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Arthritis – what is it and do I have it?

26 February 2018

Arthritis is currently the number one cause of pain and disability in the UK, with 10 million people suffering from the disease. It is estimated that a quarter of Britons leaving the workplace or taking early retirement do so as a result of arthritis.

There are many different types of arthritis and musculoskeletal conditions. They fall into five main groups: inflammatory arthritis, degenerative or mechanical arthritis, soft tissue musculoskeletal pain, back pain and connective tissue disease (CTD).

What is Arthritis?

Arthritis is a term often used to mean any disorder that affects joints. There are various types of the disease:

-       Inflammatory arthritis (IA) – this means inflammation within a joint. Inflammation is part of your body's healing process and normally occurs as a defence against viruses and bacteria. However, in some people, this can occur in the joint for no obvious reason. When your own immune system attacks the body’s own joints, it is known as an autoimmune reaction.

This causes pain, stiffness and swelling in or around the one or more joints. There are several types of IA. Importantly, IA can occur at any age including young children.

-       Rheumatoid arthritis (RA) – is the most common type of inflammatory arthritis with 400,000 affected in the UK alone. It affects most of the joints. It is a systemic illness, and so also commonly causes fatigue, depression, irritability, flu-like symptoms and anaemia. Untreated it can affect other organs of the body, including lungs. Research overwhelmingly shows that the earlier you start treatment, the more effective it will be and the better your outcome. A rheumatologist is the best person to diagnose your condition and treat you according to the type of arthritis you have.

-       Degenerative or mechanical arthritis - is a condition where the main problem is wear and tear to the cartilage (covers the ends of the bones). The cartilage is not able to take the load placed on it. The bone underneath then tries to repair this damage but overgrows, altering the shape of the joint and giving bony enlargement. This is known as Osteoarthritis.

It usually presents in mid-life onwards and particularly affects the joints that get heavy use, like hips, knees and spine. It also often affects the base of the thumb and big toe joint. It is not associated with symptoms outside the joint and is not usually associated with significant inflammation in the joint.

The other main musculoskeletal conditions include connective tissue diseases and soft tissue musculoskeletal conditions, such as bursal inflammation.

Causes and associations

As there are many various forms of arthritis; most types are a result of several factors acting together. You may be naturally more likely to develop certain disorders as a result of your genetic make-up so it is important to look at your family history.

A variety of external factors may increase the risk further if you're susceptible to a condition. These environmental factors can include a sedentary lifestyle, being overweight (osteoarthritis), high alcohol intake (gout), a physically demanding job such as a labourer (repetitive injury) or have had previous trauma to a joint/area.

General symptoms to be aware of:

-       Pain, stiffness and swelling of the joints

-       Fatigue, lethargy and apathy

-       Skin rashes, eyes and mouth

-       Weight loss

-       Can be linked to depression and impact on professional, personal life and relationships

Diagnosis and Treatment

It’s common to experience aches and pains in your muscles and joints every now and then, particularly if you take part in strenuous physical activities. However, if you do experience any of the associated symptoms, you need to consult your GP who can refer you to a Rheumatologist if required.

A specialist diagnosis for arthritis is essential as treatment differs between the different types of the disease. The earlier you get assessed, the better the outcome. Other autoimmune conditions can be associated with arthritis, such as skin psoriasis and inflammatory bowel disease, so it’s also important to rule these out.

A Rheumatologist will be able to provide blood tests, scans and take fluid from a joint to assess if you do have arthritis, and what type; this will determine the treatment/management plan. The good news is that inflammation can be controlled completely in many cases if treated early and will prevent future damage of the joints.

Long term treatment involves a combination of drugs that suppress inflammation, painkillers and physical therapies.

Outlook

Arthritis is a long term condition, which can vary over time and ‘flare’. The aim of your treatment is to keep you in remission, reduce flare- ups and minimise joint damage so that you can go back to leading a fulfilling life.

Dr Preeti Shah is a Consultant Rheumatologist at HCA The Wilmslow Hospital, expert in arthritis and musculoskeletal conditions. To book a consultation via your GP or self-referral with Dr Shah please call 01625 545 036.

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