Workshop on Arthritis
What is Arthritis?
Arthritis affects the musculoskeletal system, specifically the joints. if you have trouble moving around or feel pain and stiffness in your body, you could have arthritis. In the majority of cases arthritis causes pain and swelling in the joints.
Eventually a swollen joint can suffer severe damage. In some cases, arthritis can cause problems in the patient’s eye, skin or other organs.
Arthritis is not a single disease – it is a term that covers over 100 medical conditions. Osteoarthritis (OA) is the most common form of arthritis and generally affects elderly patients. Some forms of arthritis can affect people at a very early age.
What causes arthritis?
In order to better understand what is going on when a person suffers from some form of arthritis, let us look at how a joint works.
Basically, a joint is where one bone moves on another bone. Ligaments hold the two bones together. The ligaments are like elastic bands, while they keep the bones in place your muscles relax or contract to make the joint move.
Cartilage covers the bone surface to stop the two bones from rubbing directly against each other. The covering of cartilage allows the joint to work smoothly and painlessly.
A capsule surrounds the joint. The space within the joint – the joint cavity – has synovial fluid. Synovial fluid nourishes the joint and the cartilage. The synovial fluid is produced by the synovium (synovial membrane) which lines the joint cavity.
If you have arthritis something goes wrong with the joint(s). What goes wrong depends on what type of arthritis you have. It could be that the cartilage is wearing away, a lack of fluid, autoimmunity (your body attacking itself), infection, or a combination of many factors.
Types of arthritis
There are over 100 types of arthritis. Here is a description of some common ones, together with the causes:
With osteoarthritis, the cartilage loses its elasticity. If the cartilage is stiff it becomes damaged more easily. The cartilage, which acts as a shock absorber, will gradually wear away in some areas. As the cartilage becomes damaged tendons and ligaments become stretched, causing pain. Eventually the bones may rub against each other causing very severe pain.
This is an inflammatory form of arthritis. The synovial membrane (synovium) is attacked, resulting in swelling and pain. If left untreated the arthritis can lead to deformity.
Rheumatoid arthritis is significantly more common in women than men and generally strikes when the patient is aged between 40 and 60. However, children and much older people may also be affected.
During the first ten years after diagnosis, patients with rheumatoid arthritis have a higher risk of blood clots.
Infectious arthritis (septic arthritic)
Infectious arthritis is an infection in the synovial fluid and tissues of a joint. It is usually caused by bacteria, but could also be caused by fungi or viruses.
Bacteria, fungi or viruses may spread through the bloodstream from infected tissue nearby, and infect a joint.
Most susceptible people are those who already have some form of arthritis and develop an infection that travels in the bloodstream.
Juvenile rheumatoid arthritis (JRA)
Juvenile rheumatoid arthritis is a type of arthritis that affects a person aged 16 or less. JRA can be various forms of arthritis; it basically means that a child has it.
There are three main types:
- Pauciarticular JRA, the most common and mildest. The child experiences pain in up to 4 joints.
- Polyarticular JRA affects more joints and is more severe. As time goes by it tends to get worse.
- Systemic JRA is the least common. Pain is experienced in many joints. It can spread to organs. This can be the most serious JRA.
Signs and symptoms
The symptoms of arthritis depend on the type, for example:
The most commonly affected joints with osteoarthritis are in the hips, hands, knees and spine.
The symptoms of osteoarthritis develop slowly and get worse as time goes by. There is pain in a joint, either during or after use, or after a period of inactivity. There will be tenderness when pressure is applied to the joint. The joint will be stiff, especially first thing in the morning.
The patient may find it harder to use the joint – it loses its flexibility. Some patients experience a grating sensation when they use the joint. Hard lumps, or bone spurs may appear around the joint. In some cases the joint might swell.
The most commonly affected joints are in the hips, hands, knees and spine.
The patient often finds the same joints in each side of the body are painfully swollen, inflamed, and stiff. The fingers, arms, legs and wrists are most commonly affected.
Symptoms are usually worst on waking up in the morning and the stiffness can last for 30 minutes at this time. The joint is tender when touched. Hands may be red and puffy. There may be rheumatoid nodules (bumps of tissue under the skin of the patient’s arms).
Many patients with rheumatoid arthritis feel tired most of the time. Weight loss is common.
The smaller joints are usually noticeably affected first. Experts say patients with rheumatoid arthritis have problems with several joints at the same time.
As the arthritis progresses it spreads from the smaller joints in your hands, wrists, ankles and feet to your elbows, knees, hips, neck, shoulders and jaw.
The patient commonly has a fever, joint inflammation and swelling with infectious arthritis. They will feel tenderness and/or a sharp pain. Often these symptoms are linked to an injury or another illness.
Most commonly affected areas are the knee, shoulder, elbow, wrist and finger. In the majority of cases just one joint is affected.
Juvenile rheumatoid arthritis
The patient is a child and will experience intermittent fevers which tend to peak in the evening and then suddenly disappear. Appetite will be poor and weight may be lost.
There may be blotchy rashes on arms and legs. Anemia is also common. The child may limp or have a sore wrist, finger, or knee. A joint may suddenly swell and stay larger than it usually is. The child may experience a stiff neck, hips or some other joint.
How will it affect me?
Arthritis affects people in many different ways. How long the patient is affected and how severely it is depends on the type of arthritis. Arthritis sufferers will find there are good and bad days. Most patients with arthritis will suffer from discomfort, pain, stiffness and/or fatigue.
You may also feel frustrated that you are no longer able to grip things so well or get around like you used to. It is important to remember that if you suffer from arthritis this does not mean you have to give up having an active lifestyle. With some changes to your way of life there is no reason why you cannot continue being active.
Yoga & Arthritis
Over 75 scientific trials have been published on yoga in major medical journals. These studies have shown that yoga is a safe and effective way to increase physical activity that also has important psychological benefits due to its meditative nature. As with other forms of exercise, yoga can increase muscle strength, improve flexibility, enhance respiratory endurance, and promote balance. Yoga is also associated with increased energy and fewer bodily aches and pains. Finally, yoga is associated with increased mental energy as well as positive feelings (such as alertness and enthusiasm), fewer negative feelings (reduced excitability, anxiety, and aggressiveness) and somatic complaints. In summary, yoga is associated with a wide range of physical and psychological benefits that may be especially helpful for persons living with a chronic illness.
Additionally, physical activity is an essential part of the effective treatment of osteoarthritis (OA) and rheumatoid arthritis (RA), according to treatment guidelines published by the American College of Rheumatology. In persons with arthritis, exercise is safe and does not exacerbate pain or worsen disease. In fact, exercise may play a key role in promoting joint health, since those who do not exercise often suffer more joint discomfort than those who do. The health and psychological benefits of exercise are widely recognized. However, regular physical activity is especially important for people with arthritis, who often have decreased muscle strength, physical energy, and endurance, in part due to their arthritis and the tendency to be sedentary. Being sedentary can began a downward spiral where pain increases, leading to more inactivity which leads to greater pain and disability. The psychological benefits of exercise such as stress reduction, fewer depressive symptoms, improved coping and well-being and enhanced immune functioning also contribute to greater overall health.