How to know if you have arthritis
Arthritis affects more than half a million of us, and is the leading cause of disability in New Zealand. But despite how common it is, many of us don’t recognise the symptoms, or know how to treat it. What is arthritis, and what do you need to know if you think you, or a loved one, may be suffering from it? Arthritis literally means ‘‘inflammation of the joints’’, and can affect any joint in the body. Joints are situated where two bones meet, and their role is to enable movement and flexibility of body parts. Joints can move when the tendons and muscles attached to the bones pull in certain directions.
Cartilage covers the end of each bone protecting the surface, and between the cartilage, in the ‘‘joint space’’, is a layer of thick liquid, known as synovial fluid, which acts as a cushion. In arthritis, this area becomes inflamed, causing swollen, painful, stiff and sometimes red joints. Symptoms include:
Ongoing or recurring pain or stiffness in one or more joints.
Recurring swelling in one or more joints.
Generalised aching, stiffness and fatigue.
Weakness and muscle wasting around the affected joint.
Warmth and redness of the skin over an affected joint.
Depending on the sort of arthritis, one or multiple joints can be affected. There are more than 140 different sub-types, so working out which particular type is causing symptoms can be difficult. The most common types in New Zealand are: Osteoarthritis (OA) – also known as degenerative joint disease, OA reflects ‘‘wear and tear’’ of joints.
Typically it will affect either big, ‘‘weight-bearing’’ joints (such as hips, knees and backs) or joints that do lots of repetitive works (such as hands). As it results from long-term joint ‘‘over-use’’, it is more common as we age, but is also more common in people who do lots of sport or heavy work.
This type of arthritis causes pain and stiffness after a period of inactivity, so tends to be worse after sitting down for a while, for example. Over time, it can cause quite obvious deformities, especially of the hands, and can be very disabling. There is no ‘‘cure’’ for OA, but symptoms can usually be managed to an extent with analgesia, exercise or surgery. Rheumatoid arthritis (RA) – although rarer than OA, it is a really important type of arthritis, as left untreated it will lead to progressive damage, deformity and destruction of joints.
It affects more women than men, and is usually first noticed in the 20-55 year age range. Any joint may be affected by RA, but most commonly hands, knees, feet and wrists, and often in a symmetrical pattern. The pain, swelling and stiffness of RA is classically worse in the morning, and tends to ease a little as joints ‘‘loosen up’’.
RA can be hereditary, and is an autoimmune condition, which means that it can affect other systems of the body too, most commonly skin and eyes. As well as pain relief and exercise, there are ‘‘disease modifying drugs’’ available for RA, which will slow down or halt deterioration. Gout – this is caused by a buildup of uric acid in the blood, and can be triggered by certain foods, medications or alcohol. Acute gout ‘‘flare ups’’ classically cause a very red, hot, swollen and excruciatingly painful joint. Any joint can be affected but most common are big toes, knees and hands. Flare-ups can be treated with anti-inflammatory medications, but prevention with medication and dietary changes is the better option. Septic arthritis – this is a result of an infection in the joint space, and although uncommon is very serious and needs immediate treatment, usually in hospital. It presents suddenly, with pain, tenderness and reduced movement in a joint, and is usually accompanied by malaise or fever. If treated promptly, it shouldn’t cause long-term problems. Ankylosing spondylitis (AS) – typically AS affects men, in the 13-36 age range. It is an inflammatory condition, affecting the joints in the spine, and leads to progressive pain, stiffness and sometimes permanent disability. AS can be hereditary and is associated with the HLA B27 gene that can also cause some types of bowel disease.
Although there is no single test to detect arthritis, if you have any of the symptoms discussed above, it is important to visit your GP or a joint specialist (rheumatologist) to get the correct diagnosis and treatment as soon as possible. For more information, visit .
Dr Cathy Stephenson is a GP and medical examiner.