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	What are Joints ? A joint is formed by the meeting of the ends of two or more ....    more		About Knee Joint Replacement Knee replacement is a procedure ........   more		FAQ's Like many unsolved diseases, arthritis is probably...........   more
	What is arthritis? Many people use the word "arthritis" without knowing the meaning. Arthritis is really not a single disease. There are over 100 different kinds of arthritis, all of which affect one or more joints in the body. The word arthritis comes from two Greek words, arth meaning "joint" and itis, meaning "inflammation". Thus arthritis is "inflammation of a joint", which is somewhat misleading because in many kinds of arthritis the joint is not inflamed or swollen. The pain however may be nagging. Or at its worst, it can be physically and mentally crippling. Are there different types of arthritis? There are over 100 different types. Some common ones are - Osteoarthritis - Rheumatoid arthritis - Ankylosing spondylitis - Gout - Tuberculous arthritis Why does arthritis occur? The reason why most forms of arthritis occur is a matter of intense research and we don’t yet have all the answers. But the manner in which the joint gets damaged is known. In Osteoarthritis (OA), the cartilage gets thinned out just like the tyres of a car wear out with time and use. At first there is pain. Later the bone ends may actually rub against each other, causing stiffness. In severe cases, the bone ends become roughened and movement becomes difficult. Rheumatoid arthritis (RA), an even more crippling condition, is an autoimmune disease. The joint lining (synovium) becomes inflamed as part of the body's faulty immune system and it attacks and destroys cartilage and bone. Gout is usually the result of a defect in body chemistry with a painful buildup of uric acid crystals in the knees and big toes. Ankylosing spondylitis is a kind of arthritis that affects the spine and joints such as the sacro-iliac joint (connecting the pelvic bones to the spine) and hip joints. The joints get inflamed and loose their flexibility. The joints become stiff (ankylosed). Who gets arthritis? OA usually occurs after the age of 50 and affects one in five people. It is twice as common in women, and most often damages the knee joint. Overweight people, those with previous injury to the joint, overuse or incorrect alignment between the bones (eg, bow legs) are more commonly affected. RA strikes 3% of women and 1% of men, usually between the ages of 20 and 55 years. Gout affects 3-4 persons per 1000. It is mostly seen in men over 35 years. Ankylosing spondylitis also mainly affects men, usually between the ages of 20 and 30 years. How is arthritis diagnosed? To reduce the impact of arthritis, the key is early diagnosis. Doctors diagnose arthritis based on the pattern of symptoms, medical history, physical examination, and may ask for some tests and x-rays. Typical symptoms include pain after walking which may later occur even at rest, creaking sounds in the joint, difficulty in getting up from a chair, and pain on walking up and down stairs. Can arthritis be cured? Once the surface of the joint is damaged it is not usually possible to prevent arthritis from progressing. However, most forms of arthritis can be controlled with appropriate treatment. How is arthritis treated? Treatment must be tailored to the needs of each individual. There are different treatments for the various types of arthritis, and no two cases are exactly alike. The goals of treatment are: Joint Replacement which consists of replacing worn borne ends with artificial ones. Unicompartmental Knee Arthroplasty can be done in selected patients with Osteoarthritis affecting only half of the joint. - to relieve pain - to maintain joint motion and - to prevent further joint damage The treatment recommended by your doctor will be individualized and will depend on the type of arthritis, its severity, and your symptoms. It could include any combination of the following: Dietary supplements: such as chondroitin sulphate and glucosamine, available as over-the-counter tablets, may help to repair partially damaged cartilage in osteoarthritis. Medicines: Many drugs are available to reduce pain and inflammation. The simplest ones are paracetamol and aspirin. Others include non-steroidal anti-inflammatory drugs (called NSAIDs) like ibuprofen, piroxicam, indomethacin and diclofenac. They are best taken only for bad spells. More recently, medicines with lesser side-effects particularly on the stomach, such as meloxicam and celecoxib are also available. Local ointments may be prescribed. Occasionally an injection of cortisone into the joint may help. All these provide temporary relief of pain. For rheumatoid arthritis, there are many powerful drugs to control the disease and these include methotrexate, hydroxychloroquine and sulphasalazine. Physiotherapy: includes exercises to strengthen muscles for supporting and protecting joints, exercises to maintain range of movement and flexibility of joints, heat or cold treatments for pain relief, and use of splints. Surgery: If the pain or disability of arthritis cannot be controlled by the above means, there may be a case for one of the following operations. Arthroscopy. Special instruments are used to look inside the joint through a small opening (keyhole surgery) and remove debris, loose pieces of bone, spurs, and torn menisci. However, it cannot replace the cartilage that is damaged or destroyed. Hence pain often returns after a variable period of time. Osteotomy. This literally means 'the cutting of a bone'. This method is used to change the angle at which the bones forming the joint meet. It is used in younger patients with OA affecting only one half of the knee. The operation shifts the body weight onto the better half of the joint thereby relieving pain. However, relief is for a variable period of time depending on the state of the other half of the joint and how soon it begins to wears out. Synovectomy. This literally means cutting out or removing the synovial lining. It is used in patients with early RA. It reduces pain and swelling by removing diseased synovium which eats the cartilage. Arthrodesis means fusing or stiffening up the joint. This is rarely done because while it gets rid of the pain, it also takes away all movement occurring at the joint. Joint Replacement which consists of replacing worn bone ends with artificial ones.
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