PainCare - the leading Pain Management specialists in NH

What is arthritis?

Arthritis (arthron = joint, itis = inflammation) is the general name given to a broad group of conditions that cause inflammation of the joint structures such as the capsule, articular cartilage, meniscus, bone, tendon, and/or ligament. Arthritis is often accompanied by chronic pain and can lead to severe physical disabilities, augmented by the aging process. An estimated 40 million people in America are significantly affected by more than 100 different forms of arthritis, such as generative arthritis, aka osteoarthritis (accounting for the vast majority), rheumatoid arthritis, bacterial arthritis, and gout, just to name a few. Depending upon the type of arthritis, symptoms can be manifested in many ways, ranging from mild to severely debilitating pain, swelling, and/or stiffness.

What are the most common forms of arthritis?

Osteoarthritis (OA), also known as degenerative joint disease, is by far the most common form of arthritis. The joints most often affected are the hips, knees, fingers, and spine. It is caused by mechanical joint damage – usually from a natural process of wear and tear, or triggered by a previous bone or joint injury (called traumatic arthritis). Deterioration of the cartilage lining the joints, thickening and deformity of the underlying bone, and moderate soft tissue swelling and pain are routinely seen. This form of arthritis affects nearly all of us, in varying degrees, during adulthood. In fact, research has shown that nearly every individual will display minor radiological evidence of osteoarthritis in their joints by the third or fourth decade of life; however, not all will develop symptoms.

Rheumatoid arthritis (RA) is much less common, is usually associated with more severe inflammation of the joints than osteoarthritis, and is due primarily to a malfunctioning immune system rather than wear and tear. The arthritis in this case is thought to be initiated by the body's abnormal attack on its own joint tissue, not from overuse. About two to three million Americans suffer from rheumatoid arthritis. Hands, knees, and feet are the most often affected joints; however, particularly aggressive types of RA can affect numerous other joints including the spine. Rheumatoid arthritis is most commonly diagnosed between the ages of 25 and 50, but can afflict people of all ages, including young children (juvenile RA).

Gout is a form of arthritis that results from a build up of uric acid levels in the blood, leading to the accumulation of abrasive uric acid crystals in the joints. It classically affects the base of the big toe (the 1st MTP joint), causing swelling, redness and severe pain, but many other joints may also be involved. Some studies suggest a link between the consumption of purine-rich foods, particularly meat and seafood, with higher incidences of gout. A poorly-balanced diet (e.g. low consumption of fruits, vegetables, and dairy products, and high consumption of fatty meats) will increase the risk for those with a genetic predisposition for gout. In general, a diet similar to that for control of cardiovascular disease is recommended. Gout is estimated to afflict one million people in America, most commonly men. 

Some arthritis is a part of another complex medical condition as noted below:

What are the causes?

Arthritic changes in joints can start long before a person is aware of it and, once diagnosed, arthritis progresses at different paces and with varying associated problems.  

As discussed above, the causes of arthritis vary widely. Joint overuse, injury, and aging are the primary reasons for the onset of osteoarthritis (e.g. a sports injury to the knee or shoulder while a youth can often lead to arthritis later). Researchers suspect that an inherited defective gene may be another factor. Many forms of arthritis tend to run in families and may possibly be linked through a recessive gene.

While the exact cause of rheumatoid arthritis is unknown, scientists do know that strong genetic factors are usually involved in an immune system out of control. Some have suggested it is the combination of a particular genetic makeup with an outside event (e.g. viral infection) that most often triggers the disease cycle.

Is arthritis preventable?

Only to some extent.

In general, the best advice for preventing or living with arthritis pain is to:

In most forms of arthritis these recommendations are not a preventative but will simply make the condition more livable, and slow down progression of the disease process.

What treatment options are available?

A treatment plan must be tailored to fit not only the specific form of arthritis, but also the patient's level of pain tolerance. At PainCare, we believe it is vitally important to maintain a daily exercise program that includes incremental range of motion and strengthening. Staying active in general and maintaining ideal body weight will generally optimize range of motion and overall function. Just 30 minutes a day of regular exercise has been clearly shown to improve overall health and actually make you feel more energetic over time.

Treatments may include medications such as non-steroidal anti-inflammatories (NSAIDS), glucosamine/chondroitin, steroids, and less commonly autoimmune drugs. Simple injections into the joint using steroid or lubricant (Synvisc, Hyalgan, Euflexxa) can be extremely beneficial. Physical therapy can also be useful in treating select patients and is offered at Pinewood Physical Therapy. Ultimately, if all else fails, some joints, especially knees, hips, and shoulders, can be replaced.

When should I call PainCare

When pain becomes the main focus of everyday life, call PainCare and make an appointment to see one of our specialists. With help, many people suffering from arthritis can still enjoy active and rewarding lives, without surgery.