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Management of Arthritis

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By Dr Rotimi Adesanya

A patient who came for consultation recently was surprised to hear from me that arthritis has no cure and that medical scientists are still researching into cure for arthritis. She told me about practitioners (orthodox, herbal and alternative practitioners) who repeatedly and convincedly assured her that it is curable. The fact is there’s no cure yet for arthritis but there are many treatments that can help slow down the inflammation and symptoms.

Arthritis is a common condition that causes pain and inflammation in a joint. It affects people of all ages, commoner with older people, but it also affects children. Most types of childhood arthritis are known as juvenile arthritis. It causes pain and inflammation in one or more joints for at least six weeks. Although the exact cause of juvenile arthritis is unknown, the symptoms often improve as the child gets older, meaning they can live a normal life.
Signs and Symptoms of arthritis
Joint pain in the knee, wrist, hip, neck, elbow, shoulder, ankle, tenderness and stiffness ,swelling, inflammation in and around the joints ,restricted movement of the joints, warm, red skin over the affected joint weakness and muscle wasting . This can result in joint weakness, instability and deformities that can interfere with the most basic daily tasks such as walking, driving etc.

Types of arthritis

Degenerative Arthritis: Osteoarthritis is the most common type of arthritis. When the cartilage, cushioning surface on the ends of bones – wears away, bone rubs against bone, causing pain, swelling and stiffness. Over time, joints can lose strength and pain may become chronic. Risk factors include excess weight, family history, age and previous injury

Inflammatory Arthritis: A healthy immune system is protective. It generates internal inflammation to get rid of infection and prevent disease. But the immune system can go awry, mistakenly attacking the joints with uncontrolled inflammation, potentially causing joint erosion and may damage internal organs, eyes and other parts of the body. Rheumatoid arthritis is an examples of inflammatory arthritis. Smoking is an example of an environmental risk factor that can trigger rheumatoid arthritis in people with certain genes.
Infectious Arthritis (septic arthritis): – A bacterium, virus or fungus can enter the joint and trigger inflammation. Examples of organisms that can infect joints are salmonella and shigella, chlamydia and gonorrhea (sexually transmitted diseases) and hepatitis C. It is seen in sickle cell disorder sufferers could also be due to tuberculosis. In many cases, timely treatment with antibiotics may clear the joint infection, but sometimes the arthritis becomes chronic.
Metabolic Arthritis: Uric acid is formed as the body breaks down purines, a substance found in human cells and in many foods. Some people have high levels of uric acid because they naturally produce more than is needed or the body can’t get rid of the uric acid quickly enough leading to gout attack. it can become chronic, causing ongoing pain and disability.

Diagnosing Arthritis
Arthritis diagnosis often begins with a primary care physician, who performs a physical exam, may also do blood tests for full blood count, blood uric acid, ESR, X-rays, ultrasound scans, CT scans, MRI of affected joints, rheumatoid factors in order to determine the type of arthritis and confirm diagnosis.

An arthritis specialist, or rheumatologist, should be involved if the diagnosis is uncertain or if the arthritis may be inflammatory. Rheumatologists typically manage ongoing treatment for inflammatory arthritis, gout and other complicated cases. Orthopaedic surgeons do joint surgery, including joint replacements. When the arthritis affects other body systems or parts, other specialists, such as ophthalmologists, dermatologists or dentists, may also be included in the health care team.
Treatments: Arthritis invariably impacts on a patient’s quality of life and includes varying degrees of discomfort and pain. There’s no cure for arthritis, but there are many treatments that can help slow down the condition. The medications are often prescribed, including: painkillers, corticosteroids, antibiotics, exercise, physiotherapy, and use of cold/hot compress.

In severe cases, the following surgical procedures may be recommended by the orthopaedic surgeons : arthroplasty (joint replacement) , arthodesis (joint fusion) , osteotomy (where a bone is cut and re-aligned).

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