Arthritis – Symptoms, Types, Diagnosis, Treatment, Management
If you or any of your relatives has been affected with arthritis, you’d probably know how debilitating the disease can be. Astonishingly, according to a leading daily, arthritis affects 15% of India’s population out of which only 30-40% seek orthopaedic help. Thought to be due to the lack of sufficient awareness about the disease, this ignorance often leads to the condition worsening to a point of no return. In this mega guide, we’ll explain everything you need to know about the disease.
What is arthritis?
Arthritis is not a single disease – there are over 100 different forms of arthritis. It is a collective term for different individual illnesses, with different features, treatments, complications, and prognoses. The similarity is that all the conditions together have a tendency to affect the joints and many have the possibility to affect other internal parts of the body.
What are the types of arthritis?
Arthritis can be broadly categorised into inflammatory type or non-inflammatory type.
Some of the inflammatory types are
- Rheumatoid arthritis – the most common type of inflammatory arthritis. It is an autoimmune disease which mainly affects the joints. It has more severe symptoms causing pain, stiffness, fatigue and loss of appetite.
- Gout – most commonly seen in men, it is caused by increased uric acid in the blood, though not everybody with high levels in their blood get gout. But when uric acid levels in the blood are too high, it may form hard crystals in your joints. Being overweight, excessive alcohol drinking or eating too much meat and fish that are high in chemicals called purines increases your chances of getting gout. Some medicines, like diuretics, can also be one of the causes. Arthritis due to gout is usually characterized by a sudden attack of burning pain, stiffness and swelling in the joints.
- Psoriatic arthritis - It is associated with inflammation of the skin (psoriasis).
Some of the non-inflammatory types are:
- Osteoarthritis – also called degenerative arthritis, it is usually caused by overuse of joints. This can be due to obesity, various sports or age. It is most common in the knees, hips, feet, and spinal joints which bear weight. Cartilage covering the ends of bones serves as the body’s shock absorber. With osteoarthritis, the cartilage gradually breaks down resulting in pain when the joint is moved.
- Fibromyalgia – a syndrome characterized by long-lasting extensive pain and tenderness in muscles, ligaments and tendons. It damages the joints and/or soft tissues and causes chronic pain. It does not get worse with time and is never fatal.
- Backache - one of the most common health problems which can occur in both men and women at any age. It can present itself as anywhere between a mild to unbearable. Backache can start slowly and progress over a period of time as a result of poor posture. It may also have a sudden onset due to injury. Back pain can either last for few days or can remain for weeks, months and even years.
Different forms of arthritis have different causes. Some of the causes of arthritis are hereditary factors, infections (bacterial and viral), lack of joint fluid, autoimmunity, etc.
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Regardless of the type, arthritis causes pain and limits the functioning of your joints. If your arthritis is due to inflammation of the joints then you may experience joint swelling, redness, warmth and stiffness.
With inflammatory arthritis like rheumatoid arthritis, the various organs of your body may be affected. You may have fever, lymph nodes swelling, weight loss, tiredness, inability to use your hand, difficulty in walking and poor sleep.
It’s common to experience pain in your muscles and joints, particularly if they are overworked or strained. Most doctors will tell you that it’s imperative to diagnose the disease as soon as possible. Here are some tips on how you can distinguish between a pain caused due to strain and that caused due to other reasons.
If you see any of these symptoms you shouldn’t put off a visit to the doctor.
- If the pain last for more than a week
- If you experience unexplained joint pain usually accompanied with fever
- You experience difficulty in carrying out daily chores due to joint pain
- Your joint pain does not get better with pain killers
- There is swelling and stiffness in the joints
The diagnosis will be based on your symptoms, the inflamed joints affected and through blood and X-ray findings, MRI scan, CT scan, synovial fluid analysis and/or a urine test. You may have to visit your doctor several times before he can rule out other causes and confirm the diagnosis.
Mostly arthritis is more a source of irritation than a chronic ailment because it affects your everyday life. An early and accurate diagnosis prevents irreversible damage and disability.
The type of arthritis decides your treatment options. Treatment may include medications, physiotherapy, exercise, weight control and orthopedic bracing. Eroding forms of arthritis may require joint replacement surgery. Medications are given to reduce inflammation in the joint which decreases pain. There is no permanent cure for either rheumatoid or osteoarthritis.
- Drugs that treat the symptoms of arthritis like pain killers, non-steroidal anti-inflammatory drugs (NSAIDs) and steroids
- Drugs that suppress the underlying inflammatory disease like disease-modifying anti-rheumatic drugs (DMARDs). Biologic drugs are used in treating rheumatoid arthritis or when DMARDs are ineffective.
- Hydrotherapy - involves special exercises that you do in a warm-water pool.
- Physiotherapy – Because of the pain, you will often avoid moving the affected joint. A physical therapist can help you work out the joint stiffness without damaging it.
- Occupational therapy – Occupational therapy promotes health and well-being by teaching you how to reduce the strain on your joints during your daily activities. Your home and workplace may be modified by your occupational therapist so that you can move about without worsening your arthritis.
Surgery is usually recommended when other treatments prove ineffective the damage to your joints is severe enough to cause difficulties in everyday life. It can either be pain-relieving or reconstructive like replacing a badly damaged joint with an artificial joint, removing the inflamed lining of the joint cavity, releasing trapped nerves or fusing a joint to make it more stable. The most common form of surgery for arthritis is joint replacement.
Food habits to beat arthritis
Eating certain kinds of food could help you relieve the pain and discomfort associated with the disease while certain others could worsen the symptoms. Naini Setalvad, renowned dietician tells us more.
Spice it up
If you want to beat arthritis you need to include more vegetables such as garlic and onions into your diet. Ideally you should combine them with ginger. I would even suggest simply chewing on ginger all day long – that truly helps! In addition, stock up on the chilli family, ranging from the fresh green chilies to the capsicum. You could also use more spices such as cloves and cinnamon.
Try some variety in your rotis
When it comes to your rotis, try those made of jowar, nachani, raagi and bajri. They are great for your arthritis-ridden joints because they contain nutrients that help ease the problem,
All fats are not bad
You also need healthy fats to soothe the joints – the kind present in nuts and seeds like walnuts, cashew nuts, pistachios etc. Seeds include sunflower seeds, sesame seeds and flax seeds. Cook your food in extra virgin olive oil and don’t forget to dab some ghee on your rotis. If you do not like ghee you could eat a good amount of the coconut flesh. These fats not only help lubricate the joints, they also help absorb certain vitamins which provide nutrition to the
Beware of foods that worsen the pain
As far as possible, avoid tomatoes, lemon, amla, imli, dairy products and wheat. These foods could possibly worsen the pain in the joints. However, the worst part about this is the fact that cutting some of these foods could deprive you of Vitamin C. As a result you must ensure that you get enough guava and kokum in your daily diet. This will not only keep your vitamin C levels up, it also helps fight inflammation.
Shun the whites
Other foods that you should avoid are white flour, white sugar and table salt. Switch from white sugar to natural sweeteners like jaggery and dates. You could also replace your white salt with rock salt and sea salt. These salts contain additional minerals that are not available in white table salt, and the minerals are known to heal.
Keep a tab on your vitamins
In addition to all the healthy changes, you should also keep a regular tab on your vitamin B 12 and vitamin D 3 levels; the latter being slightly more important in the case of arthritis. If they are low, consult a physician and take the supplements as required, since low vitamin B 12 and vitamin D 3 levels are a sure shot sign of arthritis.
Reversing Rheumatoid Arthritis is possible!
33% of people suffering from rheumatoid arthritis get permanently disabled and 50% never go back to a normal life.
So if you have been recently diagnosed with the condition, or have been battling it for a while now, here is a way to reverse the disease – naturally. In a candid interview with Rachna Chhachhi, a certified nutritional therapist, we find out about how she devised her unique method and what a patient with RA can do to reverse the disease. Here are excerpts from the interview.
How did you come upon the use of nutrition and yoga to heal RA?
When I was diagnosed with RA, my rheumatologist started me on immuno-suppressants, steroids and methotrexate (a drug commonly used in chemotherapy). I was given a steroid injection on my elbow, since it had bent and would deteriorate beyond repair if no action was taken. I had to wait for three months for the immune drugs to start acting, and three months later I started to feel the effect. For seven months, I regularly took the medicines along with folic acid and glucosamine supplements to negate the side effects of the strong drugs I was taking and to build my joints.
After a while of feeling good, I noticed that my hair had started falling. I tried everything possible to get back my lost hair, but to no avail. Nothing worked. When I asked my immunologist, he told me it was a side effect of the drugs I was taking. I had to choose between balding and being able to walk.
That is when I refused to get back on the medication. Instead, I signed up for a 14-day RA treatment at a well-known Ayurvedic outlet. For seven days, they used special herbs forAbhyangam. The next seven days, they used potli – a technique where you pound the joints with a small bundle full of herbs dipped in heated oil. It was painful but I actually began to feel a little better.
Despite all this I was still in a lot of pain and couldn’t even walk, so I turned to yoga andpranayama. I found breathing exercises boring, and did the minimum amount required. Miraculously, 15 days after I started my breathing routine, I began to feel better. Within six months of all the combinations, I was almost pain free.
I continued practicing half an hour of pranayama, five days a week, and got the potli therapy done once a month. I modified my diet and included nuts, fruits and green vegetables, that help in controlling inflammation. I then added raw garlic, green tea and fish oil supplements (these foods also have anti-inflammatory components). The process was slow and took me a year to recover. But after a year, when I did my blood tests, it showed that all my markers for RA were negative. The negative results continued month after month.
That is when I decided to get certified in nutritional therapy at the Oxford school for Nutritional Therapy. My aim was to treat patients with chronic lifestyle diseases. Today my method of reversing RA is a combination of my specialty as a health expert and my experience in healing different kinds of RA patients.
How does nutrition affect the condition? How does it help reverse it?
One of the major underlying causes of RA is an accumulation of nutritional deficiencies. Since RA is primarily an immune system disorder, if the immune system is strengthened with the help of nutrition, the symptoms of RA reduce drastically.
What veggies or foods should a person with RA specifically include into their diet on a daily basis?
Generally speaking, raw foods, fruits, vegetables, nuts and seeds should form 60 to70 per cent of their diet. They should also switch to green tea instead of their regular tea and coffee. Most importantly they should eliminate foods like sugar, white flour, processed meats and cold drinks. These foods are extremely dangerous for patients with RA as they only aggravate the process of inflammation and destruction of their body’s defense mechanism.
How does yoga help in reversing RA?
Yoga and pranayama is great for people with RA. The pain and stiffness that they feel is often excruciating and causes their joints to freeze making it difficult for them to move. Therefore, a combination of yoga and pranayama helps reduce these symptoms considerably. While, yoga keeps their joints supple and flexible, pranayama helps in the efficient release of toxins from the body, thereby reducing pain.
Arthritis is a hereditary disease but there are measures to take care of their joints and slow its progression. People should exercise regularly, eat healthy and maintain their weight. Also they need to get checked regularly to assess the onset of arthritis.
Your guide to living with arthritis by Dr Smarajit Chakravarty
Since arthritis is inevitable, and will happen to the best of us, the first thing about adjustments is acceptance. Depression as a malady is commonly seen in arthritics, and it has been observed that patients who are feeling low actually tend to feel the pain of arthritis much more than those who, notwithstanding their disease state, have a more cheerful approach to life.
It would certainly be wise to alter one’s lifestyle early in adult life, before arthritis has set in. In addition, these altered habits will increase the life span of the joints gifted to us by nature by retarding the progress of the disease.
Of the things I shall talk about, exercises and weight loss are of paramount importance. My teacher in college was fond of saying that the treatment of arthritis begins with weight loss. Compared to the overweight subject, in a lean individual, since his joints are subjected to less strain, arthritis sets in slowly, and when it does, in a lean individual, the need for medicines is far less.
Concomitant to weight loss is dietary control–as opposed to dieting. Avoiding the wrong kinds of food is only one half of the exercise: one must also ensure that the right kind of food is taken in sufficient amounts to maintain a balanced dietary intake. Oils, fats, processed food and simple carbohydrates are the food items to avoid; fish, nuts, fruits, vegetables and skimmed milk must be encouraged.
Exercises will decrease pain, improve and increase the range of motion in joints, strengthen the muscles surrounding a joint, and thus reduce the symptom of pain, besides helping us to endure it better. On the other hand, inactivity, which can lead to muscle weakness, can cause instability in a joint. The ‘right’ exercises are those that will build and strengthen the muscles around a joint without damaging the joint itself, and include exercises such as walking, cycling, low-impact aerobics and swimming. High-impact exercises and those that involve repetition of the same movement are best avoided.
The use of alcohol and tobacco should be cut down or stopped. Tobacco weakens the connective tissue, thereby increasing joint laxity and alcohol can make you overweight besides altering your sensorium, making you more helpless and susceptible to injury.
Further, statistics show that arthritis is associated with other health problems such as heart disease, hypertension and Diabetes. By no means should the treatment of these diseases be ignored on account of the pain and suffering of arthritis.
Finally, simple measures like the installation of hand rails say, in the bathroom, or simple door handles instead of door knobs; the use of a walking stick, or using a ramp instead of the stairs will go a long way in helping the patient to cope and to come to terms with the pain and problems associated with arthritis.