lesser side effects and further medications being added if insufficiently effective. Treatment also depends on the type of arthritis. For example, the first line of treatment for osteoarthritis is acetaminophen (paracetamol) while for inflammatory arthritis it involves non-steroidal anti-inflammatory drugs like ibuprofen.
· Cold/Hot Applications: By using heat, analgesia is accomplished, muscle spasm relieved and elasticity of periarticular structures obtained. Heat can be used before exercise for maximum benefit. Applications are recommended for 10-20 minutes once or twice a day. Cold application is preferred in active joints where intra-articular heat increase in undesired. Cold pack, ice, nitrogen spray, and cryotherapy are different methods of cold therapy.
· Electrical Stimulation: TENS (transcutaneous electrical nerve stimulation) therapy is most commonly used method. Various studies have reported an increase in hand grip strength after daily application of 15 minutes of TENS. It is also observed that there is reduction in synovial fluid and inflammatory exudate following TENS application in acute arthritis and thus pain relief.
· Hydrotherapy: You will normally share the pool with other people during your treatment sessions. Hydrotherapy can help you in a number of ways;
Ø The warmth of the water allows your muscles to relax and eases the pain in your joints helping you to exercise.
Ø The water supports your weight, which helps to relieve pain and increase the range of movement of your joints.
Ø The water can be used to provide resistance to moving your joints. By pushing your arms and legs against the water, you can improve your muscle strength.
Ferrara LA. The biomechanics of cervical spondylosis. Advances in orthopedics 2012. Feb1, 2012.
McCormack BM, Weinstein PR. Cervical spondylosis. An update. West J Med. Jul- Aug 1996.
Kisner, Colby., 2007, Apr. Therapeutic exercise