Arthritis Treatment in Mumbai, India

Arthritis is the tenderness and inflammation of one or multiple joints in the body. The symptoms usually worsen with age and primarily involve stiffness and pain. Rheumatoid arthritis and osteoarthritis are the most common types. Treatment depends on the type and progression of arthritis, with improving the symptoms as the primary goal.

Associated Anatomy

Elbows, wrists, shoulders, feet, knees, ankles, jaw, and neck.

Alternative Name of Arthritis

Arthritis is also called osteoarthritis and degenerative joint disease.

Arthritis Symptoms

Common Symptoms of Arthritis Include:

• Pain, redness, and swelling in the joints
• Problems in mobility
• Breathing issues
• Rash or itch
• Fever
• Weight loss

Arthritis Types and Causes

There are mainly two types of arthritis – rheumatoid arthritis and osteoarthritis. Both of these affect the joints in different ways, causing the condition.

Osteoarthritis: This is the most common form of arthritis and causes wear and tear of the joint cartilage. 

Cartilage usually cushions the ends of two bones in a joint and is responsible for the joints' frictionless movement. Damage to the cartilage can cause a bone to grind directly and lead to pain and mobility restrictions.

Rheumatoid arthritis: In this type of arthritis, the body's immune system attacks the joint linings, causing them to become inflamed. 

This cause eventually destroys the bone and the cartilage and leads to long-term pain, immobility, and discomfort.

Common causes of most types of arthritis include:

• Overuse of joints results in wear and tear
• Age
• Obesity
• Injuries
• Autoimmune disorders
• Muscle weakness
• Genes/family history

Arthritis Stages

Arthritis is broadly classified into four stages:

Stage I: Minor

• Slight wear-and-tear of the joints
• Light or no pain

Stage II: Mild

• Noticeable bone spurs 
• Stiffness in the affected area
• May require the use of braces

Stage III: Moderate

• Erosion of cartilage in the affected joints
• Inflammation of the joint leads to discomfort during day-to-day activities 

Stage IV: Severe

• Intense pain
• Complete erosion of the cartilage, resulting in an inflammatory response
• Overgrowth of bony spurs

 Arthritis Tests

The first step for detecting arthritis is to get a physical exam done by your primary care physician. They will check for fluid around joints, red or warm joints, and range of motion. 

Rheumatoid Doctors may perform blood tests to detect rheumatoid factors, antinuclear antibodies, and anti-cyclic citrullinated peptides. 

Doctors may also order imaging tests such as X-rays, CT scans, and MRIs to get a clearer picture of the suspected cartilage and bones. This can also be used to detect bone spurs.

Arthritis Treatment  

The goal of treatment in arthritis is to alleviate pain and prevent further damage to the joints. Usually, a combination of one or more of these treatment options is used:

• Supplements and medications: Medications like analgesics, NSAIDs, capsaicin creams, and steroids may be used to alleviate pain and inflammation. Doctors may prescribe immunosuppressants for severe forms of inflammatory arthritis such as RA. It is also good to regularly take supplements such as turmeric and fish oil to reduce the inflammation associated with arthritis.
• Physical therapy: Physical therapy is recommended to help strengthen the muscles surrounding the affected joints.
• Nutrient-rich diet: A diet filled with all essential nutrients such as fresh vegetables, fruits, fish, nuts, and herbs can help reduce inflammation associated with arthritis. If diagnosed with arthritis, avoid some foods such as dairy products, excessive meat, and highly processed foods.
• Weight loss: Losing weight is a great way to help reduce arthritis symptoms.
• Regular exercise: Exercising regularly will help keep joints flexible and symptoms at bay. Swimming is an excellent exercise for arthritis, as it does not exert any pressure on the joints yet makes them move.
• Cold and hot compress helps with inflation and relieves pain and stiffness. 
• Devices for mobility assistance, such as walkers and canes, can reduce pressures from the affected joints and facilitate smoother mobility.

Arthritis Prevention

Certain factors that may cause arthritis are beyond control, such as old age or family history. However, a few steps can prevent arthritis or delay its onset:

Maintain a healthy weight: Excess weight puts extra pressure on the knees and hip joints. Therefore, maintaining a healthy weight will help keep the stress off the joints and alleviate pain.

Control blood sugar: High level of sugar stiffens the tissues and makes the joints more sensitive to stress.

Regular exercise: Exercising regularly helps keep the joints limber and strengthens the muscles supporting the hips and knees.

Avoid injuries: You are more likely to get arthritis in an injured joint. So, make sure to wear protective gear while working out and playing sports.

Arthritis Risk Factors

Common risk factors of arthritis include:

Age: Old age can cause many types of arthritis, such as rheumatoid arthritis, gout, and osteoarthritis. The symptoms of arthritis worsen with age as well.

Family history: Some forms of arthritis are genetic and run in the family. If your parents or sibling have arthritis, it may predispose you as well.

Previous joint injury: One may develop arthritis in a particular joint if they have previously injured it, perhaps while working out or playing sports.

Obesity: Excess body weight puts stress on the joints such as hips, knees, and spine and may lead to arthritis.

Sex: Females are more prone to develop rheumatoid arthritis, whereas males primarily suffer from gout.

Arthritis Complications

Arthritis, depending on its progression, can put a patient at higher risk of developing several conditions, mainly if not appropriately managed. 

Some of these conditions include:

• Carpal tunnel syndrome.
• Inflammation in the lungs leads to pulmonary fibrosis, shortness of breath, and persistent cough.
• Inflammation around the heart results in pericarditis.
• Eye disorders such as Sjögren's syndrome or scleritis.
• Vasculitis.
• Joint damage.
• Cardiovascular diseases like stroke and heart attack.
• Cervical myelopathy.

Pathophysiology

Arthritis is characterized by the dysregulated inflammatory processes in the joints, eventually leading to the obliteration of both the bone and cartilage of the joint. This results in disability and pain.

Epidemiology of Osteoarthritis

The most common joint disease globally, Osteoarthritis, occurs in over 10% of males and 13% of females over 60 years. 

Research suggests that this percentage is likely to increase due to the obesity epidemic and the aging population.

Arthritis Prognosis

Expected Prognosis

Arthritis can reduce a person's life expectancy by 10-15 years. That being said, many people can live with the symptoms till the age of 80 or 90 years. 

Factors such as age, lifestyle conditions such as obesity and smoking, and the disease progression affect the prognosis. The good thing is that due to advances in treatment and medications for arthritis, the prognosis for the condition is better than ever before.  

Natural Progression

Most people experience a gradual worsening of arthritis symptoms over time. As a result, they may experience periods of relief at times. However, the symptoms may flare up and become intense at other times. 

The progression of arthritis depends on several factors, including family history, age, stage of arthritis when diagnosed, specific triggers, and some antibodies in the patient’s blood.

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