“I should have had done this a long time ago…”
“Last week I hurt my hand! Tried to catch a wallet thrown from 4th floor balcony, and instead of landing in my hands it hit my left hand knuckles with a bolting speed… Needless to say, even typing hurts! Then I think about my maiya who has got Rheumatoid Arthritis from last 16 years. She used to struggle to even make saree pleats, and all we cared about was why isn’t she making fresh chapatis twice a day like before and why must we eat the stale ones at night! Thankless creatures we were… And now that my own pain persists, only then I could feel my mom’s pain! I should have had felt it a long time ago… I should have had written this article a long long time ago…This one is dedicated to my mom and all those sweet people who are in pain because of arthritis.”
This is chapter #1. of DawaiBox Arthritis Series, Arthritis 101. In consequent chapters we will focus on specific arthritic conditions, their causes, treatments, and diet!
Chapter #1. Arthritis 101 Content Index
- Rheumatoid Arthritis
- Psoriatic Arthritis
- Ankylosing Spondylitis
- Paget’s Disease
- Infectious Arthritis
- Reactive Arthritis
- Felty’s Syndrome
- Still’s Syndrome
Arthro (Joint) + itis (inflammation), the word arthritis literally means inflamed joints. The term is often used to indicate pain or stiffness of joints and surrounding muscles. 
The term, “Rheumatism” or “Rheumatic” is widely used to describe arthritic conditions. It is a term pertaining to diseases that cause joint pain. This term is interchangeably used for arthritis though it is not a valid medical term anymore!
Arthritis is an umbrella term describing multiple inflammatory or non-inflammatory diseases of musculoskeleton. There are over 150 known types of arthritic conditions.
Most prevalent ones-
Is the most common type of arthritis. This is an extremely painful condition that occurs due to erosion of bone cartilage at the site of joint!
Risk Factors: aging, injury and heredity.
Common symptoms: swollen and stiff joints.
Vulnerable Population: Men & Women above 65.
Diagnosis: Blood Test, Physical Examination, X-ray, MRI
Treatment: Exercise, Weight Management, Anti inflammatory drugs, And in severe cases, joint replacement surgery!
Arguably second most common type of arthritis which has been hurting mankind since the stone age! Rheumatoid Arthritis (RA) is an inflammatory autoimmune disease in which one’s body mistakenly starts attacking their joints hence causing the inflammation.
Causes/Risk Factors: unknown, but genetics is a strong influencer and so are inflammation causing conditions like obesity and tobacco abuse!
Common Symptoms: joint stiffness, especially in the morning, swelling, pain and same joints getting affected on both side of the body.
Vulnerable Population: Women are 3 times more likely to get it than men!
Diagnosis: Blood Test, ESR and CRP tests (markers of inflammation), test for detection of RA factor (antibody), X-ray
Treatment: Mainly anti inflammatory drugs (NSAIDS), weight management helps, Stress management helps, diet can help, and in severe cases even joint replacement surgery can help. Stem cell replacement therapy is an emerging and promising treatment.
Find complete Information on RA. Read,
Symptoms are much like that of RA which is why people get these two confused. Gout is caused by uric acid crystal formation inside a joint. The needle like crystals prick and hurt the joint from within, causing inflammation, swelling and a lot of pain! Gout attacks occur intermittently and the severity can vary from mild to extreme.
Causes/Risk Factors: Family History, Heart Ailments, some medications (diuretics and immuno-suppressants), high purine foods like red meats etc.
Common Symptoms: excruciating pain affecting one joint at a time. Mostly in lower body. Uric acid lumps formation underneath skin.
Vulnerable Population: Men(all ages) more at risk and also women past age of 60.
Diagnosis: blood and synovial fluid test for uric acid, X-ray, MRI (if necessary)
Treatment: Anti Inflammatory Medicines (NSAIDS), Weight Management, Diet and Stress Management.
Now, Somewhat less common ones-
Psoriasis, is an inflammatory skin condition. And around 30% of people suffering from psoriasis develops a form of inflammatory arthritis that is called Psoriatic Arthritis. There are subtypes like symmetrical, asymmetrical, distal, arthritis mutilans and spondylitis
Causes/Risk Factors: Family History, Autoimmune response
Common Symptoms: Joint pain, stiffness, dactylitis, vision problems, skin rashes
Vulnerable Population: Psoriasis patients and people with a family history of psoriasis
Diagnosis: Physical examination, blood tests, X-ray, Synovial fluid testing. This one is little tricky to be diagnosed and a clinician will first rule out all other types of arthritis to be very sure that it in fact is psoriatic arthritis.
Treatment: Anti-inflammatory drugs, topical medications, photo therapy etc.
A serious back problem, ankylosing spondylitis is an inflammation of back and neck joints. It usually starts from lower back and progresses upward.
Causes/Risk Factors: Genetics, Immune response to an infection
Common Symptoms: Chronic back pain with stiffness, especially first thing in the morning and also during inactivity.
Vulnerable Population: Men are more at risk
Diagnosis: Blood test, Genetic testing, Physical Examination, MRI
Treatment: Medications, Surgery
Not exactly an arthritic but a closely related condition, Paget’s disease is caused by enlargement and consequent weakening of bones due to error in bone metabolism.
Causes/Risk Factors: Not fully understood yet
Common Symptoms: Enlarged and broken bones, broken joints, pain
Vulnerable Population: Men are more likely to get it
Diagnosis: Physical exam, blood test, X-ray
Treatment: Medication, Exercise and Diet.
Is caused by inflammation due to crystal formation in the synovial fluid. The crystals are however not uric acid but calcium pyrophosphate in nature which is why it is also called Calcium Pyrophosphate Deposition Disease (CPDD).
Causes/Risk Factors: Age, Genetics/Family History
Common Symptoms: Swollen and stiff joints
Vulnerable Population: People above age of 80
Diagnosis: synovial fluid test, X-ray
And the Rare ones-
Caused by an infection in the joint.
Causes/Risk Factors: infectious hepatitis, mumps, Lyme Disease, bacterial infections
Common Symptoms: Swelling, Pain, usually in single joint, mostly affects knees.
Vulnerable Population: People with weakened immune system
Diagnosis: blood and synovial fluid test, X-ray, physical examination etc.
Treatment: antibiotics to treat the infection, coupled with pain medication.
Reactive arthritis is also an inflammatory arthritis triggered by an infection, but the difference is, site of infection and site of arthritis expression can be different. E.g. an UTI can cause swelling in knees!
Causes/Risk Factors: UTIs, especially Chlamydia, Gastrointestinal infections like Shigella, Salmonella etc.
Common Symptoms: Joint pain and swelling, especially in knees, fingers, ankle, wrist etc., spondylitis
Vulnerable Population:Men under 40
Diagnosis: Physical Exam, Blood-Urine test, X-ray
Treatment: Anti inflammatory drugs, pain medication, Treatment of STD/UTI, exercise
it is a triad of Seropositive Rheumatoid Arthritis (SRA), splenomegaly (enlarged spleen) and neutropenia (low white blood count). It is considered as a complication of RA.
Causes/Risk Factors: Not very well known
Common Symptoms: Mostly asymptomatic, but infections are common, and also obviously enlarged spleen
Vulnerable Population: RA patients
Diagnosis: Blood tests, imaging to detect enlarged spleen
Treatment: Medication, possible spleen removal
Also known as Systemic Onset Juvenile Idiopathic Arthritis. This one is a triad of high fever, salmon colored rashes and arthritis.
Causes/Risk Factors: Not yet fully understood
Common Symptoms: Extreme fatigue, nausea, weight loss, fever, rashes, Joint pain
Vulnerable Population: Children (under 16)
Diagnosis: on the basis of symptoms and blood work
Treatment: Anti inflammatory medications
Rheumatologists treat arthritic conditions. A rheumatologist is a physician, who is intensively trained to diagnose and treat autoimmune and inflammatory diseases of bones and musculoskeletal system. Apart from arthritis, a Rheumatologist will also treat related conditions like Tendinitis, Fibromyalgia, Carpal Tunnel Syndrome, Lupus, Kawasaki Disease, Scleroderma, Mixed Connective Tissue Disorder etc.
Just as a Rheumatologist will diagnose, treat and manage the arthritic conditions, an Orthopedic Surgeon is the one who will perform any form of joint replacement or reconstruction surgery! And of course a physiotherapists will guide you with right kind of exercise.
As most forms of arthritis are progressive and irreversible, medication therapy is geared towards pain management, inflammation management and suppressing immune system.
NSAIDS: Nonsteroidal Anti-Inflammatory Drugs, are used to decrease inflammation and manage pain. Some commonly used ones are aspirin, ibuprofen, fenoprofen, ketoprofen, naproxen etc.
DMARDs: Disease Modifying Antirheumatic Drugs are a combination of drugs that will modulate (change) some immune pathways and keeps inflammation in check. Some well known ones are methotrexate, salfasalazine, hydroxychloroquin, leflunomide etc.
Corticosteroids: these mimic the action of body’s natural hormones to bring down the level of inflammation. They are immunomodulatory, and thus can make you more susceptible to infections. Commonly used ones are cortisone, hydrocortisone, prednisolone etc.
Biologics: Are genetically engineered specific human proteins that bind to and deactivate specific inflammation causing immune agents. These are very specific in their action and have shown great results, although not without side effects. Most common one is Humira, but it is not easily available in India yet. The ones available in India are etanercept, infliximab, itolizumab and secukinumab.
Most of these medications are used in a combination to manage the disease effectively.
- Thought weight loss is known to relieve pressure on the joints and help alleviate the symptoms of arthritis, there is a weight loss surgery that actually causes arthritis! Yeah…it is true. Jejunoileal bypass surgery was infamous for causing arthritis, but thankfully it is no longer performed!
- Gastrointestinal diseases like Celiac Disease and Colitis are associated with increased risk of developing arthritis.
- A gluten free diet is shown to improve symptoms in RA patients.
So this was Arthritis 101. Next up is Chapter # 2. Rheumatoid Arthritis, Causes, Treatment & Diet. To get notified when new articles are published, subscribe!
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