Rheumatic Diseases

Being diagnosed with arthritis can raise many concerns and questions. On this page you will find information about arthritis itself; the kinds of treatment that are available; ways of coping; how to get help; and how to develop your own skills to manage the condition. You can also get a large amount of information from useful links.

What is arthritis?
The word arthritis literally means joint inflammation. It refers to more than 100 different diseases. These diseases usually affect the area in or around joints. Some of these diseases can also affect other parts of the body, including the skin and internal organs.

There are many types of arthritis. Most forms of arthritis are chronic, which means they may last a lifetime.

Arthritis affects people of all ages, including children. Arthritis is not, therefore, just part of the ageing process. However, some kinds of arthritis do tend to affect people in particular age groups, whilst others are more common in women than men. There are many myths about arthritis. For example, in damp or hot and humid weather, some people with arthritis feel their joints hurt more. But climate is not a cause of arthritis and there is as yet no proof of a link between arthritis symptoms and the weather. Another example is that many people claim certain foods aggravate their symptoms. Once again, there is no scientific proof for this so far.

How does arthritis feel?
Arthritis usually causes stiffness, pain and fatigue. The severity varies from person to person, and even from day to day. In some people, only a few joints are affected and the impact may be small. In other people, the entire body system may be affected.

The joints of the body are the site of much of the action in arthritis. Many types of arthritis show signs of joint inflammation: swelling, stiffness, tenderness, redness or warmth. These joint symptoms may be accompanied by weight loss, fever or weakness. The possible consequences of arthritis are inability to function properly in society and to look after oneself, anxiety, depression and frustration. These consequences may require you to adapt and readjust your life.

When these symptoms last for more than six or eight weeks, inflammatory arthritis, such as rheumatoid arthritis may be the cause. Joint inflammation may also be caused by infection, which can lead to septic arthritis. Degenerative joint disease (osteoarthritis) is the most common type of arthritis; joint inflammation is not a prominent feature of this condition. While normal joints can support a vast amount of use, mechanical abnormalities of a joint make it susceptible to degeneration.

Arthritis can make it hard to do the movements you rely on every day for work or taking care of your family.

Important Rheumatological Conditions at a Glance

  • Osteoarthritis, a degenerative joint disease in which the cartilage that covers the ends of bones in the joint deteriorates, causing pain and loss of movement as bone begins to rub against bone. It is the most prevalent form of arthritis.
  • Rheumatoid arthritis, an autoimmune disease in which the joint lining becomes inflamed as part of the body’s immune system activity. Rheumatoid arthritis is one of the most serious and disabling types, affecting mostly women.
  • Gout, which affects mostly men. It is usually the result of a defect in body chemistry. This painful condition most often attacks small joints, especially the big toe. Fortunately, gout almost always can be completely controlled with medication and changes in diet.
  • Ankylosing spondylitis, a type of arthritis that affects the spine. As a result of inflammation, the bones of the spine fuse together.
  • Juvenile arthritis, a general term for all types of arthritis that occur in children. Children may develop juvenile rheumatoid arthritis or childhood forms of lupus, ankylosing spondylitis or other types of arthritis.
  • Systemic lupus erythematosus (lupus), a serious disorder that can inflame and damage joints and other connective tissues throughout the body.
  • Scleroderma, a disease of the body’s connective tissue that causes a thickening and hardening of the skin.
  • Fibromyalgia, in which widespread pain affects the muscles and attachments to the bone. It affects mostly women.

What causes arthritis?

What causes most types is unknown. Because there are so many different types, there are likely to be many different causes. Scientists are currently researching what roles three major factors play in certain types of arthritis. These include the genetic factors you inherit from your parents, what happens to you during your life and how you live. The importance of these factors varies for every type of arthritis. Some types of arthritis can be due to infection. Others may be due to tumors or joint degeneration.

Can arthritis be prevented?

There are things you can do to reduce your risk for getting certain types of arthritis or to reduce disability if you already have arthritis.

People who are overweight have a higher frequency of arthritis. Excess weight increases your risk for developing osteoarthritis in the knees, and possibly in the hips and hands. Women are at special risk for this. In men, excess weight increases your risk for developing gout. It’s important to maintain your recommended weight, especially as you get older.

Joint injuries caused by accidents or overuse increase your risk for some types of arthritis. You can also inherit certain genes that may increase your risk for some types of arthritis.

Can arthritis be managed?

What can you do to maintain your independence if you already have arthritis? Studies show that exercise helps reduce the pain and fatigue of many different kinds of arthritis. Exercise keeps you moving, working and doing daily activities that help you remain independent.

It’s also important to control your weight if you have knee osteoarthritis. Being overweight puts you at risk for worse disease, and for getting osteoarthritis in your other knee if only one is affected now.

What is the patient’s role in treating or managing arthritis?

The patient is the most important member of the health care team. The patient plays an important role in his or her medical care and is involved in all the decision making steps. The patient can contribute to the success of a treatment plan by: learning about arthritis; following through with treatment; reporting progress and setbacks to health team; and keeping a positive attitude.

How is arthritis diagnosed?

It’s important to find out if you have arthritis and what type it is because treatments vary for each type. Early diagnosis and treatment are important to help slow or prevent joint damage that can occur during the first few years for several types.

Only a doctor can tell if you have arthritis and what type it is. When you see your doctor for the first time about arthritis, expect at least three things to happen. Your doctor will ask questions about your symptoms, examine you, and take some tests or X-rays.

The overall results from your medical history, physical exam and tests help your doctor match your symptoms to the pattern for a specific type of arthritis.

It may take several visits before your doctor can tell what type of arthritis you have.

Role of ultrasound in diagnosis and treatment

Ultrasound is a useful tool for early diagnosis and treatment of rheumatologic diseases. Ultrasound is proving to be increasingly handy in the evaluation of the musculoskeletal system for pinpointing presence of fluid in joints, joint erosions, inflammation in and around joints, and injuries. Many rheumatologic conditions have charcacteristic ultrasound features. Compared to X-rays, CT scans and MRI, ultrasound has several advantages which include ready availability, quick scan time, low cost, and absence of radiation. The ultrasound examination, as an extension of the clinical examination, permits not only diagnosis but also allows easy explanation and demonstration of abnormalities to the patient at the same time. The technique of power doppler allows easy proof of inflammation, which can be readily appreciated by the patient during the scan. Serial scanning can monitor response to treatment, especially to biologics like Humira. Interventional procedures using ultrasound guidance such as joint aspirations, joint injections, and soft tissue injections can also aid in the treatment of rheumatologic conditions.

Role of Exercise

Regular exercise is important to keep you moving and independent. Exercise helps lessen pain, increases movement, reduces fatigue and helps you look and feel better. Three types of exercises can help people with arthritis.

Range-of-motion exercises reduce stiffness. They keep your joints flexible by moving them to their fullest extent. Most people should do these exercises daily.

Strengthening exercises increase or maintain muscle strength. Strong muscles help keep your joints stable and make it easier to move. Most people should do these exercises daily or every other day.

Endurance exercises build fitness. They help keep your heart healthy and control your weight. You should exercise for a total of 20 to 30 minutes, three times a week, at a pace that raises or sustains your heart rate. Most people can build their endurance by exercising for shorter periods of time several times a day.

Plan your exercises at times of the day when you have less stiffness or pain. Start slowly. Build up the amount of time you exercise and the number of repetitions you do. Exercise at a level that allows you to talk comfortably during the activity. If pain from exercise lasts more than two hours, you may have done too much. Reduce your level of activity next time. Stop exercising right away if you have chest pains, severe dizziness or shortness of breath, or if you feel sick to your stomach.

Through exercise, you can improve your overall health and fitness, as well as your arthritis symptoms. Remember, exercise can keep joints moving, strengthen muscles around joints, keep bones strong and healthy, help you to do daily activities more easily, and improve your overall health and fitness, including increasing your energy, improving your sleep, controlling your weight, strengthening your heart and improving your self-esteem and sense of well-being.

Getting Enough Sleep

Resting is also important, especially when there is a lot of inflammation or your arthritis flares up badly.

Sleep restores your energy so that you can better manage pain. It also rests your joints to reduce pain and swelling.

Only you know how much sleep your body needs, so get into the habit of listening to your body. Most people need seven to nine hours of sleep per night.

If you feel tired and achy after lunch every day, taking a brief nap (15 to 20 minutes) can help restore your energy and spirits. If you have trouble sleeping at night, try relaxing quietly in the afternoon rather than taking a nap.

How to Sleep Better

  • Do moderate exercise on a regular basis. Avoid exercise right before bedtime.
  • Avoid alcohol and caffeine, especially late in the day.
  • Establish a regular sleep schedule. It’s especially important to get up at the same time every day, even on weekends.
  • Take a warm bath before going to bed.
  • Listen to soothing music.
  • Spend some quiet time by yourself before you go to bed.
  • Read for pleasure. Avoid technical information, work-related material, scary novels or other materials that can keep your mind from relaxing.
  • Avoid taking sleeping pills unless your doctor recommends them.
  • If you are sleeping poorly, be sure to speak with your doctor.