Rheumatology is the branch of medical science which deals with the investigation, diagnosis and management of patients. Rheumatic diseases are one of the leading causes around the world of long term disability, where patients find difficulty in completing simple everyday tasks. Arthritis, which causes painful inflammation and stiffness in the joints, is one of the most common rheumatic diseases.

Different types of arthritis

There are more than one hundred known forms of arthritis, however the three most common ones are (1);

Osteoarthritis – the most commonly occurring form of degenerating arthritis. It develops with age, joint injuries, or obesity, as each condition adds stress to the joints. Joints which bear the most weight such as the hips, knees, and spine are more likely to be affected. Osteoarthritis gradually progresses with time as cartilage breaks down between the joints, causing painful movement. The joints will appear swollen, warm to touch, and are unable to move freely.

Rheumatoid – an autoimmune disease where the joints are attacked by the immune system leading to inflammation and severe joint damage if untreated. One fifth of patients develop lumps known as rheumatoid nodules on their skin, and symptoms are more severe than osteoarthritis. Usually, multiple joints are affected in a symmetrical pattern so joints on both hands, arms, legs and feet feel stiff, painful, and swollen at the same time. Patients may feel fatigued, lose their appetite, and suffer from weight loss. Rheumatoid arthritis is estimated to affect almost 400,000 Australians currently (2).

Psoriatic – patients present with both skin and joint inflammation. The psoriasis causes red, raised areas and patchiness on the skin. The arthritis will usually begin between the ages of 30 to 50, but only one or a few joints will be affected.

Treatment and management of arthritis

Understanding the physiology of arthritis is complex and highly dependent on varying multiple factors such as the type of arthritis, the patient’s own medical history, and their lifestyle. Arthritis itself can be loosely organised into the following categories (3);

- Inflammatory, when the body’s defence system begins to attack its own tissues instead of foreign substances, viruses, or bacteria, which leads to inflammation of the joints.

- Degenerative, where there is deterioration of cartilage, bone, ligaments and muscles which are part of, or around, the affected joints.

- ‘Others’, any conditions which affect bone and soft tissues subsequently leading to damage and inflammation of joints.

While the exact science behind the cause of arthritis is still under research, it is known that previous injuries, obesity, other underlying pathological conditions, and genetics can all contribute to the onset of the disease. Diet, poor blood circulation, and lack of movement may also be linked with arthritis.

Early diagnosis is essential for prevention of joint deformities and to increase chances of remission of the disease. However each person is likely to have different experiences of living with arthritis, symptoms can vary from day to day, and treatment and management options also differ with each patient.

Treatments involve medication, physiotherapy and self-management techniques. Most medications offer pain relief and anti-inflammatory effects. Physiotherapy will use exercise to keep the patient active and help their body function optimally. Self-management consists of learning ways to manage the pain, sticking to a healthy and well-balanced diet, and protecting joints via the use of aids, equipment and gadgets which make daily tasks easier (3).


Sources:

1. Web MD
2. AIHW
3. Better Health