As people age, it is not uncommon for them to develop pain in the joints. Joints are places in the body where two or more bones meet, such as your elbow or knee. Painful, swollen, and stiff joints are seen in various types of arthritis (ar-THRY-tis meaning "joint inflammation"). Signs and symptoms of inflammation include redness, heat, pain, and swelling. These symptoms and signs indicate a medical problem which needs to be addressed. In some types of arthritis, the joints involved can become severely damaged, leading to deformity and disability.
Common Kinds of Arthritis
Arthritis is one of the most common diseases in this country. Millions of adults and half the population over 65 are troubled by this disease. Common forms of arthritis include osteoarthritis, rheumatoid arthritis, or gout, which will be discussed below.
Osteoarthritis
Osteoarthritis (OA) is the most common type of arthritis in older people. OA starts when cartilage lining the affected joints becomes damaged from "wear and tear" (i.e. the effect of obesity on the knees during walking). Cartilage is the tissue that lines and pads the bones in a joint. At OA’s worst, all of the cartilage in a joint wears away, leaving raw bones rubbing against each other--a process known as eburnation (EE-bur-NAYshun). You are most likely to have OA in your hands, neck, lower back, and/or the large weight-bearing joints of your body, such as the knees and hips.
OA symptoms can range from stiffness and mild pain that comes and goes with activities like walking, bending, or stooping to severe joint pain at rest. Sometimes OA causes your joints to feel stiff when you haven’t moved them in a while, like after riding in the car; however, this stiffness may go away when you move the joint, as during walking. In time, OA can also cause restriction of joint mobility, leading to disability or joint replacement, such as total replacement of the knee.
What causes OA?
Growing older is what most often puts you at risk for OA. Other than that, scientists think the cause depends on which part of the body is involved. For example, OA in the hands or hips may run in families. OA in the knees can be linked with being overweight. Injuries or overuse may cause OA in joints such as knees, hips, or hands.
Rheumatoid Arthritis
Rheumatoid Arthritis (RA) is an autoimmune disease (autoimmune means the body's immune system is attacking itself). In RA, that means your body attacks the lining of a joint and the tissues near the joint and bones. For example, if you had a splinter in your finger, the finger would become inflamed—painful, red, and swollen. RA leads to inflammation in your joints. The inflammation causes pain, swelling, and stiffness that lasts for hours and typically affects several joints simultaneously.
RA can attack almost any joint in the body, including the joints in the fingers, wrists, shoulders, elbows, hips, knees, ankles, feet, and neck. RA generally attacks joints in a symmetrical fashion--fingers on both sides , knees on both sides, etc. RA not only destroys joints--it can also attack organs such as the heart, muscles, blood vessels, nervous system, and eyes. People with RA often don’t feel well. They may be tired and run a fever. They are less active because of arthralgias (joint paints). People of any age can develop RA; it is more common in women.
Gout
Gout is one of the most painful forms of arthritis. An acute gouty attack begins with the release of needle-like uric acid crystals into the affected joint space--most often in the joint at the base of a great toe. Uric acid crystals are especially irritative to the tissues of the joint, and white blood cells (WBCs) are called in to "fight" the crystals. The the WBCs ingest the crystals, which causes them to explode, releasing toxic enzymes and chemicals into the joint space, resulting in severe inflammation and pain.
People with gout usually have elevated uric acid levels in the blood. Uric acid is formed from the metabolism of purines, and gout attacks often follow eating purine-rich foods like shellfish, liver, dried beans, peas, anchovies, or gravy. Using alcohol, being overweight, and certain medications may also make gout worse. Some blood pressure medicines can also increase your chance of a gout attack because they raise uric acid levels in the blood.
Gout is most often a problem in the big toe, but it can affect other joints, including your ankle, elbow, knee, wrist, hand, or other toes. Swelling may cause the skin to pull tightly around the joint and make the area red or purple and very tender. Your doctor might suggest blood tests and x-rays. Your physician might also take a sample of fluid from your joint while you are having an attack to look for uric acid crystals and white blood cells.
Other Forms of Arthritis:
Psoriatic arthritis is seen in the hands and other joints in some people with the skin condition known as psoriasis. Ankylosing spondylitis hits the spine hardest and has a strong pattern of inheritance, especially seen in persons positive for HLA-B27; it is responsive to indomethacin. Infectious arthritis occurs when bacteria, such as gonococci (Gonorrhea bacteria) or staphylococci or other infectious agent attacks a joint after introduction into the joint space. Antibiotic therapy must be ordered urgently to preserve the affected joint. Arthritis in the temperomandibular joint (where the jaw joins the skull) is known as the TMJ syndrome, for which various treatments apply.
