Arthritis is a broad and complex topic with many types, subtypes, and variations. It is defined as an acute or chronic joint inflammation that often co-exists with pain and structural damage. Arthritis affected both the Neanderthals and ancient Egyptians, Arthritis describes a set of symptoms that includes pain, stiffness, and joint deformities subsequent to an inflammatory process. The destructive process can occur through multiple pathways. Knowing the type of arthritis a person has means that informed decisions can be made.
Arthritis can refer to over 150 different conditions that affect the muscles, bones and joints. These include:
- Degenerative disease (osteoarthritis)
- Post traumatic arthritis
- Spondyloarthritis (including Psoriatic Arthritis, Ankylosing Spondylitis, Reactive Arthritis, Enteropathic Arthritis)
- Auto-immune or auto-inflammatory processes (rheumatoid arthritis and ankylosing spondylitis)
- Crystal deposition (gout and pseudogout)
- Infection (septic arthritis)
- Idiopathic (juvenile idiopathic arthritis).
The goal of this page is to provide a general overview of the most common arthritides and give links to specific arthritis pages.
Healthcare Team Management
Arthritis may be a disease of the joint but it also has systemic repercussions. The management of arthritis is ideally done by an interprofessional team that includes a nurse, dietitian, rheumatologist, physical therapist, orthopedic surgeon, pain specialist, pharmacist, and a Physician.
Almost all patients may benefit from a physical therapy. Ample evidence indicates that water-based exercise can diminish pain and improve joint function. Further, loss of weight also decreases the stress on the joint.
Polypharmacy is a major concern in these patients because of the need to resolve the pain, hence the pharmacist should closely monitor the medications to prevent serious drug interactions and if narcotics are required, monitor for overuse.
Mechanism of Injury / Pathological Process
Arthritis is the swelling and tenderness of joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. The most common types of arthritis are osteoarthritis and rheumatoid arthritis.
Osteoarthritis causes cartilage to break down.
Rheumatoid arthritis is a disease in which the immune system attacks the joints, beginning with the lining of joints.
Gout occurs when uric acid crystals form when there's too much uric acid in the blood.See image
Infections or underlying disease, such as psoriasis or lupus, can cause other types of arthritis.
Arthritis affects people in different ways and each condition will have specific symptoms. However, common symptoms are:
- Swelling, redness and warmth in a joint
- Muscular aches and pain
- Stiffness or reduced movement of a joint
- General symptoms such as fatigue and feeling unwell.
Numerous exams and tests are needed to diagnose which arthritis is present. Including
- Medical history – finding out about symptoms, family history, other health problems in the past
- Physical examination – look for redness and swelling in and around the joint, and check out the range of movement of your joints. Depending on the type of arthritis also look for rashes, check your eyes and throat, and measure your temperature
- Scans and other tests – again, depending on the type of arthritis test may include: blood tests to check for levels of inflammation in blood or specific genetic markers; x-rays; ultrasound; CT (computed tomography) or MRI (magnetic resonance imaging)
- Referral to a specialist – if appropriate your doctor will refer you to a specialist, often a rheumatologist, for diagnosis and specialised management of your condition.
Management / Interventions
Living with arthritis can be different from person to person, and symptoms can vary from day to day. Treatment and management options vary with the type of arthritis, its severity and the parts of the body affected.
There is no cure for arthritis. Management options can include medical treatment and medication, physiotherapy, exercise and self-management techniques.
A range of health professionals in the management of arthritis, including:
- General practitioner (GP) – central to your care and will help you manage day-to-day, as well as helping access other health professionals and services
- Occupational therapist
- Exercise physiologist
The Role of Exercise in Management
This brief video explains the role of exercise.
Conclusion and Physiotherapist Role in Management.
Arthritis is a broad and complex topic with many types, subtypes, and variations. The above is a summary of this expansive subject and links are provided to specific pages. The page gives an introductory synopsis of the arthritides. Physical therapist are trained and licensed in rehabilitation techniques. Physical therapists can help restore function and prevent disability for people affected by arthritis. They can also design exercise programs to help reduce pain and improve the functioning of the joint and MSK areas affected by arthritis.
- Senthelal S, Thomas MA. Arthritis. InStatPearls [Internet] 2019 Aug 22. StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK518992/ (last accessed 23.12.2019)
- Better Health Arthritis explained Available from: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/arthritis (last accessed 23.12.2019)
- CDC Arthritis apin reliever Available from: https://www.youtube.com/watch?v=gWcOGZ6A88E&app=desktop (last accessed 23.12.2019)