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ArthritisThere are different types of arthritis: Osteoarthritis Rheumatoid Arthritis Psoriatic Arthritis Juvenile Rheumatoid Arthritis Osteoarthritis Overview: Osteoarthritis is probably the most common and is not a single disease but rather the end result of a variety of disorders leading to the structural or functional failure of 1 or more of your joints. Osteoarthritis involves the entire joint including the nearby muscles, underlying bone, ligaments, joint lining (synovium), and the joint cover (capsule). Osteoarthritis also involves an advancing loss of cartilage. The cartilage tries to repair itself, the bone remodels, the underlying (subchondral) bone hardens, and bone cysts form. This process has several phases. The stationary phase of disease progression in osteoarthritis involves the formation of osteophytes or joint space narrowing. The appearance of subchondral cysts (cysts in the bone underneath the cartilage) indicates the erosive phase of disease progression in ostearthritis. The last phase in the disease progression involves bone repair and remodeling. Joint cartilage is a layer of tissue present at the joint surfaces that sustains joint loading and allows motion. It is gel-like, porous, and elastic. Normal cartilage provides a durable, low-friction, load-bearing surface for joints. Articular surface is the area of the joint where the ends of the bones meet, or articulate, and function like a ball bearing. Bone remodeling is a process in which damaged bone attempts to repair itself. The damage may occur from either an acute injury or as the result of chronic irritation such as that found in osteoarthritis. Collagen is the main supportive protein found in bone tendon, cartilage, skin, and connective tissue. Osteophytes are bony outgrowths or lumps, especially at the joint margins. They are thought to develop in order to offload the pressure on the joint by increasing the surface area on which your weight is distributed. Synovium is a membrane found within the joints that secretes a fluid that lubricates tissues where friction would otherwise occur. Subchondral bone is the part of bone under the cartilage. Endocrine: People with diabetes may be prone to osteoarthritis. Other endocrine problems also may promote development, including acromegaly, hypothyroidism, hyperparathyroidism, and obesity. Posttraumatic: Traumatic causes can be further divided into macrotrauma or microtrauma. An example of macrotrauma is an injury to the joint such as a bone break causing the bones to line up improperly (malalignment), lose stability, or damage cartilage. Microtrauma may occur over time (chronically). An example of this would be repetitive movements or the overuse noted in several occupations. Inflammatory joint diseases: This category would include infected joints, chronic gouty arthritis, and rheumatoid disease. Metabolic: Diseases causing errors of metabolism may cause osteoarthritis. Examples include Paget disease and Wilson disease. Congenital or developmental: Abnormal anatomy such as unequal leg length may be a cause of osteoarthritis. Genetic: A genetic defect may promote breakdown of the protective architecture of cartilage. Examples include collagen disturbances such as Ehlers-Danlos syndrome. Neuropathic: Diseases such as diabetes can cause nerve problems. The loss of sensation may affect how the body knows the position and condition of the joints or limbs. In other words, the body can't tell when it is injured. Other: Nutritional problems may cause osteoarthritis. Other diseases such as haemophilia and sickle cell are further examples. Pain: Aching pain, stiffness, or difficulty moving the joint may develop in 1 or more joints. The pain may get worse with overuse and may occur at night. With progression of this arthritis, the pain can occur at rest. Specific joints are affected. Fingers: Bone enlargements in the fingertips (first joint) are common. These are called Heberden nodes. They are usually not painful. Sometimes they can develop suddenly and are painful, swollen, and red. This is known as nodal osteoarthritis and occurs in women older than 45 years. Hip: The hips are major weight-bearing joints. Involvement of the hips may be seen more in men. Farmers, construction workers, and firefighters have been found to have an increased incidence of hip osteoarthritis. Researchers think that a heavy physical workload contributes to OA of the hip and knee. Knees: The knees are also major weight-bearing joints. Repetitive squatting and kneeling may promote osteoarthritis. Spine: Osteoarthritis of the spine can cause bone spurs or osteophytes, which can pinch or crowd nerves and cause pain and potentially weakness in the arms or legs. Self-Care at Home for Osteoarthritis: Lifestyle changes may delay or limit osteoarthritis symptoms. Weight loss: One study suggested that, for women, weight loss may reduce the risk for osteoarthritis in the knee. Exercise: Regular exercise may help to strengthen the muscles and potentially stimulate cartilage growth. Avoid high-impact sports. The following types of exercise are recommended: range of motion, strengthening, and aerobic. Diet: Antioxidant vitamins C and E may provide some protection. Vitamin D and calcium are recommended for strong bones. The recommended daily dose of calcium is 1000-1200 mg. The current guideline for vitamin D is 400 IU per day. Avoid more than 1200 IU of vitamin D per day. Heat: Hot soaks and warm wax (paraffin) application may relieve pain. Orthoses: These assistive devices are used to improve function of moveable parts of the body or to support, align, prevent, or correct deformities. Splints or braces help with joint alignment and weight redistribution. Other examples include walkers, crutches or canes, and orthopedic footwear. Over-the-counter (OTC) medications: Acetaminophen (Tylenol) is the first drug recommended for osteoarthritis. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used for arthritis pain. These include aspirin, ibuprofen (Motrin or Advil), naproxen (Aleve), and ketoprofen (Orudis). Newer OTC preparations include chondroitin and glucosamine sulfate, which are natural substances found in the joint fluid. Chondroitin is thought to promote an increase in the making of the building blocks of cartilage (collagen and proteoglycans) as well as having an anti-inflammatory effect. Glucosamine may also stimulate production of the building blocks of cartilage as well as being an anti-inflammation agent. Glucosamine was found to increase blood sugar in animal studies, so people with diabetes should consult their doctor first. A recent study showed that glucosamine slowed progression of osteoarthritis in the knee. Rheumatoid arthritis overview: Rheumatoid arthritis should not be confused with other forms of arthritis, such as osteoarthritis or arthritis associated with infections. Rheumatoid arthritis is an autoimmune disease. This means that the body’s immune system mistakenly attacks the tissues it is supposed to protect. The immune system produces specialized cells and chemicals, which are released into the bloodstream and begin to attack body tissues. This response causes abnormal growth and inflammation in the synovium, the membrane that lines the joint. This process is called synovitis and is the hallmark of an inflammatory arthritis such as rheumatoid arthritis. As the synovitis expands inside and outside of the joint, it can damage the bone and cartilage of the joint and the surrounding tissues, such as ligaments, tendons, nerves, and blood vessels. Rheumatoid arthritis most often affects the smaller joints, such as those of the hands and/or feet, wrists, elbows, knees, and/or ankles. The symptoms often lead to significant discomfort and disability. Many people with rheumatoid arthritis have difficulty carrying out normal activities of daily living, such as standing, walking, dressing, washing, using the toilet, preparing food, and carrying out household chores. The symptoms of rheumatoid arthritis interfere with work for many people. As many as half of those with rheumatoid arthritis are no longer able to work 10-20 years after their condition is diagnosed. On average, life expectancy is somewhat shorter for people with rheumatoid arthritis than for the general population. This does not mean that everyone with rheumatoid arthritis has a shortened life span. Rheumatoid arthritis itself is not a fatal disease. However, it can be associated with many complications and treatment-related side effects that can contribute to premature death. Although rheumatoid arthritis most often affects the joints, it is a disease of the entire body. It can affect many organs and body systems besides the joints. This is what is meant by systematic disease. Musculoskeletal structures: Damage to muscles surrounding joints may cause atrophy (shrinking and weakening). This is most common in the hands. Atrophy also may result from not using a muscle, usually because of pain or swelling. Damage to bones and tendons can cause deformities, especially of the hands and feet. Osteoporosis and carpal tunnel syndrome are other common complications of rheumatoid arthritis. Skin: Many people with rheumatoid arthritis form small nodules on or near the joint that are visible under the skin. These rheumatoid nodules are most noticeable under the skin on the bony areas that stick out when a joint is flexed. Dark purplish areas on the skin (purpura) are caused by bleeding into the skin from blood vessels damaged by rheumatoid arthritis. This damage to the blood vessels is called vasculitis, and these vasculitic lesions also may cause skin ulcers. Heart: Collection of fluid around the heart from inflammation is not uncommon in rheumatoid arthritis. This usually causes only mild symptoms, if any, but it can be very severe. Rheumatoid arthritis related inflammation can affect the heart muscle, the heart valves, or the blood vessels of the heart (coronary arteries). Lungs: Rheumatoid arthritis effects on the lungs may take several forms. Fluid may collect around one or both lungs, or tissues may become stiff or overgrown. Any of these effects can have a negative effect on breathing. Digestive tract: The digestive tract is usually not affected directly by rheumatoid arthritis. Dry mouth, related to Sjögren syndrome, is the most common symptom of gastrointestinal involvement. Digestive complications are much more likely to be caused by medications used to treat the condition, such as gastritis (stomach inflammation) or stomach ulcer associated with NSAID therapy. Any part of the digestive tract may become inflamed if the patient develops vasculitis, but this is uncommon. If the liver is involved (10%), it may become enlarged and cause discomfort in the abdomen. Kidneys: The kidneys are not usually affected directly by rheumatoid arthritis. Kidney problems in rheumatoid arthritis are much more likely to be caused by medications used to treat the condition. Blood vessels: Vasculitic lesions can occur in any organ but are most common in the skin, where they appear as purpura or skin ulcers. Blood: Anemia or “low blood” is a common complication of rheumatoid arthritis. Anemia means that you have an abnormally low number of red blood cells and that these cells are low in hemoglobin, the substance that carries oxygen through the body. (Anemia has many different causes and is by no means unique to rheumatoid arthritis.) Nervous system: The deformity and damage to joints in rheumatoid arthritis often leads to entrapment of nerves. Carpal tunnel syndrome is one example of this. Entrapment can damage nerves and may lead to serious consequences. Eyes: The eyes commonly become dry and/or inflamed in rheumatoid arthritis. This is called Sjögren syndrome. The severity of this condition depends on which parts of the eye are affected. Like many autoimmune diseases, rheumatoid arthritis typically waxes and wanes. Most people with rheumatoid arthritis experience periods in which their symptoms worsen (flares or active disease) separated by periods in which the symptoms improve. With successful treatment, symptoms may even go away completely (remission, or inactive disease). About 2.1 million people in the United States are believed to have rheumatoid arthritis. About 1.5 million of these are women. Women are 2-3 times more likely to develop rheumatoid arthritis than men. Rheumatoid arthritis affects all ages, races, and social and ethnic groups. It is most likely to strike people aged 35-50 years, but it can occur in children, teenagers, and elderly people. (A similar disease affecting young people is known as juvenile rheumatoid arthritis.) Worldwide, about 1% of people are believed to have rheumatoid arthritis, but the rate varies among different groups of people. For example, rheumatoid arthritis affects about 5-6% of some Native American groups, while the rate is very low in some Caribbean peoples of African descent. The rate is about 2-3% in people who have a close relative with rheumatoid arthritis, such as a parent, brother or sister, or child. Although there is no cure for rheumatoid arthritis, the disease can be controlled in most people. Early, aggressive therapy to stop or slow down inflammation in the joints can prevent or reduce symptoms, prevent or reduce joint destruction and deformity, and prevent or lessen disability and other complications. Causes of Rheumatoid Arthritis: The cause of rheumatoid arthritis is not known. Many factors are involved in the abnormal activity of the immune system that characterizes rheumatoid arthritis. These factors include genetics (heredity), hormones (explaining why the disease is more common in women than men), and possibly infection by a bacterium or virus.
Symptoms of Rheumatoid Arthritis: Although rheumatoid arthritis can have many different symptoms, joints are always affected. Rheumatoid arthritis almost always affects the joints of the hands (such as the knuckle joints), wrists, elbows, knees, ankles, and/or feet. The larger joints, such as the shoulders, hips, and jaw may be affected. The vertebrae of the neck are sometimes involved in people who have had the disease for many years. Usually at least 2 or 3 different joints are involved on both sides of the body, often in a symmetrical (mirror image) pattern. The usual joint symptoms include the following: Stiffness: The joint does not move as well as it once did. Its range of motion (the extent to which the appendage of the joint, such as the arm, leg, or finger, can move in different directions) may be reduced. Typically, stiffness is most noticeable in the morning and improves later in the day. Inflammation: Redness, tenderness, and warmth are the hallmarks of inflammation. Nodules: These are hard bumps that appear on or near the joint. They often are found near the elbows. They are most noticeable on the part of the joint that juts out when the joint is flexed. Pain: Pain in rheumatoid arthritis has several sources. Pain can come from inflammation or swelling of the joint and surrounding tissues or from working the joint too hard. The intensity of the pain varies by the individual. These symptoms may keep you from being able to carry out your normal activities. General symptoms include the following: Malaise (blah feeling) Loss of appetite Weight loss Myalgias (muscle aches) Weakness or loss of energy The symptoms usually come on very gradually, although in a small number of people they come on very suddenly. In some cases, the general symptoms come before the joint symptoms, and you may think you have the flu or a similar illness. The following suggest that rheumatoid arthritis is in remission: Morning stiffness lasting less than 15 minutes No fatigue No joint pain No joint tenderness or pain with motion No soft tissue swelling If you have joint pain or stiffness, you may think it is just a normal part of getting older and that there is nothing you can do. Nothing could be further from the truth. You have several options for medical treatment and even more to help prevent further joint damage and symptoms. You should discuss these measures with your health care provider to find ways to make them work for you.
Arthritis self-help course: The Arthritis Foundation offers an educational program on the causes and treatment of arthritis. Exercise, nutrition, relaxation, and pain management programs are covered as well as ways to communicate with your doctor. Completion of the program reduced pain by 20% and doctor visits by 40%. Aromatherapy, naturopathy aim to alter the body’s chemistry. Holisitic therapists aim to look at the whole person – nutrition, stress, weight and old injuries are just a few areas which can be explored. Sometimes whilst it can be very difficult to affect the joints too much especially if the arthritis has been long standing it may be possible to help to reduce the pain. Detoxifying the body can help the body to throw off poisons and then painkilling essential oils can be used in baths and massage along with creams and oils which can be regularly massaged in to the joints. Aromatherapy oils should be added to a daily bath. Compresses can be excellent for providing pain relief. Cold compresses are better if the pain is acute. For chronic pain use a hot compress or even a mixture of hot and cold. To make the compress put a few drops of essential oil into water and soak a flannel or absorbent cloth before applying to the area. Massage is very beneficial as it can assist with the elimination of toxins and improve the circulation round the painful areas. Essential oils for arthritis can fall into different categories: analgesic, detoxifying, anti-inflammatory, cleansing oils, pain relieving oils & oils to improve the circulation. Analgesic essential oils: Benzoin, Cajeput, Chamomile Roman, Eucalyptus, Frankincense, Geranium, Ginger, Lavender, Marjoram, Peppermint, Rosemary Detoxifying essential oils: Black Pepper, Cypress, Fennel, Ginger, Grapefruit, Juniper, Lemon, Rosemary, Sage, Thyme Essential oils to improve the circulation: Benzoin, Black Pepper, Eucalyptus, Geranium, Ginger, Lemon, Mandarin, Marjoram, Rosemary, Sage, Thyme Anti Inflammatory essential oils: Celery Seed, Chamomile Roman, Chamomile German, Lavender, Myrrh, Patchouli, Peppermint, Sandalwood, Tagetes, Yarrow Cleansing essential oils: Black Pepper, Cypress, Fennel, Ginger, Juniper, Lemon, Marjoram, Rosemary, |
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