World Arthritis day is marked on October 12th the aim of this day is to raise awareness of rheumatic and musculoskeletal diseases. “Arthritis” is an umbrella term for approximately 100 different forms of arthritis and related diseases. The website from the Arthritis Foundation www.arthritis.org has an extensive list of types of Arthritis and further information. The most common types of arthritis are:
2) Rheumatoid Arthritis
3) Psoriatic Arthritis
All types of Arthritis have the familiar symptomology of painful joints and muscles with an increasing loss of function and fatigue. However, some of the arthritis types have significant factors that set them apart from each other. This is why early referral to a specialist, especially with signs and symptoms of the more inflammatory arthritis is important to get fully diagnosed and treated.
Lets have a look at these in more detail.
OA is the most common type of arthritis, affecting 3.3% of the population, afflicting men and women as they become older. It is also known as degenerative arthritis as it effects mostly the over 60’s. Signs and Symptoms include: joint pain and stiffness, joint swelling, muscle weakness. These symptoms come on gradually over years, only affecting the joint cartilage and underlying bone; specifically of the fingers, base of thumb, the great toe, neck, lower back, hips and knees, usually on one side first but can spread to both sides with time.
RA is an autoimmune disorder that primarily affects the joints but can involve others parts of the body such as inflammation of the lungs and heart. RA affects approximately 1% of the population, afflicting middle age women 2.5 times as frequently as men. Signs and symptoms include: warm, swollen and painful stiff joints, that worsens with rest. Low-grade fever and fatigue can be present as well as symptoms of chest pain, shortness of breath and changes in heart mechanics. These symptoms can come on over weeks or months and often more quickly than OA and it is the effect of the body’s immune system attacking the joint cartilage and bone and thickening of the joint capsule. The most commonly affected joints are the wrists and hands and usually presents on both sides.
Psoriatic arthritis is another inflammatory arthritis, which is caused by an autoimmune disease linked to the skin condition psoriasis. Psoriatic arthritis affects up to 30% of psoriasis suffers and can occur in children as well as adults. There is a strong genetic link and individuals may have the HLA-B27 genotype present, but affects both men and women equally. Signs and symptoms include: swelling of the whole fingers or toes, with indentations and thickening to the nails causes the nail bed to sometimes detach. There are also the typical skin changes such as red, scaly and itchy plaques, evident in psoriasis. Psoriatic arthritis can cause significant low back pain from inflammation of the vertebral and sacroiliac joints (spondylitis and sacrolilitis) and well as problems with the lower legs calf muscles and Achilles tendons and plantar fascia. Psoriatic arthritis can cause widespread exhaustion and can flare up and down.
Fibromyalgia is a condition that is describes as widespread pain and heightened response to pain and pressure. Fibromyalgia has so many different signs and symptoms and varies so widely between patients, it is very difficult to diagnose. The common signs and symptoms experienced by most sufferers are: joint and muscle aches, extreme exhaustion, sleep disturbances, poor memory and concentration, restlessness, pins and needles and numbness as well as bowel and bladder disturbances and sensitivity to sound and light. Fibromyalgia is estimated to affect 2-8% of the population and women are twice as affected as men. There is no known cause for fibromyalgia but it is thought to be linked with environmental factors like post traumatic stress disorder, infections and genetic factors, which alter the central nervous systems response to pain and pressure causing central sensitisation syndrome. Treatment for fibromyalgia is difficult due to the complexity of the signs and symptoms.
Gout is an inflammatory arthritis, which is characterized by rapid onset and flare ups more commonly at night of red, hot, swollen tender joints, typically the great toe. Gout is due to the constant elevated levels of uric acid in the blood, which crystallises and deposits into joints, tendons and surrounding tissues. Gout more commonly occurs in individuals who eat red meat, seafood, beer and red wine, affecting approximately 1-2% of the population.
Lupus is a collection of autoimmune diseases where the body’s natural immune system attacks healthy tissues. There are 4 main types but many sub-types. The most common and serious type is systemic lupus erythematosis (SLE), which affects joints, skin, kidney, blood cells, heart and lungs. Symptoms vary between individuals, that makes diagnosis difficult, but almost everyone develops joint pain and swelling with arthritis. Other signs and symptoms can be fatigue, lowgrade fever, swollen lymph nodes, chest pain and photosensitivity to light. The most significant symptom is the development of a butterfly shaped rash across one’s face and occurs in 50% of cases. SLE is more common in women than men and affects more African, Caribbean and Chinese descent and often between the ages of 15-45 years of age.
This years campaign is about the importance of gaining early diagnosis and access to care. Research from the British Medical Journal (BMJ) states that inflammatory types of arthritis have improved outcomes when they are detected early and treatment with disease modifying anti-rheumatic drugs (DMARD’s), Non-steroidal anti-inflammatory drugs (NSAID’s) and corticosteroids. These drugs improve function, symptomology and radiographic outcomes. Lifestyle changes have a large role to play and many of these inflammatory arthritis symptoms can be managed with manual therapy such as osteopathy. Nutrition is a major factor as there are often certain foods that tend to aggravate symptoms of inflammatory arthritis, for example diets high in sugar and gluten can make fibromyalgia symptoms worse. This is further supported by the UK National Institute for Health and Care Excellence who recommend early aggressive treatment, robust pathways and communication for specialist and complimentary therapies management of the principles for arthritis care. So “Don’t Delay, Connect Today” is the slogan for World Arthritis Day 2018.
By Carol Baker
BSc ( Hons) OST MED, DO, ND.