What is Arthritis?
Arthritis is the inflammation and changes in the bones and cartilage in the knee joint or any other part of the body that helps in easy movement. There are many types of Arthritis but two conditions are most common: Osteoarthritis and Rheumatoid Arthritis. If it caused due to wear and tear, then it is osteoarthritis, or if it caused due to inflammation, then it is rheumatoid arthritis. However, the most vulnerable part of the body is knee joint, and it can experience both conditions.
Osteoarthritis: It is also known as degenerative joint disease and most common form of arthritis. The cartilage, which acts as a soft cushion between the two bones wears away or become thin resulting in both the bones rubbing each other, which will cause massive pain and uneasiness in the knee.
Both the cartilage and lubricating fluid in the knee joint makes the movement easy and smooth. When the osteoarthritis occurs, bending or straightening your knee will be hindered because the two bones rub on each other causing osteoarthritis pain in the joint.
Rheumatoid Arthritis: It is the inflammation in the membranes lining the joints resulting in swelling, redness, etc. It slowly starts in smaller joint sin the body such as hands and feet, and later proceed towards larger joints such as knees, elbows, hips and shoulders. It is chronic inflammatory disorder, which can result in permanent joint deformity.
Rheumatoid Arthritis is also known as systemic inflammatory disorder, which means long term swelling sensation through the body. Despite there is no proper cure for this condition, there are many treatments which can hinder the progress and provide massive relief to the patient.
What are the Symptoms of Arthritis?
The symptoms of the arthritis differ according to the severity of the condition in every person. However, the pain develops gradually over the time but there is slight possibility of some sudden onset of pain due to injury. The symptoms of Rheumatoid Arthritis as well as Osteoarthritis are similar and they even develops slowly. In addition, the symptoms fluctuate according to the weather.
Patients often complaint about the pain in the joint while trying to bend or straighten the knee. Whenever climbing or descending stairs, squatting, or performing any activity, pain can be experienced. Sometimes, knee will become stiff after a prolonged inactivity.
Due to the forming of bone spurs i.e. osteophytes, extra fluid is formed in the knees, which will results in swelling or inflammation. The skin will become reddish, tender and warm. Due to weakness in muscles, one can feel the sensation of knee giving away or knee buckling. Cracking or popping sound i.e. crepitus can be experienced in the knee joint.
Arthritis greatly restrict the range of motion and prevents you from performing daily activities. In case of osteoarthritis, bone spurs will occur resulting in poor range of motion. Delaying the treatment will result in joint deformity and it will generally range from unnoticeable to quite severe.
What are Causes of Arthritis?
Both the conditions of arthritis – Osteoarthritis and rheumatoid arthritis damages the joints of the body in different ways. In the case of osteoarthritis, the cartilage gets damaged resulting in bone grinding and extreme pain. As for the rheumatoid arthritis, the synovial membrane becomes inflamed due to pressure from immune system, which will tear down cartilage causing pain in the knee joint.
One of the major causes of arthritis is age factor and people over age of 65 are most vulnerable to this condition. The simple reason is that as we age, all our body parts such as bones, muscles, joints, etc. becomes weak and results in the damage to the cartilage.
Overweight or obesity is also the major cause in the case of osteoarthritis because the when we walk, the weight of the entire upper body goes through the knees, which will eventually tears the cartilage. Obese people with BMI above 27 are 3 times more vulnerable to the osteoarthritis. Gender is also a cause of arthritis, as women are more prone to men because the former have fast hormonal change and bone loss, whereas latter has large skeleton and their bones loss start slowly compared to women. The abovementioned causes doesn’t indicate that only overweight and women are affected with arthritis but this is an analysis of years of research and data collected by healthcare officials from all around the world.
Sometimes, arthritis is triggered by serious knee injury such as meniscus tear. Even though the meniscus tear is healed or cured, the cartilage is not developed as it was before the injury and this results in the condition of arthritis. In addition, cartilage heals very slowly because the blood supply to this part is very poor and it lies in the one of the most unstable part of the body i.e. knee joint. Flat feet and hereditary are also causes of arthritis.
According to a study, approximately 60% of osteoarthritis cases are linked with genetics. Even the patients, who have undergone the menisectomy ( surgery performed to remove the cartilage from the joint) , they are also most likely to be get affected with arthritis because the cartilage in the joint redevelops slowly or sometimes never redevelops.
Diagnosis of Arthritis :
Doctors will speak with about the symptoms and medical history during your appointment. They will conduct comprehensive physical test such as inflammation, redness, tenderness, crepitus, range of motion, etc.
X-ray, MRI scan, CT scan, Ultrasound, blood test, synovial fluid analysis, biopsy, urine test, and bone scan are also needed to differentiate the various conditions of arthritis and to get the comprehensive structure of the bone.
Treatment of Arthritis:
There is no proper cure for arthritis but certain treatments effectively ease the pain and most likely hinder the progress of joint deformity. Some of the effective and most common treatments for arthritis are:
- Exercises: “Exercise will aggravate the arthritis” is a myth because exercises are undoubtedly one of the effective ways of strengthening the muscles and relieving the pain.
- Hamstring Stretch
- Quadriceps Stretch
- Forward Bend
- Chair Squat
- Calf Raise
- Quadriceps Lift
- Side Leg Raise
- Knee Curl
- Lifestyle Modification: Slight changes and modification can bring massive relief from the pain and hinder the development of arthritis to other parts of the body. Minimizing the aggravating activities like climbing stairs is a great viable solution. Avoid sports like tennis, jogging or running and switch to aerobic activities like swimming, walking and bicycling.
- Knee Braces: When we walk, massive amount of force goes through the knee joint due to our weight and Knee braces reduces the pressure and helps in stabilizing as well as well as balancing the weight. There are several types of knee braces and some are specific to certain conditions and sports injuries.
- Heat: Providing warmth to the arthritis affected joint will bring massive amount of relief because it will block pain and allow the blood to flow with ease. Consult your physical therapist for proper guidance in using heat treatment. Generally hot water is poured in water bottle and wrapped with a towel, and it is placed on the knee for approx. fifteen to twenty minutes. It will bring relief and respite from the pain.
- Ice: Applying ice for 10-20 minutes several times a day will help in reducing or minimizing the swelling. Use icepacks or ice wrapped in towel for maximum effectiveness from the ice treatment. Never ever apply ice directly to the arthritis affected
- Continue Movement: Ensure you move around sufficiently because prolonged inactivity will trigger the pain. The lubricating fluid present in the knee joint dries up due to expanded hours of inactivity. So, it’s wise to perform simple exercises every hour or so.
- Physical Therapy: Consult your physiotherapist to design a specific and individualized exercise program that can help you in increasing the flexibility, stability and range of motion in the knee.
- Acupuncture: It is short-term but most effective alternative treatment that can provide much needed relief from the arthritis pain. It releases the chemicals called endorphins, which block the pain and decrease the pain. Many studies conducted all around the world has suggested that acupuncture do provide assistance in the decreasing the arthritis pain.
- Dieting: There is some correlation between dieting and arthritis but it should be followed along with drug treatment prescribed by the doctor. Meals with vitamins, minerals, antioxidants and other nutrients are very effective. In addition, Mediterranean-style diet is also useful in healing the arthritis pain, which generally contains fish (rich of omega-3 fatty acids), pulses, nuts, olive oil and plenty of fruit and vegetables.
- Losing Weight: Weight plays a great role in arthritis. It is also a major cause and place extra pressure on the knee joints. So, losing weight will improve the mobility, reduce the pressure on knee joint, increase the flexibility and range of motion.
- Natural Remedies: Natural remedies are used for generations and since there are no side effects, many people love to adopt them with other treatment methods. Turmeric, an Indian spice is usually applied to the swelling area, which will cause a burning senation but eventually reduces the swelling. Other than that glucosamine and chondroitin also alleviate the arthritis pain. In addition, Epsom salt soak, Dandelion Leaves and ginger tea are some of the thousands of natural remedies that provide relief from the arthritis pain. Even magnesium and copper bracelets are women by many people especially women.
- Homeopathy: Homeopathy is one of the oldest, traditional and holistic method of treatment. All the remedies of homeopathy are in diluted form and manufactured from natural substances. Since there are no harmful chemicals and additives found in the homeopathy, side-effects are extremely minimal. It is generally believed as faith-healing method and some of the most common homeopathy remedies for arthritis are rhus tox, bryonia, apis, and belladonna.
- Walking Aids: Stick, cane or crutches are used to reduce the pressure or force exerted by our weight on the knees. If you are experiencing pain in left leg, then hold the stick in right hand and vice versa. This is most effective way of using the walking aids to reduce the effect of arthritis.
- Comfortable Footwear: High heeled and fashionable footwear can aggravate the condition. So, it’s wise to wear cushioned footwear with low heels or completely no heel so that you will be comfortable while walking. Nowadays, footwear are specifically designed to assist in the treatment of arthritis.
- NSAIDs: Nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen sodium helps in alleviating the pain as well as inflammation in the knee joint. Some NSAIDs are available in the form of gels and creams, which is extremely useful. All you have to do is rub or gently massage on the affected joints. However, consult your physical before diagnosing the medicines.
- Corticosteroid Injections: Corticosteroid Injections generally contains prednisone and cortisone, which effectively reduces swelling and pain in the knee joint.
- Synvisc or Joint Lubricant Injections: This drug is injected in the affected joints to reduce the pain and it generally contains gel to lubricate the joints in the knee.
- Gentle Massage: Regularly massaging gently on the affected joints will improve the range of motion. However, ensure you consult a qualified massage therapist. Massaging will reduce the pain and stiffness in the knee.
- Herbal Supplements: There are many herbal supplement that can alleviate the pain and reduce the inflammation in the joint. Some of the effective and useful herbs are boswellia, bromelain, devil’s claw, ginkgo, stinging nettle, aloe vera, cat’s claw, eucalyptus, ginger, green tea, thunder god vine, turmeric, willow bark, etc.
- Surgical Treatments: If ever you are not getting relief from the pain, doctors may recommend surgery. Some of the common knee surgeries for arthritis are:
- Arthroscopy: Small incision is made with thin instruments to treat the problem but it is actually conducted when arthritis is accompanied with any meniscal tear. Otherwise, arthroscopy for arthritis is debatable and not often recommended.
- Cartilage Grafting: Healthy cartilage is transferred from another part of the knee to fill the affected area. However, this surgery is conducted in younger patients.
- Synovectomy: It is performed to remove the synovium i.e. swollen part of the knee joint. It helps in reducing the pain as well as swelling.
- Osteotomy: In this surgery, one of the two important bones i.e. tibia (shinbone) or femur (thighbone) is cut and reshaped in order to shift the weight to healthy cartilage area and provide relief to the knee joint.
- Arthroplasty: (a) Total Knee Replacement: If the condition is worse, doctors may remove the damaged cartilage and bone. Then, replace it with plastic or metal surface.
- (b) Partial Knee Replacement: It is also known as unicompartmental knee replacement, wherein the only one part of the knee is replaced for proper functioning of the knee joint.
Recovery Period for Arthritis: The recovery from arthritis depends on many factors such as age, health, muscles strength and condition so the joint. A physiotherapist will teach you the dos and don’ts after the surgery. You will continue your activities as usual after 3-12 months. It’s a general recovery period and tends to change according to individuals and type of condition.
The outlook is good and you will be able to walk holding stick or crutches initially. Knee braces are extremely useful post surgery.