Monday, September 26, 2011

Arthritis Education (Con't)


Arthritis
Joint inflammation
Last reviewed: February 14, 2011.
Arthritis is inflammation of one or more joints. A joint is the area where two bones meet. There are over 100 different types of arthritis.

Causes, incidence, and risk factors
Arthritis involves the breakdown of cartilage. Cartilage normally protects a joint, allowing it to move smoothly. Cartilage also absorbs shock when pressure is placed on the joint, such as when you walk. Without the normal amount of cartilage, the bones rub together, causing pain, swelling (inflammation), and stiffness.
Joint inflammation may result from:
·         An autoimmune disease (the body's immune system mistakenly attacks healthy tissue)
·         Broken bone
·         General "wear and tear" on joints
·         Infection, usually by bacteria or virus
Usually the joint inflammation goes away after the cause goes away or is treated. Sometimes it does not. When this happens, you have chronic arthritis. Arthritis may occur in men or women. Osteoarthritis is the most common type. See: Osteoarthritis
Other, more common types of arthritis include:
·         Ankylosing spondylitis
·         Gonococcal arthritis
·         Gout
·         Juvenile rheumatoid arthritis (in children)
·         Other bacterial infections (nongonococcal bacterial arthritis)
·         Psoriatic arthritis
·         Reactive arthritis (Reiter syndrome)
·         Rheumatoid arthritis (in adults)
·         Scleroderma
·         Systemic lupus erythematosus (SLE)
Symptoms
Arthritis causes joint pain, swelling, stiffness, and limited movement. Symptoms can include:
·         Joint pain
·         Joint swelling
·         Reduced ability to move the joint
·         Redness of the skin around a joint
·         Stiffness, especially in the morning
·         Warmth around a joint
Signs and tests
The health care provider will perform a physical exam and ask questions about your medical history.
The physical exam may show:
·         Fluid around a joint
·         Warm, red, tender joints
·         Difficulty moving a joint (called "limited range of motion")
Some types of arthritis may cause joint deformity. This may be a sign of severe, untreated rheumatoid arthritis.
Blood tests and joint x-rays are often done to check for infection and other causes of arthritis.
Your doctor may also remove a sample of joint fluid with a needle and send it to a lab for examination.
Treatment
The goal of treatment is to reduce pain, improve function, and prevent further joint damage. The underlying cause cannot usually be cured.
LIFESTYLE CHANGES
Lifestyle changes are the preferred treatment for osteoarthritis and other types of joint inflammation. Exercise can help relieve stiffness, reduce pain and fatigue, and improve muscle and bone strength. Your health care team can help you design an exercise program that is best for you.
Exercise programs may include:
·         Low-impact aerobic activity (also called endurance exercise)
·         Range of motion exercises for flexibility
·         Strength training for muscle tone
Physical therapy may be recommended. This might include:
·         Heat or ice
·         Splints or orthotics to support joints and help improve their position; this is often needed for rheumatoid arthritis
·         Water therapy
·         Massage
Other recommendations:
·         Get plenty of sleep. Sleeping 8 to 10 hours a night and taking naps during the day can help you recover from a flare-up more quickly and may even help prevent flare ups.
·         Avoid staying in one position for too long.
·         Avoid positions or movements that place extra stress on your sore joints.
·         Change your home to make activities easier. For example, install grab bars in the shower, the tub, and near the toilet.
·         Try stress-reducing activities, such as meditation, yoga, or tai chi.
·         Eat a healthy diet full of fruits and vegetables, which contain important vitamins and minerals, especially vitamin E.
·         Eat foods rich in omega-3 fatty acides, such as cold water fish (salmon, mackerel, and herring), flaxseed, rapeseed (canola) oil, soybeans, soybean oil, pumpkin seeds, and walnuts.
·         Apply capsaicin cream over your painful joints. You may feel improvement after applying the cream for 3-7 days.
·         Lose weight, if you are overweight. Weight loss can greatly improve joint pain in the legs and feet.
MEDICATIONS
Medications may be prescribed along with lifestyle changes. All medications have risks, some more than others. It is important that you are closely monitored by a doctor when taking arthritis medications.
Generally, over-the-counter medications are recommended first:
·         Acetaminophen (Tylenol) is usually tried first. Take up to 4 grams a day (two arthritis-strength Tylenol every 8 hours). Do not take more than the recommended dose or take the drug along with a lot of alcohol. Doing so may damage your your liver.
·         Aspirin, ibuprofen, or naproxen are nonsteroidal anti-inflammatory drugs (NSAIDs) that can relieve arthritis pain. However, they have many potential risks, especially if used for a long time. Potential side effects include heart attack, stroke, stomach ulcers, bleeding from the digestive tract, and kidney damage.

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