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Arthritis

What is Arthritis?

Arthritis is characterized by the inflammation of one or multiple joints. Its main symptoms are joint pain and stiffness that worsen over time. Though it is most prevalent in older people aged 65 and above, this joint disorder can also develop in younger adults, sometimes even affecting children and teenagers. It has been found to affect more women than men, as well as those who are overweight.

Contrary to what many people think, arthritis is not a single disorder; in fact, it has over 100 types, each having different causes and treatments. The most common types, however, are osteoarthritis, in which the cartilage deteriorates, and rheumatoid arthritis, a disorder where the body’s immune system attacks the joints.

Damage done to the joints are irreversible, but their progression can be stopped and their symptoms relieved through targeted treatments, which vary depending on the type and stage of the arthritis.

What Causes Arthritis?

With more than a hundred variations of arthritis, the cause greatly depends on its specific type. The different causes are generally:

  • Hereditary Factors – Having a close relative with some form of arthritis can increase the risk of one developing the condition.
  • Environmental Factors – Exposure to toxic substances and excessive heavy lifting may trigger or worsen the condition.
  • Infections – Certain variations of the illness, such as septic joint inflammation, are caused by bacterial, fungal or viral infections. Some infections also result in the thinning and deterioration of the cartilage, which lead to joint pain and arthritis.
  • Injury – In some cases, arthritis is caused by damage due to past trauma and injury to the joints.
  • Metabolic Disorders – Gout, for instance, is caused by unhealthy levels of uric acid in the blood, which results in swollen joints and tenderness.
  • Autoimmune Diseases – Lupus and rheumatoid arthritis or rheumatism are caused by an overactive immune system that mistakenly attacks the joints, resulting in pain and inflammation.
  • What Are the Risk Factors for Arthritis?

    There are certain risk factors involved when it comes to the joint disorder, and while some can be controlled (modifiable, others cannot (non-modifiable).

    Typical modifiable risk factors include:

    DietCertain types of food are unhealthy and can lead to obesity or metabolic complications like gout.
    InjuryBone fractures or trauma to the ligaments and cartilage in the joints could lead to pain and inflammation.
    Sedentary lifestylePhysical inactivity leads to metabolic disorders, which in turn may result in arthritis.
    SmokingIt increases the chances of developing rheumatoid arthritis and lupus, and worsens their symptoms as well.
    WeightBeing overweight or obese increases the risk of developing knee and hip osteoarthritis.
    Work environmentSome occupations involve placing excessive pressure on the joints, be it through constant standing or heavy lifting.

    Risk factors that are non-modifiable include:

    AgeThe chances of getting arthritis increase with age.
    GenderWomen are more likely to have rheumatoid arthritis or rheumatism, while men are more inclined to have gout, lupus and ankylosing spondylitis.
    GeneticsA close genetic link to someone with the disease can make one more likely to develop the joint disorder.

    What Are the Symptoms of Arthritis?

    Depending on the type of arthritis, symptoms can vary. Common symptoms include:

  • Joint pain
  • Joint stiffness
  • Joint swelling and redness
  • Joint tenderness
  • Joint warmth
  • Limited joint movement
  • Limping
  • Locking of joint
  • Weakness
  • Symptoms are said to be much worse in the morning, upon waking up. In some cases, the joint condition may trigger uncommon symptoms such as fever, swollen lymph nodes, weight loss and malaise.

    How Is Arthritis Diagnosed?

    The first step in diagnosing arthritis and identifying its specific variation is through a thorough physical examination. During this stage, the doctor or rheumatologist will check for the presence of fluid, warmth, tenderness and limited motion around the joints. Depending on the prognosis and the suspected type of arthritis, the specialist may recommend further testing, such as:

  • Laboratory Tests – Drawing and analysing blood, urine and fluid from the affected joint can help the doctor determine the type of arthritis.
  • X-rays – Usually, X-rays are conducted to determine the severity of damage done to the cartilage and bone.
  • Computerized Tomography (CT) Scan – A CT scan can show an image of the affected area in various angles, giving the physician a clearer look at the bone and soft tissues.
  • Magnetic resonance imaging (MRI) – An MRI scan can give a detailed view of the cartilage, ligaments and tendons.
  • Ultrasound – Aside from being used as a guide during injections and aspirations, ultrasound can also be used to produce images of soft tissues, bursae and cartilage.
  • From the results of these tests, the physician will then give a final diagnosis and recommend a customised treatment for arthritis.

    How to Treat Arthritis?

    The purpose of arthritis treatments is to help manage the pain and discomfort that comes with the disorder, and prevent further damage to the joints. At home, people find relief with hot or cold packs, while others use canes or walkers to relieve pressure from sore, weight-bearing joints. Physical therapy is commonly used to move and strengthen the joints, keeping them as flexible and functional as possible.

    Additionally, the doctor may prescribe medications, such as:

    • Analgesics for pain management
    • Nonsteroidal anti-inflammatory drugs to reduce pain and inflammation
    • Capsaicin or menthol creams to block the transmission of pain signals
    • Immunosuppressant to control inflammation
    • Corticosteroids or disease-modifying anti-rheumatic drugs to suppress the immune system (for those with rheumatoid arthritis or rheumatism)

    Osteoarthritis treatment, for example, usually requires medicines to manage inflammation and pain, and very rarely necessitates surgery. For more advanced stages, however, surgery is required, the most common of which are:

  • Joint repair – Typically done arthroscopically, this procedure involves smoothing or realigning the joints to improve joint function and reduce pain.
  • Joint replacement – Commonly used on the knees and hips, this procedure removes the damaged joint and replaces it with an artificial one.
  • Joint fusion – This involves joining two ends of joints in a bone so that they heal into one unit. It is usually done for smaller joints in the fingers, ankles and wrists.
  • Our Services

    There are more than 100 different types of rheumatic disorders. Our team works together to diagnose and treat the full spectrum of these disorders, including autoimmune diseases, such as lupus, rheumatoid arthritis and psoriatic arthritis, as well as other forms of arthritis, such as osteoarthritis, gout and Arthritis. Treatments for the various conditions may include lifestyle changes, medication and surgery. A/Prof Leong will tailor each treatment plan to effectively manage the condition in each patient.

    Click on each service to find out more

    About Our Arthritis Specialist

    A/Prof Leong Keng Hong is a senior consultant rheumatologist at Gleneagles Medical Centre and an Adjunct Associate Professor at Yong Loo Lin School of Medicine at the National University of Singapore. He is the founder of the Osteoporosis Society (Singapore) (OSS), established in 1996, and served as its President until 2004. He also served as the Inaugural Chairman of the Chapter of Rheumatologists in the Academy of Medicine, Singapore from 2004-2007 and was delegated as Chairman until 2013.

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