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What Is Arthritis?

Fortunately, many of the problems commonly labeled "arthritis" are easily healed or controlled, and the prospects of debilitating complications are far less than they were for our parents and grandparents.

Although the term is applied to a wide variety of disorders, arthritis means inflammation of a joint, whether the result of a disease, an infection, a genetic defect or some other cause. The inflammation causes pain, stiffness and swelling in the joints and surrounding tissues. Many people, however, perceive arthritis as any kind of pain or discomfort associated with body movement, including such localized problems as low back pain, bursitis, tendinitis and general stiffness or pain in the joints.

For many, although by no means everyone, arthritis seems to be an inevitable part of the aging process and there are no signs of real cures on the immediate horizon. On the positive side, advances in both conventional medical treatment and alternative therapies make living with arthritis more bearable

The Major Types of Arthritis

Osteoarthritis, or degenerative joint disease, refers to the pain and inflammation that can result from the progressive loss of cartilage in the joints. It is the most common form of arthritis affecting approximately 21 million adults in the US, particularly in the elderly. In osteoarthritis, the protective cartilage that cushions the ends of bones within joints gradually wears away. It can affect almost any joint in the body but commonly involves the weight bearing joints - knees, hips and spine. It can also affect the fingers and any joint with previous injury from trauma, infection or inflammation. The inner bone surfaces become exposed and rub together and in some cases, bony spurs develop on the edges of joints, causing damage to muscles and nerves, pain, deformity and difficulty in movement.

Although the mechanism behind osteoarthritis is unknown, some people appear to have a genetic predisposition to degenerative bone disorders. In rare cases, bone deformation appears at an early age. Misuse of anabolic steroids, which are popular among some athletes, can also bring on early osteoarthritic degeneration. Being overweight also contributes to early and more rapid progression of joint problems, especially in the knee.

In many people, the onset of osteoarthritis is gradual and has no serious debilitating effect, although it can change the shape and size of bones. In other people, bony growths and gnarled joints may cause painful muscle inflammation or nerve damage, along with significant changes in posture and mobility. Osteoarthritis is part of the aging process. The condition may be associated with broken bones and can develop in young adults from wear and tear on the body's load-bearing joints, often as a result of intense athletic activity. In cases of osteoarthritis, the cartilage and bone cannot repair themselves sufficiently to keep up with the damage.

Rheumatoid arthritis can occur at any age but generally begins to affect people between ages 25 and 55, and in women two to three times as frequently as men. It is the second most common form of arthritis affecting 2.1 million people in the US. Rheumatoid arthritis is characterized by inflammation and pain in the hands - especially the knuckles and next closest finger joints - as well as in the arms, legs, and feet and by general fatigue and sleeplessness. It can also cause damage to other parts of the body, including the heart, lungs, eyes, nerves, and muscles. The discomfort of rheumatoid arthritis usually develops over weeks or months and tends to be most severe on awakening.

Rheumatoid arthritis in some people may eventually cause the hands and feet to become misshapen as muscles weaken, tendons shrink, and the ends of bones become abnormally enlarged.
While there is no complete cure, treatment begun at the onset of the disorder relieves symptoms in most people. With early treatment, the likelihood of permanent disability is reduced in all but 5%-10% of sufferers.

Juvenile rheumatoid arthritis, or Still's disease, is characterized by chronic fever and anemia. The disease can also have secondary effects on the heart, lungs, eyes, and nervous system. The disease is characterized by persistent arthritis in one or more joints for at least 6 weeks after other possible illnesses have been ruled out. Treatment is essentially the same as for adults, with heavy emphasis on physical therapy and exercise to keep growing bodies active. Permanent damage from juvenile rheumatoid arthritis is now rare and most affected children recover from the disease fully without experiencing any lasting disabilities.

The cause of rheumatoid arthritis is not fully understood, though most research shows that it is an autoimmune disorder - meaning that the body is attacking the cartilage like it's a foreign object. One theory suggests that it is an immune reaction to a viral or bacterial infection somewhere in the body. It is not contagious and can not be spread from one person to another. Some people may have a genetic or inherited factor that makes them more likely to develop rheumatoid arthritis.

Infectious arthritis refers to various ailments that affect larger arm and leg joints as well as the fingers or toes. It is caused by a bacterial or viral invasion of the joints and typically comes on the heels of another disease, such as staph infection, tuberculosis, gonorrhea, or Lyme disease. It can also be a complication of injury.

Infectious arthritis is much less common than arthritic conditions that come on with age. Because the symptoms may be masked by the primary injury or illness, infectious arthritis may go unnoticed and, if left untreated, can result in permanent disability.

Other arthritic conditions include ankylosing spondylitis (arthritis of the spine), bone spurs (bony growths on the vertebrae or other areas), gout (crystal arthritis) and systemic lupus (inflammatory connective-tissue disease).

Medically reviewed by Tracy Shuman, MD, July 2005.

SOURCES: American College of Rheumatology. DePuy Orthapaedics. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Arthritis Foundation. Markkula Center for Applied Ethics, Santa Clara University. Arthritis-forum.net. National Institutes of Health. The Center for Current Research. National Internet Health. Alternative Medicine Foundation. , MD, June 2002.

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