Arthritis & Joint Problems
Arthritis – Rheumatoid: Overview
Answer: Rheumatoid arthritis (RA) is a chronic disease, in which various joints in the body are inflamed, leading to swelling, pain, stiffness, and the possible loss of function. Some experts classify rheumatoid arthritis as type 1 or type 2.
- Type 1, the less common form, lasts a few months at most and leaves no permanent disability.
- Type 2 is chronic and lasts for years, sometimes for life.
The process probably develops in the following way:
- The disease process leading to rheumatoid arthritis begins in the synovium, the membrane that surrounds a joint and creates a protective sac.
- This sac is filled with lubricating liquid, the synovial fluid. In addition to cushioning joints, this fluid supplies nutrients and oxygen to cartilage, a slippery tissue that coats the ends of bones.
- Cartilage is composed primarily of collagen, the structural protein in the body, which forms a mesh to give support and flexibility to joints.
- In rheumatoid arthritis, an abnormal immune system produces destructive molecules that cause continuous inflammation of the synovium. Collagen is gradually destroyed, narrowing the joint space and eventually damaging bone.
- If the disease develops into a form called progressive rheumatoid arthritis, destruction to the cartilage accelerates. Fluid and immune system cells accumulate in the synovium to produce a pannus, a growth composed of thickened synovial tissue.
- The pannus produces more enzymes that destroy nearby cartilage, aggravating the area and attracting more inflammatory white cells, thereby perpetuating the process.
- This inflammatory process not only affects cartilage and bones but can also harm organs in other parts of the body.
Arthritis – Rheumatoid: cause
Answer: The exact cause of Rheumatoid arthritis is not known. Many researchers in the field of arthritis believe that the condition is unlikely to be due to a single cause, but rather a combination of genetic and environmental factors that trigger an abnormal immune response.
Arthritis – Rheumatoid: Epidemiology
Answer: Rheumatoid arthritis (RA) is an ancient disease. Bone changes indicating the condition have been identified in skeletons thousands of years old. RA affects an estimated 2.1 million Americans, or 1% of the US population.
Arthritis – Rheumatoid: Age distribution
Although the disease can occur at any age from childhood to old age, it usually starts in young adulthood, with age of onset peaking between 20 and 45. Still, about 50,000 children may be afflicted with the juvenile rheumatoid arthritis.
Arthritis – Rheumatoid: Sex distribution
Up to three quarters of rheumatoid arthritis sufferers are women. (The risk for women is slightly lower if they have been pregnant.) Women are also at higher risk for the severe type 2 rheumatoid arthritis.
Arthritis – Rheumatoid: Family History
There is evidence that the risk of developing RA increases in those with a family history of rheumatoid arthritis.
Arthritis – Rheumatoid: Other Risk Factors
There appear to be other factors that may place certain susceptible individuals at higher risk for developing RA. These include:
- Long-Term Smoking.
- History of Blood Transfusions.
- Obesity.
- Coffee Consumption. A 2000 Finnish study reported a direct association between coffee consumption and an increased risk for RA, possibly because coffee's effect on rheumatoid factor. The study did not account for other factors, however, such as other behaviors or habits, or the way coffee is prepared (typically without filters in Finland). Further investigation is needed.
- Silicone Implants. Most studies to date have found no association between silicone breast implants and rheumatoid arthritis or other autoimmune disease (except possibly Sjögren's syndrome).
Arthritis – Rheumatoid: Role of Allergies
Reports from a Dutch study suggest that hay fever sufferers have a reduced risk of developing rheumatoid arthritis, and, conversely, arthritis patients are less likely to have hay fever.
Arthritis - Osteoarthritis
Osteoarthritis, also known as degenerative joint disease, is the most common arthritic disease. Osteoarthritis occurs in the joints of the body when cartilage is damaged and lost and bones undergo abnormal changes. Many Osteoarthritis patients report better pain relief from NSAIDs than from acetaminophen, but prolonged use of NSAIDs can have severe side effects, particularly gastrointestinal bleeding.
Joint Strains/ Sprains:
Strains occur when a muscle, tendon (which connects muscle to bone), or ligament (which connects bone to bone) is overused or stretched forcibly beyond its normal length. It usually takes a few days for the pain and swelling of a minor strain to go away.
If the tendons or ligaments are partly or completely torn, the injured area is sprained. The affected area may be swollen, bruised, stiff, and sore. In severe cases, the joint may be unstable or fractured.
The usual treatments for most minor strains and sprains are rest (with a splint if needed), ice, and nonsteroidal anti-inflammatory medications like ibuprofen. Most minor injuries heal in 1-2 weeks, although recovery time varies depending on which tendon was strained and how serious the injury is.
If a joint is unstable or possibly fractured, an X-ray of the area and evaluation by an orthopedic specialist may be necessary. Severe injuries require immobilization with a splint or cast.
If you are still suffering significant pain 5 days after the injury, see your doctor.
Arthritis – Jaw (TMJ/ “locked jaw”)
The Temporo-mandibular joint is the main hinge that allows the jaws to open and close. Many different forms of arthritis affect the jaw--especially the temporo-mandibular joint (TMJ), the joint between the temple bone (temporo) and the jaw bone or mandible. In people over 40, Osteoarthritis in the TMJ can cause creaking and pain in that joint only. Juvenile or adult rheumatoid arthritis can also affect the jaw. Last, irritations of the jaw--temporo-mandibular pain syndrome (TMPS)--can strike at any age. The most common symptom of this is a clicking of the joint that is caused by an abnormal muscle spasm that disrupts the normal movements of the jaw.
