ARTHRITIS

Risk Factors


Certain factors have been shown to be associated with a greater risk of arthritis. Some of these risk factors are modifiable while others are not.

Non-modifiable risk factors


Age: The risk of developing most types of arthritis increases with age.


Gender: Most types of arthritis are more common in women; 60% of all people with arthritis are women. Gout is more common in men.


Genetic: Specific genes are associated with a higher risk of certain types of arthritis, such as rheumatoid arthritis (RA), systemic lupus erythematous (SLE), and ankylosing spondylitis.


Modifiable risk factors


Overweight and Obesity: Excess weight can contribute to both the onset and progression of knee osteoarthritis.


Joint Injuries: Damage to a joint can contribute to the development of osteoarthritis in that joint.
Infection: Many microbial agents can infect joints and potentially cause the development of various forms of arthritis.


Occupation: Certain occupations involving repetitive knee bending and squatting are associated with osteoarthritis of the knee.



Arthritis Symptoms


Although rheumatoid arthritis can have many different symptoms, joints are always affected. Rheumatoid arthritis almost always affects the joints of the hands (such as the knuckle joints), wrists, elbows, knees, ankles, and/or feet. The larger joints, such as the shoulders, hips, and jaw may be affected. The vertebrae of the neck are sometimes involved in people who have had the disease for many years. Usually at least 2 or 3 different joints are involved on both sides of the body, often in a symmetrical (mirror image) pattern. The usual joint symptoms include the following:
1.Stiffness: The joint does not move as well as it once did. Its range of motion (the extent to which the appendage of the joint, such as the arm, leg, or finger, can move in different directions) may be reduced. Typically, stiffness is most noticeable in the morning and improves later in the day.


2.Inflammation: Redness, tenderness, and warmth are the hallmarks of inflammation.
Swelling: The area around the affected joint is swollen and puffy.


3.Nodules: These are hard bumps that appear on or near the joint. They often are found near the elbows. They are most noticeable on the part of the joint that juts out when the joint is flexed.


4.Pain: Pain in rheumatoid arthritis has several sources. Pain can come from inflammation or swelling of the joint and surrounding tissues or from working the joint too hard. The intensity of the pain varies by the individual.These symptoms may keep you from being able to carry out your normal activities. General symptoms include the following:


1.Malaise (blah feeling)
2.Fever
3.Fatigue
4.Loss of appetite

5.weight loss
6.Myalgias (muscle aches)
7.Weakness or loss of energy



The symptoms usually come on very gradually, although in a small number of people they come on very suddenly. In some cases, the general symptoms come before the joint symptoms, and you may think you have the flu or a similar illness.
The following suggest that rheumatoid arthritis is in remission:


1.Morning stiffness lasting less than 15 minutes
2.No fatigue
3.No joint pain
4.No joint tenderness or pain with motion
5.No soft tissue swelling



Self-Care at Home


If you have joint pain or stiffness, you may think it is just a normal part of getting older and that there is nothing you can do. Nothing could be further from the truth. You have several options for medical treatment and even more to help prevent further joint damage and symptoms. You should discuss these measures with your health care provider to find ways to make them work for you.


1.First of all, don’t delay diagnosis or treatment. Having a correct diagnosis allows your health care provider to form a treatment plan. Delaying treatment increases your risk that the arthritis will get worse and that you will develop serious complications.


2.Learn everything you can about your condition. Ask your health care provider if you have questions. If you want to learn more, ask him or her to direct you to reliable sources of information. Some Internet resources are listed later in this article.


3.Become an active participant in your care. Know the pros and cons of all of your treatment options, and work with your health care provider to decide on the best options for you. Understand your treatment plan and what benefits and side effects you can expect. If you don’t understand, ask.


4.Learn about your symptoms. If you have rheumatoid arthritis, you probably have both general discomfort (aches and stiffness) and pain in specific joints. Learn to tell the difference. Pain in a specific joint often results from overuse. Pain in a joint that lasts more than 1 hour after an activity probably means that that activity was too stressful and should be avoided.


Increase your physical activity.


1.Exercise is a very important part of a complete treatment plan for rheumatoid arthritis.


2.You may think that exercise is bad for arthritic joints, but research overwhelmingly shows that exercise in rheumatoid arthritis helps reduce pain and fatigue, increases your range of motion (flexibility) and strength, and keeps you feeling better overall.


3.Three types of exercise are helpful: range of motion exercise, strengthening exercise, and endurance (cardio or aerobic) exercise. Water aerobics are an excellent choice because they increase range of motion and endurance while keeping weight off the joints of your lower body.


4.Talk to your health care provider about how to start an exercise program and what types of exercises to do. He or she may refer you to a physical therapist or exercise specialist.


Protect your joints.


1.At least once a day, move each joint through its full range of motion. Do not overdo or move the joint in any way that causes pain. This helps keep freedom of motion in your joints


2.Avoid situations that are likely to strain your joints. Remember that your joints are more susceptible to damage when they are swollen and painful. Avoid stressing the joint at such times.


3.Learn proper body mechanics. This means learning to use and move your body in ways that reduce the stress on your joints. This is especially true for your hands, since you want to protect their flexibility. Ask your health care provider or physical therapist for suggestions on how to avoid joint strain.


4.Be creative in thinking up new ways to carry out tasks and activities.


5.Use the strongest joint available for the job. Avoid using your fingers, for example, if your wrist can do the job.


6.Take advantage of assistive devices to carry out activities that have become difficult. These simple devices can work very well to reduce stress on certain joints. Talk to your health care provider or physical and/or occupational therapist about this.


Alternate periods of rest and activity through the day. This is called pacing.


1.General rest is an important part of rheumatoid arthritis treatment, but avoid keeping your joints in the same position for too long a time. Get up and move; use your hands.


2.Holding the joint still for long periods just promotes stiffness. Keep the joints moving to keep them flexible.


3.If you must sit for long periods, say at work or while traveling, take a short break every hour: stand up, walk around, stretch, and flex your joints.


4.Rest before you become tired or sore.




Take part in activities you enjoy every day.


1.This can improve your outlook and help you put your arthritis in perspective.


2.Some enjoyable activities are even helpful for your joints, such as walking, swimming, and light gardening.


Take steps toward a healthier lifestyle.


1.Losing weight not only helps you look better, it helps you—and your joints—feel better. Reducing weight helps take stress off joints and reduces pain. A healthy weight also can help you prevent other serious medical conditions such as heart disease and diabetes.


2.Eat a varied diet with plenty of fruits and vegetables, lean proteins, and low-fat dairy products. Make sure you are getting enough vitamin C and calcium. Ask your health care provider if you think you are not getting sufficient vitamins and minerals.


3.Quit smoking. Not only will you feel better, but also you will be reducing your risk of complications of rheumatoid arthritis. You will also be reducing your risk of lung cancer, emphysema, and other breathing problems.



Get the most out of your treatment.


1.Take your medications as directed by your health care provider. If you think a medication is not working or is causing side effects, talk to your health care provider before stopping the medication. Some medications take weeks or even months to reach their full benefit. In a few cases, stopping a medication suddenly can even be dangerous.


2.Help yourself. If you feel tired and achy, a warm bath before bed can help you relax and feel better. Massages feel good and may help increase your energy and flexibility. Apply an ice pack or cold compress to a joint to reduce pain and swelling. (Keep a reusable ice pack in your freezer or try a bag of frozen vegetables!)