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Arthritis is a general term used to
describe a condition where a joint is damaged, inflamed or painful.
The ends of our bones are covered by a glistening, shiny white coating as they form into the
joints. This substance, known as the cartilage, is a
specialized tissue that provides a very smooth slippery surface allowing
the bones within the joint to move against each other with very little
friction or effort. However this surface is very thin and can be
damaged easily. When this thin coat of cartilage is damaged or worn
through, ones gets to the bones underneath which are not at all smooth and
slippery. When the arthritic joint moves, cartilage loss causes
"bone on bone" grating against one another. This is often
perceived by the patient as a sensation of crackling or slippage as the
irregular surfaces move.
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A normal knee joint |
An arthritic knee joint |
Aside from the bone and cartilage, a
joint consists of soft tissue surrounding the entire structure. This
is known as the joint capsule. Within this substance, lies
the synovium, which is a specialized tissue structure producing
fluids and enzymes to nourish and "lubricate" the
cartilage. When the bones and cartilage first become arthritic, the
synovial tissue reacts by enlarging, and produces additional joint
fluid. This condition causes a joint effusion (water on the knee)
and thickening of soft tissue (synovitis).
As mentioned, arthritis is a general
term. Many conditions can lead to the situation described
above. The two most common of the several types of arthritis are osteoarthritis
and rheumatoid arthritis.
When your physician informs you that
you have "arthritis", this usually implies osteoarthritis.
This form of arthritis, affecting an estimated 2.7 million people, is
commonly caused by the "wear and tear" of the joint surfaces as
we age. This is an ongoing mechanical process that often progresses
with time, especially in the weight-bearing joints of the spine, hips,
knees, ankles or feet. If a previous fracture or injury occurred in
the joint, the conditions leading to arthritis are often intensified, thus
causing post-traumatic arthritis.
Rheumatoid arthritis is an
inflammatory disease affecting the synovial tissue. The synovium of
the joint becomes enlarged and inflamed. This swelling of the tissue
can actually erode the surrounding bone, ligaments and joint
cartilage. The end result is similar to osteoarthritis in that the
joint surfaces are destroyed and painful, although rheumatoid arthritis
starts differently and has additional problems both in the joint and
elsewhere in the body.
Although there is no cure and little
prevention for osteoarthritis, there are ways to help relieve the pain and
keep active and productive. Treatment recommendations include the
following:
Medication
Non-prescription acetaminophen (Tylenol),
aspirin,
ibuprofen (Motrin) or naproxen (Aleve).
Prescription medications, particularly
nonsteroidal
anti-inflammatory drugs (NSAIDs).
Cortisone injection.
Heat/Cold
Heat helps relax aching muscles and relieve joint
pain and
soreness, and cold (ice pack) helps numb the area and
reduce swelling.
Exercise
Moderate stretching to help keep joint and soft
tissues
flexible and strong.
Low-impact exercises (such as aerobics) may reduce pain
Joint Protection
Avoid long, repetitive tasks; take frequent breaks
Use assistive devices; canes, special seats, grab bars,
etc.
Weight Control
Losing weight may lessen pain by reducing joint
stress.
Viscosupplementation
A relatively new treatment for osteoarthritis of the
knee. A
clear gel-like substance is injected into the knee that helps
the joint fluid regain its ability to lubricate the
cartilage.
Viscosupplementation restores joint movement, thus
reducing pain and allowing greater mobility.
Surgery
Arthroscopy, joint fusion, bone reconstruction (osteotomy)
or joint replacement are various kinds of surgical procedures
which benefit patients with arthritis. Some kinds of
surgery
repair bone deformity, fuse joints, or rebuild part of a joint.
Other kinds of surgery replace your own joint with an
artificial joint.

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