Understanding and living with arthritis

From freemalaysiatoday.com

For those who suffer from arthritis, everyday actions such as standing or bending over can cause great pain. While it is widely known that arthritis presents itself more often in older people, those in their 20s can also develop this condition, which will worsen with age.

Arthritis remains a leading cause of pain and disability worldwide. According to the United States Centers for Disease Control and Prevention, more than one-third of adults who have arthritis say it limits their leisure activities and work, while 25% report it causes severe pain.

There are two main types of arthritis, both of which will cause immense pain if left untreated.

• Degenerative arthritis

Degenerative arthritis is caused by wear and tear in a joint. It is usually non-symmetrical as it only affects a particular joint on one side of the body.

“When a person overuses their joints, such as their knees or shoulders, they tend to develop degenerative arthritis which will decrease their range of motion,” said Dr Cheah Chee Ken, consultant rheumatologist at a hospital in Sunway City, Subang Jaya.

Symptoms such as pain, stiffness, swelling and redness are more concentrated on the joints and are mechanical in nature, meaning they get worse upon movement and are relieved with rest.

• Inflammatory arthritis

This describes a group of joint diseases with inflammatory joint pain as the main feature. Other symptoms include pain at rest, marked early-morning joint stiffness, and joint swelling with occasional skin redness.

This form of arthritis can be caused by different conditions, ranging from acute injury or infection to or an overactive immune system that attacks the joints.

In the latter case, the patient’s immune response does not know how to differentiate itself from foreign substances, leading to ongoing inflammation and subsequent permanent joint damage.

There are more than 100 types of arthritis and related conditions that can also affect young adults. (Rawpixel pic)

Unlike degenerative arthritis, inflammatory arthritis may affect multiple joints simultaneously and symmetrically. Systemic symptoms such as fatigue are common.

Taking the burden off your joints

Treatment principles for arthritis include:

• diagnosing the type of arthritis;
• arresting inflammation to avoid structural damage;
• controlling pain and symptoms; and
• preserving joint functions and maintaining quality of life.

Certain conditions require simple steps such as exercises and physiotherapy, while in other cases, surgery may be required. For inflammatory arthritis, treatment primarily consists of medical therapy.

Here are some general ways degenerative arthritis is addressed, depending on where it occurs in the body:

Hip arthritis

1. Weight management

Being overweight or obese puts extra strain on one’s joints and contributes to inflammation due to a higher body mass index. Establish an exercise programme such as walking, swimming, or aerobics – low-impact activities that lessen the strain on joints.

Also maintain a healthy diet, which will have a positive effect on one’s joints. For example, the addition of fish oils rich in omega-3 fatty acids and vitamin D3 can modestly reduce pain and swelling.

2. Surgery

This is usually recommended only if lifestyle changes and exercise do not help. There are two forms of surgery:

Hip resurfacing: when the surgeon trims away damaged bone and cartilage and replaces them with a metal stem inserted into the thigh bone, creating an artificial surface.
Hip replacement: when the surgeon removes damaged sections of the hip joint and replaces them with an artificial joint.

Natural therapies such as acupuncture could bring relief to sore and swollen joints. (Envato Elements pic)

3. Natural therapies

These include acupuncture, cognitive behavioural therapy, application of heat pads, and/or topical ointments.

Hand arthritis

1. Hand exercises

Moving and exercising the affected joints can increase hand strength and improve finger and thumb mobility. You may be referred to a hand therapist for this treatment method.

2. Splinting or braces

These are used to support and protect the affected joint, reducing strain and promoting proper joint alignment. It is not advisable, however, to wear splits or braces long-term as this could weaken your muscles.

3. Surgery

Joint fusion is a form of surgery that uses a plate and screws to keep the bones of your joint together. You’ll have a stable and pain-free joint but have less movement and flexibility.

Inflammatory arthritis can cause tendons to rupture. If this happens, a tendon transfer – literally transferring a healthy tendon from elsewhere to your hand – can restore function.

Knee arthritis

1. Activity modification

Remaining physically active is key to managing symptoms and strengthening the knee. However, do avoid movements such as lunges or squats that could strain your joints.

“Even after surgery, previous sport injuries can linger, causing damage to both cartilage and bone in the knee,” Cheah warned.

Assistive devices such as canes or walkers can help reduce weight-bearing on one’s joints. (Envato Elements pic)

2. Walking aids

Specialists will recommend using assistive devices like canes or walkers to provide support, as these lessen the weight-bearing load on the arthritic joint, thereby reducing pain.

3. Surgery

There are three options available:

• Knee replacement, to resurface the damaged knee joint and relieve pain. Metal and plastic parts are used to cap the ends of the bones that form the knee joint and kneecap.
• Knee osteotomy, which realigns the joint, shifting pressure onto the better side of the knee and reducing wear and tear on the bad side. This can postpone the need for a total knee replacement by up to 10 years.
• Cartilage restoration, or bone-marrow stimulation, encourages cartilage growth by making precise microfractures in the surrounding bone.

https://www.freemalaysiatoday.com/category/leisure/health/2022/11/01/understanding-and-living-with-arthritis/