Living with
Arthritis

What is arthritis?

If you have arthritis it means that you have a condition that causes inflammation in one or more of your joints. There are over 100 different types of arthritis, but many share the main of joint pain and stiffness.

 

Arthritis is a very common condition that affects people of all ages, races and gender. The most common types of arthritis are osteoarthritis, which is a large contributor to disability and increases in prevalence with age (especially after 65 years), and rheumatoid arthritis, an autoimmune disease.

 

Treatment of your arthritis depends on the type of arthritis you have. The main goals of arthritis treatments are to reduce pain and other symptoms to improve quality of life.

What are some of the different types of arthritis?

There are over 100 different types of arthritis but the most common are:

  1. Osteoarthritis
  2. Rheumatoid arthritis
  3. Ankylosing spondylitis
  4. Gout
  5. Juvenile Arthritis
  6. Psoriatic Arthritis
  7. Septic arthritis

How do you know you have arthritis?

The most common signs and symptoms of arthritis involve the following in your joints depending on the type of arthritis you have:

  • Pain
  • Stiffness
  • Swelling
  • Redness and heat
  • Decreased mobility/flexibility.

What causes arthritis?

 

 

 

 

While exact data on the prevalence of all types of arthritis in South Africa is lacking, a 2015 study of the literature reported an estimated prevalence of osteoarthritis (the most common cause of arthritis) of 55 % to 82 % of people aged 65 years or older; while the Arthritis Foundation of South Africa reports rheumatoid arthritis (the second most common cause of arthritis) is prevalent in 1 % of the total population.

The cause will determine what type of arthritis you have. The most common risk factors for arthritis in general include:

  • Genetics/Family history: Some types of arthritis seem to run in families and certain genes may make you more susceptible to environmental factors that can trigger arthritis.
  • Age: The risk of developing many degenerative types of arthritis namely – osteoarthritis and gout – and rheumatoid arthritis increases with age.
  • Sex: Women are three times more likely than men to develop rheumatoid arthritis; while you are more likely to get gout if you are male.
  • Previous joint injury or surgery: You are more likely to develop arthritis in a joint that you have injured or that has been operated on.
  • Overweight and obesity: Carrying excess weight puts extra stress on your joints, particularly weight-bearing joints like your knees, hips and spine. Therefore, if you are overweight, you have a higher chance of developing arthritis.

Regardless of the cause or type of arthritis, the main disease process is the same: There is breakdown of the cartilage that cushions the ends of the bones between joints. Cartilage is a firm but slippery tissue that enables frictionless joint motion, and if it wears down, bone can rub on bone, causing the signs and symptoms of arthritis.

Living and managing

Learn about lifestyle changes to manage your symptoms and slow arthritis disease progressions, such as:

  • Staying active: By strengthening the muscles around your joints, low-impact exercise can make your joints more stable. Try light aerobic activities (like walking, swimming or water aerobics) that limit the stress placed on joints.
    Do not overdo exercise, such that you feel pain in your joints, and stretch and rest as needed before and during exercise. Try not to do hard repetitive movements or to hyperextend your joints while exercising.
    You can read here about how much exercise you should be doing regularly in order to stay healthy.
  • Maintain a healthy weight: Carrying extra weight increases the stress on your joints, especially on those that are weight-bearing like the hips and knees. Even minor weight loss can relieve the stress on your joints. Talk to a dietitian about healthy ways to lose weight, including eating a healthy and low-fat diet.
  • Eat well for good bone health: While there is no evidence that one diet will benefit you if you have arthritis, it is recommended that you eat a healthy, balanced diet to stay generally healthy.
    Be sure to include lots of foods rich in calcium in your diet. Calcium is a mineral found in dairy products, dark green leafy vegetables like spinach and broccoli, the bones of canned oily fish and in soy products like tofu. Calcium is essential for strong, healthy bones. Men and women between the ages of 18-50 years need 1 000 milligrams of calcium per day, while women older than 50 years and men older than 70 years need 1 200 milligrams per day.
    See Cooking from the Heart for healthy recipes and to find out more about how to include more foods that are high in calcium into your diet.
  • Apply heat and cold: These can be used to relieve pain and swelling in your joints. Heat can help relax muscles, while cold can relieve muscle aches after exercise and decrease muscle spasms.
  • Use braces, shoe inserts and assistive devices as necessary: If you have arthritis, then braces, shoe inserts or other devices can be used to help reduce pain when you stand or walk. They help support joints. Assistive devices like walking canes, on the other hand, help relieve stress on some of your joints.
  • Quit smoking: Talk to your doctor about ways to quit smoking, as smoking is bad for your health in general and can increase inflammation and therefore worsen many different types of arthritis.
  • Limit your alcohol consumption: Do not drink more than two alcoholic beverages per day, as any more than this intake can speed up bone loss and reduces your body’s ability to absorb calcium, especially if you drink during meals.
  • Cut down on caffeine: Caffeine may increase calcium loss in the urine. However, moderate caffeine use (about two cups of coffee a day) is probably not harmful if your diet contains enough calcium.
  • Get plenty of vitamin D: Vitamin D improves your body’s ability to absorb calcium. In South Africa, it is quite possible to get enough vitamin D from sunlight; however, good dietary sources of vitamin D include eggs and fish (salmon and canned tuna, for example).

 

 

 

 

Additionally, different healthcare professionals may also be involved in helping with your therapy in the following ways:

  • Physical therapist: A physical therapist shows you how exercises can be used to strengthen the muscles around your joint, increasing the joint’s flexibility and reducing pain.
  • Occupational therapist: An occupational therapist can help teach you about ways to do everyday tasks without putting extra stress on affected joints.

What treatment is available for arthritis?

Medications that can help relieve arthritis symptoms, primarily pain, include general analgesics/painkillers, particularly:

  • Corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids: Over-the-counter/Consumer NSAIDs, such as ibuprofen and meloxicam, taken at recommended doses, can relieve arthritic pain. Courses of corticosteroids, like cortisone, and stronger NSAIDs are available by prescription from your doctor.
    NSAIDs can cause stomach, cardiovascular and bleeding problems, as well as liver and kidney damage – so take care to use these medications correctly and only as indicated.
    NSAID gels (diclofenac, for example) can be applied to the skin over an affected joint, and, in such a way, may cause fewer side-effects and be more effective at relieving pain than some oral NSAIDs.
    You can also ask your doctor about injectable cortisone or anti-inflammatory treatments for an affected joint. If you have severe symptoms, your doctor may also consider prescribing you opioid medications, such as tramadol.

Other medications for treatment will depend on what type of arthritis you have; for example, if you have rheumatoid arthritis then you will probably have to take a disease-modifying anti-rheumatic drug or DMARD.

If symptoms persist or worsen, even after conventional therapy, you may want to consider, in consultation with your doctor, procedures such as:

  • Joint repair: Sometimes, joint surfaces can be smoothed out or realigned. Usually, these types of procedures are done arthroscopically (the navigation by scope procedure through small incisions into a joint).
  • Joint replacement surgery: In joint replacement surgery (arthroplasty), your surgeon removes your damaged joint surface(s) and replaces them with plastic or metal parts (prostheses). Artificial joints can also wear out with time and you may eventually need to replace them
  • Joint fusion: This is a procedure typically used on the smaller joints of the wrist, ankle and fingers where the ends of the two bones in the joint are removed, locking the two ends together until they heal into one rigid unit.

What are the complications associated with arthritis?

Again, possible complications you may experience as a result of your arthritis depends on what type of arthritis you have. The symptoms of any type of severe arthritis can make it difficult for you to do daily tasks, even sitting up or walking, and this can lead to serious disability.

The pain and functional limitations created by arthritis are also strongly associated with:

Sources

Statistics: Usenbo, Anthony & Kramer, Veronika & Young, Taryn & Musekiwa, Alfred. (2015) Prevalence of Arthritis in Africa: A Systematic Review and Meta-Analysis. PLoS ONE. Available from: https://www.researchgate.net/publication/281817038_Prevalence_of_Arthritis_in_Africa_A_Systematic_Review_and_Meta-Analysis

 

Statistics: Maharaj A. (n.d.) Rheumatoid Arthritis: What is Rheumatoid Arthritis? Arthritis Foundation of South Africa. Available from: https://www.durbanrheumatologist.co.za/rheumatoid-arthritis.php

 

Arthritis Foundation. (2019). Arthritis by Numbers. Available from: https://www.arthritis.org/getmedia/e1256607-fa87-4593-aa8a-8db4f291072a/2019-abtn-final-march-2019.pdf

 

Mayo clinic staff. (n.d.) Symptoms and Causes: Arthritis. Mayo Clinic. Available from: https://www.mayoclinic.org/diseases-conditions/arthritis/symptoms-causes/syc-20350772

 

Mayo clinic staff. (n.d.) Diagnosis and Treatment: Arthritis. Mayo Clinic. Available from: https://www.mayoclinic.org/diseases-conditions/arthritis/diagnosis-treatment/drc-20350777

 

Disability info South Africa. (2016) Arthritis. Available from: http://disabilityinfosa.co.za/mobility-impairments/types-mobility-impairment/arthritis/

 

Arthritis Foundation. (2019). Arthritis by Numbers. Available from: https://www.arthritis.org/getmedia/e1256607-fa87-4593-aa8a-8db4f291072a/2019-abtn-final-march-2019.pdf

 

Butler N. (2020) Arthritis. Healthline. Available from: https://www.healthline.com/health/arthritis

 

Nichols H. (2017) What are the causes and types of arthritis? MedicalNewsToday. Available from: https://www.medicalnewstoday.com/articles/7621#causes

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Sources

Statistics: Usenbo, Anthony & Kramer, Veronika & Young, Taryn & Musekiwa, Alfred. (2015) Prevalence of Arthritis in Africa: A Systematic Review and Meta-Analysis. PLoS ONE. Available from: https://www.researchgate.net/publication/281817038_Prevalence_of_Arthritis_in_Africa_A_Systematic_Review_and_Meta-Analysis

 

Statistics: Maharaj A. (n.d.) Rheumatoid Arthritis: What is Rheumatoid Arthritis? Arthritis Foundation of South Africa. Available from: https://www.durbanrheumatologist.co.za/rheumatoid-arthritis.php

 

Arthritis Foundation. (2019). Arthritis by Numbers. Available from: https://www.arthritis.org/getmedia/e1256607-fa87-4593-aa8a-8db4f291072a/2019-abtn-final-march-2019.pdf

 

Mayo clinic staff. (n.d.) Symptoms and Causes: Arthritis. Mayo Clinic. Available from: https://www.mayoclinic.org/diseases-conditions/arthritis/symptoms-causes/syc-20350772

 

Mayo clinic staff. (n.d.) Diagnosis and Treatment: Arthritis. Mayo Clinic. Available from: https://www.mayoclinic.org/diseases-conditions/arthritis/diagnosis-treatment/drc-20350777

 

Disability info South Africa. (2016) Arthritis. Available from: http://disabilityinfosa.co.za/mobility-impairments/types-mobility-impairment/arthritis/

 

Arthritis Foundation. (2019). Arthritis by Numbers. Available from: https://www.arthritis.org/getmedia/e1256607-fa87-4593-aa8a-8db4f291072a/2019-abtn-final-march-2019.pdf

 

Butler N. (2020) Arthritis. Healthline. Available from: https://www.healthline.com/health/arthritis

 

Nichols H. (2017) What are the causes and types of arthritis? MedicalNewsToday. Available from: https://www.medicalnewstoday.com/articles/7621#causes