In our quest to stay healthy, we do a lot of things — from taking control of our diet to eating and sleeping on time, and exercising regularly. But sometimes, we may be at risk of developing a painful condition that can then turn into a lifelong struggle. On the occasion of World Arthritis Day today, Dr Ashok Rajgopal, the Group Chairman at Institute Of Musculoskeletal Disorders and Orthopaedics, Medanta, shares some valuable insights on how arthritis develops, and if we are at risk.
Find out everything you need to know.
What is it?
An inflammation in one or more joints is referred to as arthritis. Arthritis inflammation causes pain, stiffness, and swelling in the joints and the surrounding tissues, which usually worsen with age. The two most common types are osteoarthritis and rheumatoid arthritis.
“Arthritis seems to be an inevitable part of ageing for a majority of people and with growing age, they accept limitations in their lifestyle as irreversible. There, however, are many ways of overcoming the discomfort and disability caused by arthritis,” says Dr Rajgopal, adding that while osteoarthritis is usually caused by normal wear and tear, rheumatoid arthritis is an autoimmune disorder. The other types of arthritis can be caused by infection, uric acid crystals and an underlying disease such as psoriasis or lupus.
Osteoarthritis affects older adults particularly. It is a degenerative joint disease in which the pain or swelling occurs due to the progressive loss of cartilage in the joints. The protective cartilage that cushions the ends of bones within joints gradually wears away, which is why it is also called ‘wear and tear’ arthritis. The inner surface of the bones become exposed and rub together, and in some cases, bony spurs develop on the edges of joints, causing pain, deformity, and difficulty in movement. Osteoarthritis can affect almost any joint in the body, but commonly occurs in the weight-bearing joints such as knees and hips. It can also affect the fingers and any joint with previous injury from trauma, infection, or inflammation, the doctor explains.
“While the mechanism behind osteoarthritis is unknown, some people can have a genetic predisposition to degenerative joint disorders. This is especially relevant for people who develop it at an early age. The other causes for osteoarthritis include misuse of anabolic steroids (used by some athletes), trauma to joint surfaces and being overweight, which can cause early and more rapid progression of joint problems, especially in the knees.
“The onset of osteoarthritis is gradual and has no serious debilitating effect in the beginning in case of many people, although it can change the shape and appearance of the joint. Bony growths called spurs and gnarled joints may cause painful symptoms along with significant changes in posture and mobility,” he says.
Understanding rheumatoid arthritis
While rheumatoid arthritis can occur at any age, it mostly begins to affect people when they are between 30-50 years of age. The prevalence is higher in women by two to three times more as compared to men. Rheumatoid arthritis is characterised by inflammation, swelling, and pain in the hands, especially the knuckles and next closest finger joints, as well as in the wrists, elbows, shoulders, knees, and feet. This can be accompanied by fatigue as well.
Another form of rheumatoid arthritis is Juvenile Rheumatoid Arthritis, and as the name suggests, it affects the young population — usually between 12-18 years of age, warns Dr Rajgopal.
How can they be prevented?
It is advisable to follow simple measures to prevent the disease process from advancing and thus interfering with our lives. Several risk factors — modifiable and non-modifiable — are associated with arthritis. “While we don’t have control on the latter, modifiable risk factors can be managed for preventing the disease. Eat sensibly, control your weight, and exercise regularly — these are all mantras for keeping knee problems at bay.”
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What are the risk factors?
* Obesity is clearly a risk factor for developing arthritis. Data from the first National Health and Nutrition Examination Survey in the USA showed that obese women were nearly four times more likely to have osteoarthritis. Exercise regularly — the safest exercises are those that place the least body weight on the joints, such as cycling, swimming and hydro aerobics, advises the doctor.
* Dietary factors also play a role. Although no specific diet has been shown to prevent osteoarthritis, certain nutrients have been associated with a reduced risk of the disease. These include omega-3 fatty acids and vitamin D. Fatty acids are known to reduce joint inflammation and can be found in certain plant and nut oils including walnut, soyabean, flaxseed and olive oil. Vitamin D supplements can help decrease knee pain in osteoarthritis. The body makes most of it needs in response to sunlight and this can be supplemented by fatty fish such as salmon, mackerel, tuna, eggs, etc.
* Injuries also act as risk factors. Dr Rajgopal advises that we avoid injuries and once injured, get it treated immediately. “A long-term study at the Johns Hopkins Medical School found that people who injured a knee in adolescence or young adulthood were three times more likely to develop osteoarthritis in that knee, compared to those who had not suffered an injury,” he says.
“Arthritis can be treated through occupational or physical therapy, exercise, and over-the-counter pain relieving medication. Alternate medicine like Ayurveda, massages with medicinal oils and homeopathy also offer relief to some people in the early stages of arthritis.
“Surgical options for the treatment of arthritis include arthroscopy, synovectomy, osteotomy, and total joint replacement. While the first three offer relief from pain, they cannot cure the condition. The only cure for arthritis is joint replacement surgery,” Dr Rajgopal concludes.
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