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Treatment for arthritis is mainly focused on symptom management and slowing the progression of the disease, says Dr Vishal Shinde, consultant, orthopedics and joint replacement, at the Wockhardt Hospitals, Mumbai.
Have you recently been complaining of pain or stiffness in your knees and joints?
There is a high chance that you may have arthritis.
Until a few decades ago, the condition that mainly affected citizens above the age of 60, is now a rising concern among young adults aged between 25 and 50.
Unfortunately, as per the findings of the World Health Organisation, women are at a higher risk than men (external link).
October 12, designated as World Arthritis Day, is meant to raise awareness about the different types of arthritis and how you can take the necessary precautions to safeguard your health.
Can arthritis affect younger people?
Yes, it can. Though it is much more common in older generations, arthritis can affect people of all ages.
When it comes to this disease, we tend to imagine senior citizens whose joints have changed shape and cause pain.
The fact is arthritis can affect joints at any age.
When it happens to children, it is called juvenile arthritis; thousands of children are affected by it globally.
Young adults are often surprised with a diagnosis of arthritis because they associate it with old age.
Limitations related to mobility and daily activities at any age affect quality of life.
What are the different types of arthritis?
Arthritis is a general term used by common individuals. However, it can be associated with 100 or more joints or surrounding tissues.
Some of the most common types of arthritis that can affect young people are:
Juvenile idiopathic arthritis (JIA)
This affects children younger than 16 years.
It is an autoimmune disease, which means that the immune system mistakenly attacks the joints. This can result in swelling, redness, pain and stiffness.
The causes of juvenile idiopathic arthritis aren't very well understood but have been linked with genes and environmental factors.
Rheumatoid arthritis (RA)
An autoimmune condition that sometimes occurs in young adults, the way it develops is similar to JIA.
The immune system begins attacking the healthy tissue in the joint causing inflammation.
People as young as 20 years can develop RA.
If left undiagnosed and untreated, the inflammation of the joints becomes chronic, resulting in permanent deformity of the joint.
Osteoarthritis (OA)
Although generally an adult-onset disease, osteoarthritis can occur at any age because of joint injury or repeated stress to the joint from activities such as contact sports or due to occupational reasons.
In this condition, the cartilage that cushions the ends of the bones in our joints wears down over time, causing pain and stiffness.
Psoriatic Arthritis (PsA)
This is a type of arthritis that affects people with a skin disease known as psoriasis.
This disease is known to initiate between the ages of 30 and 50 but can sometimes begin earlier.
It is an autoimmune condition much like RA and causes joint inflammation, swelling and stiffness.
Ankylosing Spondylitis (AS)
This is a form of arthritis that primarily affects the spine but other joints may be involved.
It usually begins in late adolescence or early adulthood. It leads to chronic pain and stiffness and eventually it causes the bones of the spine to fuse.
The early detection of arthritis can prevent chronic infection of the joint and limit damage with appropriate treatment.
What are the warning signs of arthritis?
Some of the common symptoms of arthritis include the following:
Joint pain
Characterised by chronic pain that persists in one or several joints of the body, this gets worse with physical activity but can be constant.
The discomfort ranges from minimal pain to excruciating, unbearable pain.
Swelling and inflammation
The joints can swell, become red and feel warm to touch due to inflammation. The swelling might occur during flare-ups and can be recurrent, changing from time to time.
Stiffness
A significant portion of patients with arthritis suffer from stiffness in the joints, particularly after periods of inactivity and also upon waking in the morning.
In severe cases, this stiffness can last for hours.
Reduced mobility
As the arthritic condition progresses over time, it can result in the loss of flexibility in the joint, causing difficulty with simple activities such as bending walking or gripping things.
Fatigue
Many forms of arthritis, especially the autoimmune forms like RA or JIA, are associated with systemic symptoms including fatigue, fever and/or weight loss.
Constant fatigue, even if the person has had adequate rest, can be an indicator of the arthritis and must be correlated with other symptoms and pathology.
What causes arthritis in youngsters?
Based on the type of arthritis, arthritis can be attributed to some factors that medical research continues to explore. These are:
Genetics
Arthritis can run in families and therefore a family history of any type of arthritis, mainly autoimmune forms like RA or JIA, can make an individual prone to the conditions.
Some genetic markers have been associated with the risk of developing arthritis.
Injury
Injuries to the joints, such as those while playing a sport or from a fall, can act as a trigger for premature osteoarthritis.
Repeated stress on a joint can also lead to injury of the joint based on the nature of the physical activity that an individual pursues.
Autoimmune response
Sometimes the body's immune system mistakes our own tissues as a foreign body and attacks them. This can happen to the joints and surrounding tissues.
Environmental and intrinsic stresses, for instance, infections can trigger autoimmune responses in the body.
Obesity
Excess body weight stresses the joints, especially the weight-bearing ones, such as knees ankles, and hips. This, over time, accelerates the wear and tear of the joint and osteoarthritis can set in at an early age.
Infections
Some forms of arthritis appear as consequences of infections. For example, reactive arthritis can result from infections in the gastrointestinal or urinary tract.
Substance abuse
Smoking, alcohol consumption or any kind of substance abuse are risk factors for RA.
What do doctors recommend for the management and treatment of arthritis?
There is no cure for arthritis. It must be managed conservatively.
Treatment for arthritis is mainly focused on symptom management and slowing the progression of the disease. The type and severity of arthritis will often determine the kind of treatment.
Treatment may include the following methods:
Anti-inflammatory drugs (NSAIDs): NSAIDs such as Ibuprofen may be bought over the counter to address inflammation and pain.
Disease-modifying antirheumatic drugs (DMARDs): DMARDs are drugs that may slow down the progression of the disease or prevent damage to the joint in patients with autoimmune arthritis, such as RA.
Biologics: They are drugs that target specific parts of the immune system causing inflammation in autoimmune arthritis.
Steroids: In some instances, steroids are prescribed for short-term use to curb inflammation and flare-ups.
Physical therapy: This is to strengthen the muscles around the involved joints to enable easy movement that may reduce both pain and stiffness.
A physical therapist can draft exercises geared toward your needs and mobility level.
Physical therapy must be adopted after taking advise from an orthopaedic doctor.
A healthy body weight supported with exercise may help the joint in case of osteoarthritis.
Adaptations/changes in lifestyle: Low-impact exercises like swimming, cycling or yoga help maintain the flexibility and strength of the joints without putting pressure on them.
Surgery: Very severe arthritis unable to be managed with other modes of treatment may require surgical interference such as joint replacement.
With an increasing number of young people and women being affected by arthritis, knowing the early signs and learning how to manage arthritis can support an active lifestyle for younger people.
If you suffer from arthritis, it is important that you never self-medicate. Please see a healthcare professional for an accurate diagnosis and treatment plan.
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