There are two broad categories of arthritis - inflammatory and osteoarthritis, and they
all have individual sub-features. Rheumatoid arthritis has particular features - it affects
the small joints of the hands. For example, gout may affect peripheral joints, but it
can have other distributions too, ankylosing spondylitis may affect the back, and some peripheral joints,
and osteoarthritis tends to affect more the large joints but also the small joints in
the tips of the fingers. They can be interchangeable, so osteoarthritis can have inflammatory components,
and rheumatoid arthritis can go on to have osteoarthritis changes. Fortunately there
are very clearly defined ways of assessing patients both clinically and in terms of different
investigations to determine the form and type of arthritis each individual has - and we
also have very many effective treatments which can be tailored to that individual, to help
reduce the symptoms or to get them into remission, and in some cases into drug free remission.
Arthritis sometimes may have no symptoms, only have some clues in the blood tests and
other investigations that we might be doing, but often the cardinal symptoms are: pain
and swelling, stiffness, and difficulty with movement or function and disability generally.
There can also be systemic features so not the joints, but other parts of the body might
be affected, such as the lungs or kidneys, or muscles. The key features as far as the
joints are concerned are pain and swelling. If there is any swelling that's a high probability
of inflammation or infection or something significant with the joint, and the individual
should be assessed. It really should be looked at as a medical emergency because having
any symptoms leads to loss of function, which then takes a huge amount of effort to recover
and to improve. So it's best to prevent progression and get timely treatment - we're going to
be covering treatment later on - but if we delay treatment, conditions are less responsive,
and may not be as effective, and so it's really important that the treatment is carried out
as early as possible with the appropriate drugs.
Fortunately there are several different treatment approaches in arthritis that have been proven
to be effective. We can broadly categorise them into non-drug, drug, and surgical. The
aim of all treatment should be to eradicate the symptoms, and to restore function, and
if we treat early and if we treat appropriately, we should be able to achieve that in the majority
of cases - and in some cases, we are even able to achieve drug-free remission, drug-free
and symptom free, and restore the individual back to their former health. The range of
option that we might have in broad categories: there's non-drug, such as nutrition, exercise,
physiotherapy - of the drug treatments there are a number of different agents, and they
can be administered in a range of different ways such as tablets, creams, infusions or
injections into a given joint, and of the surgical approaches, maybe keyhole surgery
or open joint surgery. All of these treatments used appropriately can help significantly
or fully control symptoms, and restore function, and hopefully prevent progression of the condition.
Our understanding of arthritis and the risk factors has improved significantly - there
are a number of genetic factors that cannot be changed - but there are also some lifestyle
factors that can be altered, and the risk of developing arthritis reduced, such as smoking,
alcohol, diet, exercise can have a role to play. But it's important to bear in mind that
if you do have any symptoms, to seek help early - even such a thing as a tennis elbow
or a symptom related to a given one joint can have an impact on the related structures
and lead to muscle wasting, and lead to some loss of function or disability, and reduce
your energy and your productivity. Treatment early is more effective than waiting for a
period of time before you have treatment, or some degree of disability has set in. So
we would advise you to seek help early to be fully assessed and have adequate treatment
to help reduce the symptoms and to prevent any progression, and hopefully get to a point
where you are symptom-free and you don't need any ongoing treatment.