9 October 2020

On October 12 many countries celebrate World Arthritis Day, which has been held annually at the initiative of the World Health Organization (WHO) since 1996.

The main goals of this Day are to draw the attention of the general public around the world to the problem of rheumatological diseases, to raise awareness of arthritis in all its forms, to unite the efforts of doctors, patients and the public in addressing issues of prevention, early diagnosis, medical and social rehabilitation of patients with this disease.

Arthritis is a serious inflammatory disease of a joint or several joints that, if untreated, leads not only to pain and limited movement, but also to disability and work incapacity. The causes of the disease are different. Often arthritis occurs with repeated minor injuries, open or closed injuries of the joints, with frequent physical overstrain or with a genetic predisposition. In addition, viral and bacterial infections, hypothermia, physical and mental overload and even excessive smoking provoke the development of arthritis. In some cases the factors of disease’s occurrence and the mechanisms of development are not fully clarified.

The inflammatory process causes a violation of the structure and function of the joints that leads to pain, stiffness, swelling, which ultimately leads to irreversible destruction and disability of the patient. In general, a large group of joint diseases, which includes more than 100 diagnoses, is called arthritis. The most common of them are arthrosis and rheumatoid arthritis.

The most dangerous thing is that any person from a baby to an old man may be at risk for this disease. But most often severe rheumatic diseases of the joints associated with the rapid development of arthritis affect the working people aged between 30 and 50. By the way, women suffer from this disease 5 times more often than men. Moreover, joint diseases can not always be recognized immediately because of their "hiddenness" and "disguise", and subsequently they need long-term and constant medical supervision and treatment, and patients need rehabilitation and social adaptation.

Therefore, underestimating the importance of the problem associated with pain in the joints and spine leads to late visits to doctors and, as a result, reduces the patients' chances to recover or achieve remission and increases the risk of disability.

Today joint diseases have become literally a global problem. According to the WHO, every tenth inhabitant of the planet suffers from arthritis. And over the past decade, the tendency towards an increase in the number of the musculoskeletal system and connective tissue diseases, including arthritis, has not decreased, and rheumatological diseases occupy high positions in the ranking of causes for morbidity and disability.

Although the causes of arthritis are varied, doctors are unanimous in the opinion that the best cure for arthritis is prevention. You can reduce the risk of developing these diseases by following a few simple tips: spend more time outdoors, refuse bad habits, lead a healthy lifestyle and do not neglect physical exercise and proper nutrition. And all this should be regardless of the person’s age and his occupation. After all, it’s clear that the body's ability to resist disease depends on the general physical condition and mental balance.

Due to the breadth and severity of the problem, the World Arthritis Day becomes increasingly relevant every year. As part of this day, special attention is paid to the prevention of illness and measures that help to coordinate actions in tandem "patient-doctor" in the best way.

Clinical picture

The disease is caused by disturbances in metabolic processes inside the joint, as a result of which there is an increase in the synovium that leads to tissue proliferation and destruction of cartilage. Excess fluid in the joint stimulates inflammation and causes pain and fever.

Signs of arthritis can appear gradually, ranging from a simple feeling of slight swelling and discomfort in the flexion of the joint or phalanges of the fingers to acute pain and other symptoms.

Types

According to the localization, arthritis is divided into:

  • monoarthritis – arthritis in a single joint;
  • oligoarthritis (two or three affected regions);
  • polyarthritis – arthritis of more than 3 joints.
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According to the type of changes, arthritis is divided into: 

  • inflammatory arthritis, which is characterized by the presence of inflammation,
  • degenerative arthritis, when first there is a malnutrition of the cartilage, dystrophy, a change in the appearance of the affected joint, followed by its deformation.
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Arthritis can be acute or chronic:

  • Acute arthritis develops rapidly, accompanied by severe pain and inflammation in the tissues which disappear in 2-3 days.
  • Chronic arthritis progresses gradually, slowly becoming a serious illness.
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Due to the origin of the disease, arthritis is divided into:

  • Infectious or suppurative arthritis. It manifests itself under the influence of a certain infection.
  • Rheumatoid arthritis. Formed due to the predominance of infectious and allergic diseases. This type is more dangerous than the first, as it often spills over into chronic inflammation. If rheumatoid arthritis is left untreated, the person may experience difficulties in walking.
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  • Juvenile rheumatoid arthritis. This type is predominantly found in children under the age of 16. Unfortunately, the etiology of the disease is still unknown, but it has serious consequences: difficulties in walking and disability in children.
  • Reactive. Reactive arthritis manifests itself mainly due to changes in immunity in people who have a hereditary disposition to insufficient utilization of antigen complexes. Sometimes reactive arthritis can be the consequence of many infections. Most often it is a result of enterocolitis.
  • Gouty arthritis. Usually one joint is affected, an attack of pain develops at night or in the early morning hours. If the disease is untreated, attacks recur more often and last longer, the level of uric acid in the blood is increased.
  • Osteoarthritis. The joints become disabled over several years. A characteristic feature is a crunch in the fingers or toes. It is dangerous because it can affect the spine and may begin to swell and hurt.
  • Traumatic. It manifests itself in the presence of open and closed joint injuries and in the case of regularly occurring minor injuries.
  • Rheumatism – a chronic connective tissue disease with predominant damage to the heart and joints. Its etiology is also not clear, as well as the reasons for the development of rheumatoid arthritis.
  • Arthrosis – a form of arthritis which affects only the joints and periarticular tissues and not any other organs.
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Causes

An unambiguous and precise cause of arthritis has not yet been determined, but doctors have identified some factors that can trigger the development of arthritis:

  • infections caused by bacteria, fungi, viruses;
  • allergies;
  • metabolic disease;
  • injury;
  • lack of vitamins (vitamin deficiency);
  • insufficient intake of nutrients;
  • diseases of the nervous system;
  • disorders in the immune system;
  • excessive load on the joints;
  • unhealthy diet, including. the use of alcohol;
  • overweight;
  • endocrine disorders;
  • genetic predisposition;
  • bites of insects, such as wasps, bees, etc.
  • hypothermia;
  • some diseases: tuberculosis, brucellosis, gout, dysentery, gonorrhea.

Arthritis symptoms

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The leading symptom of arthritis is pain in one or more joints. At first, they are weak and practically do not affect the ordinary life of a person. Over time, the pain syndrome grows: the pain becomes wavy in nature, intensifying with movement, at night and closer to morning. The intensity of pain varies from mild to very strong that dramatically impedes any movement.

Secondary symptoms:

  • morning stiffness,
  • swelling,
  • redness of the skin,
  • an increase of local temperature in the area of inflammation,
  • deterioration of the patient's motor activity, 
  • limiting in his mobility,
  • the formation of persistent deformities of the joints.
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It's important to remember that the first sign of arthritis is pain. In the initial stages, it is weakly expressed, in the acute period it is especially pronounced, and in chronic arthritis it can change (from mild to strongly expressed and vice versa). As mentioned above, symptoms can be different for different types of disease.

The stages of the disease

Symptoms of arthritis are different in manifestations of pain and aggravation of pathological processes from stage to stage. So, if the disease flows into a complicated form, then the symptoms will be more noticeable. Let’s consider all four stages of arthritis manifestation:

1st stage

Clinically, the disease does not manifest itself, but the first signs of inflammation are present on X-rays of the joints. Sometimes there is a slight stiffness of movements and periodic pain during physical exertion.

2nd stage

The progressive inflammatory process leads to thinning of the articular structures tissue and erosion of the bone heads. Swelling appears in the area of the affected joints; often there is a local increase in temperature and redness of the skin, movements are accompanied by a crunch.

3rd stage

The third stage of the disease is characterized by the following symptoms:

  • X-ray examination shows severe deformation;
  • Often a person is assigned a disability at this stage;
  • Mobility is limited, it is difficult for the patient to move if the lower body is injured;
  • Arm movements are made with great difficulty. It becomes difficult for the patient to make even basic self-care actions. The hands are affected symmetrically;
  • Pain follows a person even when he is at rest;
  • The limbs are fixed in the wrong position due to muscle spasm caused by pain. This ultimately leads to even greater deformation of the joints.

4th stage

Leads to almost complete immobility of damaged joints, with severe pain around the clock. It is impossible to move independently. Negative changes in the bones already become irreversible. If the knees are affected, muscle contractures are formed.

Complications

Ignoring the symptoms of arthritis can lead to serious complications that trigger other diseases:

  • Diseases of the internal organs.
  • Cardiac insufficiency.
  • Soft tissues damage.
  • Tendon ruptures.
  • Spine dislocation.
  • Numbness in the arms and legs.

Despite the fact that arthritis is a common condition that most people face, its treatment should be taken responsibly. Timely diagnosis and treatment will help maintain flexibility and mobility of the joints, which will make it possible to lead an active lifestyle even in old age.

Diagnostics of arthritis includes:

  • complete blood count, biochemical analysis; 
  • urine test;
  • X-ray allows to determine the condition of the bones and identify changes caused by arthritis;
  • computed tomography for assessing the state of soft tissues;
  • magnetic resonance imaging helps to more clearly examine the state of bone structures as well as soft tissues;
  • isotopic scanning of the skeleton;
  • ultrasound helps to determine the degree of damage to large joints;
  • analysis of synovial fluid helps to identify in infectious arthritis, inflammatory agents and to choose an appropriate treatment method;
  • arthroscopy is an endoscopic method which involves the introduction of a special sensor into the joint cavity to study its condition;
  • arthrography determines the condition of the cartilage and soft tissues that surround the joint;
  • myelography assesses the condition of the spinal cord, spine and its roots and is used in conjunction with a computer tomograph.
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Arthritis treatment

The sooner you worry about treatment, the greater the benefit. The first stages of arthritis already affect the joints, and the process, if properly treated, can be slowed down. Special exercises therapeutic physical training are developed, they are prescribed during the improvement period so that the muscles develop flexibility. Effective medications are also prescribed.

Arthritis treatment depends on the stage and form of the disease. Therefore, at the first signs, be sure to contact a specialist and do not self-medicate.

How to treat arthritis without medication?

Reducing load on diseased joints:

  • selection of orthopedic shoes with comfortable sole;
  • weight loss;
  • the use of knee pads, arch supports, walking sticks;
  • a complex of physiotherapy exercises that can be performed in different initial positions and in water.

Gymnastics should not cause discomfort or cause pain. Squats and exercises with bent knees should be excluded. A visit to the pool is recommended.

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Physiotherapeutic procedures:

  • heat treatment;
  • magnetic therapy for joints;
  • ultrasound;
  • massage;
  • hydrotherapy;
  • acupuncture;
  • laser therapy;
  • electropulse muscle stimulation.

To prescribe any physiotherapeutic procedures, the patient should have no contraindications. The patient must get rid of bad habits and drinking large quantities of coffee forever.

Dieting

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The goal pursued by nutritional therapy for arthritis is to normalize the immune response, weaken inflammatory responses and restore the full mobility of the affected joint. General recovery nutritional rules for any type of arthritis have been developed:

  • food should be low-calorie, the diet is aimed to not gain excess weight which puts load on the joints. It is necessary to remove the extra kilograms;
  • it is necessary to balance the intake of all necessary components;
  • food should be steamed, boiled or stewed, but not fried;
  • to restore the damaged structure of the joint, it is recommended to eat food made from boiled bones (jellied meat), which you can eat as much as you like, it has natural chondroprotectors that restore cartilage tissue, but such dishes should not be eaten for gout;
  • fatty meat is prohibited – fats can only be of vegetable origin;
  • fresh juices from fruits, beets and carrots help enrich the body with vitamins, remove toxins and slags from it;
  • it is necessary to abandon alcohol, strong coffee and tea, limit the use of pickles, seasonings and hot spices, except for ginger and turmeric.

The energy value of the diet is 2170-2400 kilocalories per day, and the nutrient content corresponds to the following scheme:

  • proteins – 85-90g, of which 45-50g are of animal proteins;
  • fats – 70-80g, of which 25-30g are of vegetable fats;
  • carbohydrates – 300-330g, no more than 30-40g of which are complex sugars.

For overweight, a hypocaloric diet is shown, the energy value of which is 1340-1550 kilocalories per day.

Prevention

Although the causes of arthritis are varied, doctors are unanimous in the opinion that the best cure for arthritis is prevention. You can reduce the risk of developing these diseases by following a few simple tips: spend more time outdoors, refuse bad habits, lead a healthy lifestyle and do not neglect physical exercise and proper nutrition. And all this should be regardless of the person’s age and his occupation. After all, it’s clear that the body's ability to resist disease depends on the general physical condition and mental balance.

Therefore, it is important to remember that only early diagnostics and timely treatment can prevent serious consequences for the patient with arthritis. According to the doctors, arthritis can be cured with early diagnostics and individually tailored treatment. Therefore, the diagnostics of arthritis is a very important step to recovery, and modern methods of therapy can significantly improve the quality of a patients’ life.

Joint prevention should be taken care of by people who are at risk for their professional activities. And also by patients:

  • with a heredity to arthritis;
  • who survived viral diseases;

You can reduce the risk of developing pathology if you adhere to several rules. The attending doctor is obliged to tell about preventive measures, especially to persons of advanced age. Prevention of arthritis of the joint involves:

  • weight control;
  • avoidance of injuries while walking, playing sports;
  • protection of joints from excessive load.

If you feel that pain comes back or noticed redness and swelling, see your doctor. Timely seeking medical help will prevent severe destruction of the joints.

 Valeologist
of the 4th City Clinical Hospital named after M. Saŭčanka U. Čarnoŭ

The material is based on the information from WHO and open sources