What is Arthritis?

Originally published in Hospital for Special Surgery's HealthConnection: Your Good Health Newsletter

Jessica R. Berman, MD
Jessica R. Berman, MD

Assistant Program Director, Rheumatology Fellowship, Hospital for Special Surgery
Associate Attending Physician, Hospital for Special Surgery

Arthritis is a common problem. As many as 70 million American (1 in 3 adults) are affected. A common misconception is that arthritis is an 'old person's disease.' In fact, arthritis can affect people at any age. There are over 100 different types of arthritis. Some forms, such as osteoarthritis, are more common as we age, whereas inflammatory types of arthritis can affect people at any age.

The most common type of arthritis is known as degenerative joint disease (DJD), or osteoarthritis. This type occurs as a result of a wearing down of cartilage, which can result from many years of use as we age or as the result of a previous injury to the joint. As the normally smooth surface of the cartilage is destroyed, the joint becomes more painful to move and the range of motion may diminish. This type of arthritis usually involves one or more large weight-bearing joints such as a hip or a knee. With this type of arthritis, pain is usually made worse with activity and is better with rest. It is common for symptoms to be at their worst at the end of the day.

Things that may increase the risk of developing this type of arthritis include obesity, a history of injury in the past and genetic factors such as whether your relatives developed the problem. This type of arthritis may become gradually worse over time as cartilage continues to thin. Osteoarthritis is treated with medications such as acetaminophen (Tylenol) and anti-inflammatory drugs such as ibuprofen (Advil) to relieve pain. Physical therapy can help to strengthen muscles which can help the joint work better. Staying active is very important. Often, in advanced cases, surgery to replace the problem joint is needed.

Inflammatory forms of arthritis can affect people at any age, but can often be diagnosed as early as age 20 or 30; they are more common in women. They are much less common than osteoarthritis. This includes problems like rheumatoid arthritis and lupus, just to name a few.

Inflammatory arthritis usually involves many joints throughout the body at the same time and is caused by a problem with the immune system becoming over-active, resulting in joint inflammation. Arthritis caused by inflammation is usually worse after periods of rest or inactivity, particularly in the morning. Swelling, redness and warmth may be present in the affected joints. Other areas in the body can be affected by the inflammation as well, including the skin and internal organs such as the lungs and heart.

Inflammatory arthritis is usually treated with a combination of medications to relieve swelling and pain and others, which regulate the immune system, such as steroids or immunosuppressive drugs. The natural history of inflammatory joint problems is one of alternating periods of 'flare' of symptoms and periods of inactivity. Achieving a balance between periods of rest, to prevent flare of symptoms, and activity, to prevent loss of function, is essential.

One thing that is for certain-no matter what type of arthritis you have, with proper treatment and ongoing care from a doctor knowledgeable in the treatment of joint problems, staying functional and keeping pain under control is definitely possible!


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