Arthritis

senior woman close up hand rubbing hand arthritis

What you need to know about arthritis

According to The Canadian Arthritis Society more than 4.6 million Canadians 15 years or older are living with some form of arthritis. By 2036, this number is expected to grow to an estimated 7.5 million Canadian adults.

What is arthritis?

Arthritis means inflammation of the joints (“artho” Latin for joint and “itis” Latin for inflammation) and describes 200+ rheumatic diseases and conditions that affect joints, the tissues around joints and connective tissues.

Arthritis can occur in any and often many joints in the body, ranging from relatively mild forms of bursitis or tendinitis to more disabling conditions like rheumatoid arthritis. Arthritis is particularly common in weight-bearing joints such as the knee, hip and spine, but can also occur in fingers and other non-weight-bearing joints.

Left untreated, arthritis can eventually lead to long-term debilitating joint damage and even potentially affect some internal organs.

 


woman outside trail workout clothes holding knee arthritis

What are the symptoms of arthritis?

The symptom common to most forms of arthritis is joint and/or musculoskeletal pain. This usually results from inflammation of the lining of one or more joints, which is why there are so many conditions grouped together as 'arthritis’.

The most common symptoms of arthritic inflammation are redness, swelling, heat, pain and/or difficulty moving one or more joints. Because there are so many potential causes for joint inflammation, the pattern, location and specific symptoms can vary greatly.

Arthritis symptoms can develop suddenly, or gradually over time. As arthritis is typically a chronic disease, symptoms may come and go, or persist regularly.

How do you know if you are experiencing the symptoms of arthritis? There are four key warning signs that should prompt a discussion with a health care provider. These include:

Pain

Arthritis pain can be constant, come and go, or be associated with specific joint use. Arthritis pain might be isolated to one joint or felt in many parts of the body.

Swelling

The skin over an inflamed joint can become warm to the touch, red and even visibly swollen.

Stiffness

A common symptom of arthritis is joint stiffness. Some forms of arthritic stiffness can be worse after waking up, after sitting for extended periods or when exposed to certain weather conditions such as humidity or extreme cold.

Joint immobility

Although restricted joint movement can also be an indication of other conditions, it is often associated with arthritis, particularly long-term inflammation.


What are the types of arthritis?

The two most common forms of arthritis are osteoarthritis, a degenerative disease that affects the joints specifically and rheumatoid arthritis, an autoimmune disorder that often affects the hands and feet.

Osteoarthritis

Osteoarthritis results from wear-and-tear to the joint cartilage that coats the ends of bones. If enough damage occurs, connecting bones will grind directly against each other, causing pain and mobility issues. This wear and tear can occur over many years, or it can be accelerated by a joint injury or infection.

Rheumatoid arthritis

Rheumatoid arthritis occurs when the immune system attacks the inner lining (synovial membrane) of the joint capsule.  The capsule encloses all parts of the joints and when the synovial membrane becomes inflamed and swollen the surface of the bones are affected.    This condition can eventually destroy the cartilage and bone of the joint.

Beyond osteo and rheumatoid arthritis, there are more than 100 types of arthritis. They are categorized into seven main groups:

  • Inflammatory arthritis
  • Autoimmune
  • Degenerative 
  • Crystalline or Neoplastic
  • Metabolic arthritis
  • Infectious arthritis

man picking grapes field squatting

What causes arthritis?

Because arthritis has symptoms that can result from such a wide variety of conditions, there is no single cause of arthritis; rather, the cause or causes vary according to the type or form of arthritis. Although some forms of arthritis have no obvious cause, most types of arthritis are caused by a combination of factors.

Arthritis risk factors can be broken into two categories; modifiable and non-modifiable:

Non-modifiable arthritis risk factors:

  • Age - the risk of many types of arthritis increases with age.
  • Gender – different conditions can be more common based on gender. Women are more likely than are men to develop rheumatoid arthritis, while most men are more likely to develop gout.
  • Family history - there is a higher risk of developing arthritis if parents or siblings have a history themselves.
  • Immune system dysfunction - such as in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE).

Modifiable arthritis risk factors:

  • Previous joint injury - People who have previously or repeatedly injured a joint are more likely to eventually develop arthritis in that joint.
  • Obesity - Extra pounds puts stress on already stressed load-bearing joints, particularly knees, hips and spine.
  • Infection- Microbial agents can infect joints and trigger the development of various forms of arthritis. Many of these kinds of infections can be treated under the supervision of a doctor.
  • Occupation - Occupations that involve physical repetition, such as knee bending or squatting can lead to a variety of conditions that can result in arthritis

doctor holds xray arthritis

How do doctors diagnose arthritis

Consultation with your health care provider is recommended when persistent joint pain is identified. If arthritis is suspected, then one or more of the following imaging methods will be used to identify the extent and severity of the condition.

X-rays

X-rays can show cartilage loss, bone damage and bone spurs. X-rays may not reveal early arthritic damage, but they are often used to track progression of the disease.

CT Scans

CT scanners take x-rays from multiple angles to create a 3D view of a joint, providing a more sophisticated view.

MRI

MRI’s use radio waves and a strong magnetic field to produce detailed cross-sectional images of soft tissues in a different way than x-rays.

Ultrasound

High-frequency sound waves are used to image soft tissues, cartilage and fluid-containing structures such as bursae. Ultrasounds, although not as detailed an image as an MRI, can produce images in motion showing joint action.


physiotherapist massaging man on his side lower back

What are treatments for arthritis

For both inflammatory and non-inflammatory types of arthritis; or even a painful case of gout, there are numerous medical and non-medical options to relieve pain and ensure that joints do not become further damaged.

Any form of repetitive or persistent joint pain should be evaluated by a doctor. The doctor will identify the underlying cause or causes of the problem and then recommend a treatment program.

Arthritis treatment focuses on relieving symptoms and improving joint function. A combination of several different treatments may be needed depending on the underlying condition, or combination of conditions.

Physiotherapy

Doctors will often recommend physiotherapy to help overcome some of the challenges of arthritis and improve mobility. Therapies and exercises can increase range of motion and strengthen the muscles surrounding affected joints. In some cases, splints or braces may be warranted.

  • Physiotherapy – a physiotherapist is a licensed professional with clinical experience and a robust understanding of arthritic conditions. A physiotherapist can develop and support non-medical programs and rehabilitation therapy programs for arthritis.
  • Massage - manual compression and kneading of muscles can increase blood flow and stimulate affected joints, temporarily relieving pain. Make sure your massage therapist knows which joints are affected by arthritis.
  • Yoga or tai chi -the slow, stretching movements associated with yoga and tai chi may help improve joint flexibility and range of motion in people with some types of arthritis.
  • Warm water therapy - exercises in a warm-water pool or tubs enables gradual flexing, stretching and strengthening of muscles surrounding affected joints with less weight and pressure.
  • Occupational therapy – certified professionals can provide advice on managing everyday tasks, choosing specialized equipment, and protecting the joints from any further potential damage caused in the workplace.

Medications

The medications used to treat arthritis vary depending on the type of arthritis. Commonly used arthritis medications include:

  • Analgesics
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Counterirritants
  • Disease-modifying antirheumatic drugs (DMARDs)
  • Biologic response modifiers
  • Corticosteroids

Surgery

In extreme cases where physical and medicinal treatment still does not alleviate the pain or disability caused by arthritis, a doctor may recommend surgical intervention.

  • Joint repair - in some instances, joint surfaces can be smoothed or realigned to reduce pain and improve function. These types of procedures can often be performed arthroscopically — through small incisions over the joint.
  • Joint replacement -this procedure removes the damaged joint and replaces it with an artificial one. Joints most commonly replaced are hips and knees.
  • Joint fusion -this procedure is more often used for smaller joints, such as those in the wrist, ankle and fingers. It removes the ends of the two bones in the joint and then locks those ends together until they heal into one rigid unit.

woman kitchen unpacking grocery bag broccoli pineapple

Tips for managing arthritis

In combination with medical treatment, self-management of arthritis symptoms is also important. There are seven important self-management habits that can help control and even reduce the impacts of arthritis.

Be organized

Keep track of symptoms, pain levels, medications, and possible side effects for consultations with a supervising doctor.

Manage pain and fatigue

Medication regimens can be combined with non-medical pain management to manage pain and mitigate the resulting fatigue.

Stay active

Exercise is beneficial for managing arthritis, by strengthening the surrounding muscles, and also improves overall health.

Balance activity with rest

In addition to remaining active, rest is equally important when inflammation is flaring up.

Eat a healthy balanced diet

A nutrient-rich diet can help achieve a healthy weight and control inflammation. Avoid refined, processed foods and pro-inflammatory animal-derived foods. Choose whole plant foods that are high in antioxidants and have anti-inflammatory properties.

Get enough sleep

Sleep deficits can aggravate arthritis pain and fatigue. Take steps to improve sleep hygiene to make it easier to fall and stay asleep.

Joint care

Use other stronger joints for everyday activities and movements to alleviate pain and pressure on those affected by arthritis.