Managing rheumatoid & osteoarthritis arthritis

There are two main types of arthritis; Rheumatoid arthritis and Osteoarthritis:

Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune disease; the immune system targets the joints attacking first the synovium (the outer cover of the joint) before starting to break down bone and cartilage beneath, altering the joint’s shape. Rheumatoid arthritis is a chronic (long-term) condition. Hands, feet and wrists are most commonly affected by swelling pain and stiffness in the joints. Women are more likely than men to develop the condition. This is thought to be because of rheumatoid arthritis-specific genes that are specific to the X chromosome (women have two X-Chromosomes, whereas men have one).

Osteoarthritis

Osteoarthritis is the most common form of arthritis. Areas of the body that are most frequently affected are the knees, hips, hands and spine. It happens when there is damage to the joints that the body is not able to heal successfully. The condition initially affects the soft cartilage, causing it to erode. This means bones in the joints then start rub against one another causing pain and stiffness. Again, more women are more likely to develop the condition due to a range of factors: hormonal (as oestrogen levels decline), biology (women’s lower body is designed to be more elastic for childbirth) and genetics.

Managing Rheumatoid Arthritis

Though it is not possible to cure rheumatoid arthritis, early treatment can reduce the amount of damage that is caused to the joints and therefore limit the progression of the condition. There are a wide range of treatments that can help;

• Physiotherapy (helping build muscle strength and flexibility of joints)
• Chiropractic/Acupuncture/Osteopathy
• Podiatry (treat foot problems such as misalignment, provide orthotics and joint supports)
• Regular exercise, though not very tempting if you are suffering from rheumatoid arthritis, does help the condition by helping keep the joints flexible, maintain muscle strength, and helping you to keep weight levels down (even carrying a little extra weight can exacerbate symptoms)
• Diet (some people find that they can identify trigger foods to flare-ups of the condition)
• There are medications available. As usual, with pharmaceutical products, there are side effects that go with them. The following types of medication are often prescribed:
• Painkillers (particularly NSAIDs due to anti-inflammatory response)
• DMARDs (these block the chemicals that attack the joints during the body’s immune response)
• Biological medications (these block the chemicals that activate the joint-attacking immune response)
• Corticosteroids (can reduce pain and inflammation in the short-term)
• Surgery, which again, comes with a lot of risks. There are surgeries that are used for specific areas such as:
• Hands/wrists: Carpal tunnel release, release of tendons in fingers, removal of inflamed tissues around the finger joints
• Arthroscopy: Joint tissue removal
• Joint replacement

Managing Osteoarthritis Arthritis

Again, there is no cure for this condition, but there are treatments that can limit its impact:

• As with rheumatoid arthritis, graded exercise is essential to maintain mobility and strengthen muscles.
• Extra weight can worsen the pressure on the joints, so it is important to eat healthily
• Painkillers can be taken consumed or applied topically to treat the pain. Anti-inflammatories (NSAIDs such as ibuprofen, etc.) and COX-2 medications are often used, but these are not suitable for everyone and tend to break down the stomach lining causing further issues such as peptic ulcers. For this reason, proton pump inhibitors (PPIs) are often taken in combination with NSAIDs. Capsaicin cream applied topically, may also be used if painkillers do not have enough effect. Again, corticosteroid injections may also be prescribed in severe cases.
• TENS machines (electrical stimulation) and applying hot and cold packs may also help with the pain.
• Manual therapy (a type of physiotherapy using hands to manipulate joints and muscle tissue) can also help to ease pain and maintain flexibility.
• There are a number of assistive devices available based on your specific osteoarthritic difficulties, for instance, there are aids to assist with tap turning, splints for resting joints, walking aids, insoles and so forth.