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Can you answer JosephA’s question about Arthritis?:

I’ve heard that rheumatoid arthritis almost always starts in the fingers and causing visible swelling and redness. In terms of fingers, is it possible for a person with RA to just have stiffness and pain in the fingers with little to no swelling? Also, how often do people with Juvenile RA recover?

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Can you answer pfr305′s question about Arthritis?:

I am only 23 but I have had a knee injury since a year ago off and on and now I am experiencing osteoarthritis symptoms. (stiffness in the knee joint in the morning followed by pain of and on during the day) Could these symptoms be caused by something else or do I have arthritis already?

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Leena woke up to find her knees wobbly. It was painful for her to stretch her leg for a minute. Then she became okay. This had become a daily phenomenon and Leena decided to consult her Doctor. The Doctor asked her to get her X-ray done for the knee joint. The diagnosis: Osteoarthritis.

Being a member of an orthodox joint family, Savithri, aged 48, had to have her meals seated on the ground along with all her family members. Of late, however, Savithri was finding it extremely difficult to sit cross legged on the ground. Her leg refused to straighten up while rising from the seated posture. After a few seconds of discomfort, she would straighten her leg very slowly and then get up. Savithri consulted her family physician, and again the diagnosis: Osteoarthritis.

Vinita, a teacher by profession, around 45 years of age, found that she was taking more time to cut vegetables in the morning. It was due to a nagging pain at the end of her thumb. The flexibility of her finger joint was gradually being affected, resulting in slowing down of her actions. An X-ray report on the advice of her doctor revealed slight inflammation of the finger joint. Again a type of osteoarthritis was the diagnosis.

All these are not isolated cases. The incidence of osteoarthritis in India is as high as approximately 12 percent. Upto the age of 50, it occurs equally in both sexes. Above 50 however, more and more number of women seem to suffer from this disease. The possible reason for this could be the menopausal age group of the women.

How does one know that one is suffering from the beginning stages of osteoarthritis?

According to medical experts, there are some warning signs. An onset of pain, stiffness and sometimes swelling around a joint that lasts for more than 2 weeks could indicate the onset of the disease. If you experience persistent pain, you should definitely consult the doctor.

What exactly is osteoarthritis?

Osteoarthritis is a disease that affects joints in the body. It can involve any joint, but usually concerns hands and weight-bearing joints such as hips, knees, feet and spine. Cartilage is the tough elastic material that covers and protects the ends of bones. In healthy joints, cartilage acts as a shock absorber when you put weight on the joint. The slippery surface of the cartilage allows the bones to move smoothly. When a joint develops osteoarthritis the cartilage gradually becomes rough and thin, and the bone

underneath thickens. With the passage of time the bones may form bumps called spurs on their ends.

What is the exact cause of osteoarthritis?

The exact cause of osteoarthritis is as yet unknown. But there are some indicatory factors like the incidence of the disease seems to increase with advancing age, probably due to wear and tear of the joints. The excess weight in obese people puts strain on the weight bearing joints such as hips and knees and could be a contributory factor to getting the disease. Even a previous injury which has not completely healed and subsequent overuse of that particular joint could lead to osteoarthritis after a prolongued period of time. Heredity could also be one of the causes.

What can be done to lessen the pain?

Although there is no cure for osteoarthritis, a lot can be done to cope with the pain and discomfort the disease brings along with it. As we all know, excess weight puts extra stress on the weight-bearing joints, especially the knees and hips. The good news is losing weight, even just 10 pounds (4.5 kilograms), can help prevent osteoarthritis in your knees. Even if you have osteoarthritis in your knees, losing weight can make you feel better.

Take care of your joints. You may be 30, 40 or 50 years of age. It does not matter. Now is the time to decrease that excess weight and reduce the strain on your knee joints. Exercising is a must if you are suffering from osteoarthritis. Non usage of a joint could lead to weakening of the muscles around the affected joint resulting in more pain. However never do exercises without consulting a doctor or a physiotherapist. They are trained for this specifically, and they could teach you the correct exercises as necessitated by your condition. The only exercises you can start on your own are the light impact ones like walking and swimming which do not put unnecessary strain on your joints.

What exercises are advocated for afflicted patients?

A physiotherapist can teach you strengthening exercises which will improve muscle tone and strength which in turn will stabilize and protect the affected joints and reduce the pain. He or she could also show you a range of motion exercises which will help to maintain normal joint movement and relieve stiffness in the said joint.

Advice for a patient regarding change in his lifestyle:

You can do certain things to modify your daily workload at home. Plan your tasks in a paced manner, and alternate between heavy and light tasks, so that you give your leg and hand muscles ample rest between jobs. Use the stronger joints to carry loads and do not hold in the same position for long.

For example, you can use a shoulder bag to carry vegetables or provisions instead of a hand held one but remember to change the shoulder you carry it on every few minutes so that you do not strain the muscles of one shoulder unnecessarily.

Luggage carts, grocery carts and use of movable shelves do relieve the stress on our limbs. The kitchen gadgets like microwave ovens and food processors can also make our lives slightly easier. So why not make optimum use of them. Taking a hot shower can sometimes do wonders for our aching bodies. We all know that. The same hot shower can relieve pain in our knees or hips too. Heat applied to an arthritic area can reduce pain, stiffness and muscle spasm. It promotes blood circulation, which nourishes and detoxifies muscle fibers. You should not apply heat to an inflamed joint though. Ice packs can be applied to injuries and inflamed joints, as cold applied to inflamed joints reduces pain and swelling by constricting blood flow.

When is surgery recommended?

Surgery is and has to be the last resort. One of your joints may digress to a point where surgery could be indicated. Again there are different types of surgery performed on osteoarthritis patients. The surgeon may just recommend a minor surgery to clean out cartilage debris from the joints. This is more so in case of knee joints. This is called arthroscopic surgery and is generally performed as an outpatient surgery. When the joint is really badly damaged then a joint replacement surgery, a major surgery is called for. This is generally recommended for hip and knee joints. Replacement surgery does relieve pain and can restore your ability to move your joints and function normally. Artificial joints can last 10-20 years before they require replacement, which is why this type of surgery is delayed until it is clearly necessary.

There is a tendency among osteoarthritis patients especially women above 50, to feel helpless and depressed. Try not to give in to this feeling. Knowing about the disease and learning how to cope with it in daily life can reduce your helplessness, and give you an impetus to lead a full and normal life.



Thanks to Lalitha Balasubramanian for contributing this article to our Arthritis blog:

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