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Causes of arthritis

There are many different factors that contribute to the development of arthritis.

  1. Sex - Certain types of arthritis are more likely to occur in women compared to men.
  2. Genetic - It can run in the family.
  3. Age - the incidence of certain types of arthritis increases with age.
  4. Injuries, infection and allergies can all be contributing factors.
  5. Lifestyle factors including diet and smoking can also be a major contributing factor.

Types of arthritis

Osteoarthritis - This is the most common type of arthritis and it affects 8 million people. The incidence of this is common in those over the age of 50 years. However, due to an injury or any other joint related condition it can occur at any age. Osteoarthritis can initially affect the smooth cartilage lining of the joints, it can make movement more difficult and this can result in pain and stiffness. The lining of the cartilage can then thin and the tissue within the joint can become more active. This leads to swelling and formation of bony spur, (osteophytes).

Rheumatoid arthritis - Women are three times more likely to be affected by men by this type of arthritis and, it affects more than 400,000 people in the UK. It can start when a person is between 40 and 50 years of age. Rheumatoid arthritis is an autoimmune disease that causes inflammation in the synovium . The inflammation is a result of the build-up of fluid and cell in the synovium.

Osteoarthritis and rheumatoid arthritis are the most common types of arthritis.Other types of arthritis include psoriatic arthritis, enteropathic arthritis, reactive arthritis, secondary arthritis, polymyalgia rheumatic.

Signs and symptoms of Arthritis

  • Joint pain, tenderness and stiffness
  • Inflammation in and around the joints
  • Restricted movement of joints
  • Warm and red skin over the joint

Treatment

There are many treatment options available for patients with arthritis. Firstly regular exercise is very beneficial for patients. Many patients find it provides them with much relief of their daily symptoms. Physiotherapy can also provide relief of symptoms.

The first recommendation is usually exercise which can provide some relief and also pain relief medication, such as non-steroidal anti-inflammatory (NSAIDs) drugs and analgesics. Analgesics and NSAIDs both help in providing pain relief. However, the NSAIDs can reduce the inflammation therefore providing more relief. Example of NSAIDs include ibuprofen, diclofenac, naproxen, celecoxib and etoricoxib.

Osteoarthritis
In osteoarthritis if painkillers do not control pain adequately patients may be offered intra-articular injections for corticosteroids. Examples include betamethasone, methylprednisolone, triamcinolone. These can reduce pain and swelling.

Rheumatoid arthritis
Disease modifying anti-rheumatic drugs (DMARDs) can be of particular use Rheumatoid arthritis in providing relief of symptoms in addition, to slowing down the progress of the condition. DMARDs work by blocking the effects of released chemicals when the immune system attacks the joints. This could otherwise lead to further damage to nearby bones, tendons, ligaments and cartilage.

The most common types of DMARDs used, include methotrexate, leflunomide, hydroxychloroquine and sulfasalazine.

Biological treatments are another treatment option for rheumatoid arthritis. This includes etanercept, infliximab, adalimumab, certolizumab, golimumab, rituximab, abatacept and tocilizumab. They are usually used in combination with another DMARD and are commonly only used if these medicines alone have not been beneficial. Biological treatments are given by injection and they work by stopping certain chemicals in the blood from activating the immune system to attack the joints.

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