Arthritis means joint inflammation but the term is used to describe about 200 disorders affecting joints, tissues surrounding the joint, and other connective tissues. It is a state of rheumatoid arthritis.
Osteoarthritis is the most common type of Arthritis. Many severe arthritis-related rheumatoid arthritis disorders include gout, fibromyalgia and rheumatoid arthritis ( RA).
Rheumatic disorders tend to cause pressure, pain , stiffness and swelling of one or more joints and around it. The symptoms that slowly or abruptly grow. Some forms of rheumatoid arthritis may also include the body’s immune system and various internal organs.
Some forms of arthritis can affect multiple organs and cause widespread symptoms, such as rheumatoid arthritis and lupus (SLE).
54.4 million people in the United States have been diagnosed with some form of arthritis according to the Centers for Disease Control and Prevention ( CDC). For these, by their disability 23.7 million people have in some way curtailed their operation.
Arthritis is more common in adults 65 years of age or older, but can affect people of all ages, including babies.
Important facts about arthritis
- Arthritis refers to around 200 rheumatic diseases and conditions that affect joints, including lupus and rheumatoid arthritis.
- It can cause a range of symptoms and impair a person’s ability to perform everyday tasks.
- Physical activity has a positive effect on arthritis and can improve pain, function, and mental health.
- Factors in the development of arthritis include injury, abnormal metabolism, genetic makeup, infections, and immune system dysfunction.
- Treatment aims to control pain, minimize joint damage, and improve or maintain quality of life. It involves medications, physical therapies, and patient education and support.
Arthritis treatment aims at pain management, reducing joint damage, and enhancing or preserving function and quality of life.
A range of lifestyle and medication strategies can help achieve this and protect the joints from further damage.
Possible treatment may include:
- non-pharmacologic therapies
- physical or occupational therapy
- splints or joint assistive aids
- patient education and support
- weight loss
- surgery, including joint replacement
Non-inflammatory types of arthritis, such as osteoarthritis, are often treated with pain-reducing medications, physical activity, weight loss if the person is overweight, and self-management education.
Such therapies also refer to inflammatory arthritis types, such as RA, along with anti-inflammatory medications, such as corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs), anti-rheumatic disease-modifying medications (DMARDs), and a relatively new class of drugs known as biologics.
Medicines may depend on the Arthritis type. Drugs which are widely used include:
- Analgesics: these reduce pain, but have no effect on inflammation. Examples include acetaminophen (Tylenol), tramadol (Ultram) and narcotics containing oxycodone (Percocet, Oxycontin) or hydrocodone (Vicodin, Lortab).
- Non-steroidal anti-inflammatory drugs (NSAIDs): these reduce both pain and inflammation. Some NSAIDs are available as creams, gels or patches which can be applied to specific joints.
- Counterirritants: some creams and ointments contain menthol or capsaicin, the ingredient that makes hot peppers spicy. Rubbing these on the skin over a painful joint can modulate pain signals from the joint and lessen pain.
- Disease-modifying antirheumatic drugs (DMARDs): used to treat RA, DMARDs slow or stop the immune system from attacking the joints. Examples include methotrexate (Trexall) and hydroxychloroquine (Plaquenil).
- Biologics: used with DMARDs, biologic response modifiers are genetically engineered drugs that target various protein molecules involved in the immune response. Examples include etanercept (Enbrel) and infliximab (Remicade).
- Corticosteroids: prednisone and cortisone reduce inflammation and suppress the immune system.
A healthy, balanced diet with regular exercise, avoiding smoking and not consuming too much alcohol will help people with arthritis improve their overall health.
There is no particular diet that prevents arthritis, but some food types may help minimize inflammation.
Foods found in a Mediterranean diet can provide numerous nutrients that are good for common health:
- nuts and seeds
- fruits and vegetables
- olive oil
- whole grains
Foods to avoid
There are some items that arthritis sufferers may want to avoid.
Night shade vegetables, such as tomatoes, contain a chemical called solanine that has been related to arthritis pain by some studies. Research results are inconsistent when it comes to these vegetables, but some people have reported a reduction in symptoms of arthritis while removing vegetables from night shade.
Self-management of arthritis symptoms is also important.
Key strategies include:
- staying physically active
- achieving and maintaining a healthy weight
- getting regular check-ups with the doctor
- protecting joints from unnecessary stress
Seven habits that can help a person with arthritis to manage their condition are:
- Being organized: keep track of symptoms, pain levels, medications, and possible side effects for consultations with your doctor.
- Managing pain and fatigue: a medication regimen can be combined with non-medical pain management. Learning to manage fatigue is key to living comfortably with arthritis.
- Staying active: exercise is beneficial for managing arthritis and overall health.
- Balancing activity with rest: in addition to remaining active, rest is equally important when your disease is active.
- Eating a healthful diet: a balanced diet can help you achieve a healthy weight and control inflammation. Avoid refined, processed foods and pro-inflammatory animal-derived foods and choose whole plant foods that are high in antioxidants and that have anti-inflammatory properties.
- Improving sleep: poor sleep can aggravate arthritis pain and fatigue. Take steps to improve sleep hygiene so you find it easier to fall asleep and stay asleep. Avoid caffeine and strenuous exercise in the evenings and restrict screen-time just before sleeping.
- Caring for joints: tips for protecting joints include using the stronger, larger joints as levers when opening doors, using several joints to spread the weight of an object such as using a backpack and gripping as loosely as possible by using padded handles.
Do not sit in the same position for long periods. Take regular breaks to keep mobile.
Doctors will often recommend a physical therapy course to help arthritis patients overcome some of the challenges, and reduce mobility limitations.
Forms of recommendable physical therapy can include:
- Warm water therapy: exercises in a warm-water pool. The water supports weight and puts less pressure on the muscles and joints
- Physical therapy: specific exercises tailored to the condition and individual needs, sometimes combined with pain-relieving treatments such as ice or hot packs and massage
- Occupational therapy: practical advice on managing everyday tasks, choosing specialized aids and equipment, protecting the joints from further damage and managing fatigue
Evidence indicates that while individuals with arthritis can experience short-term pain increases when starting exercise first, continued physical activity can be an effective way to minimize long-term symptoms.
Arthritis patients may engage in joint physical activity either on their own or with friends. Given that many people with arthritis have another illness, such as heart disease, choosing suitable activities is important.
Joint physical activities appropriate for arthritis- and heart disease adults include:
A health care provider will help you find ways to lead a safe lifestyle and a better quality of life.
A variety of alternative treatments to different forms of arthritis have been proposed.
Some work has supported the use of Devil’s claw, rosehip, and Boswellia, from the Frankincense tree, according to the organization Versus Arthritis, based in the UK.
There is some evidence that turmeric can help, but to confirm their efficacy, further studies are needed.
RA has been recommended for various other herbs and spices, but more research is needed again. Among them are turmeric, garlic , ginger, black pepper and green tea.
Anyone who is considering using natural remedies for any form of arthritis should talk to a doctor first.
Both forms of arthritis are not caused singlely. The cause or causes differ depending on the Arthritis type or form.
Possible causes may include:
- injury, leading to degenerative arthritis
- abnormal metabolism, leading to gout and pseudogout
- inheritance, such as in osteoarthritis
- infections, such as in the arthritis of Lyme disease
- immune system dysfunction, such as in RA and SLE
Most forms of arthritis are associated with a variety of causes, but some have no apparent cause and in their appearance seem unpredictable.
Some people may have a greater genetic probability of developing certain arthritic conditions. Additional factors, such as prior injury , illness, smoking and physically demanding occupations, may interfere with genes to increase the risk of arthritis even further.
Diet and nutrition can play a role in controlling arthritis and the likelihood of arthritis, while arthritis is not known to cause particular foods, food sensitivities or intolerances.
Foods that increase inflammation, especially foods derived from animals and diets high in refined sugar, can intensify the symptoms, as can eating foods that cause an immune response.
Gout is one form of arthritis closely associated with food, as it is caused by elevated levels of uric acid that can result from a diet high in purines.
Diets containing high-purine foods such as fish, red wine, and meats can cause a flare-up in gout. However, vegetables and other plant foods which contain high purine levels do not seem to exacerbate the symptoms of gout.
Risk factors for arthritis
Arthritis has been linked with some of the risk factors. Some of these can be changed while others can not.
Non-modifiable arthritis risk factors:
- Age: the risk of developing most types of arthritis increases with age.
- Sex: most types of arthritis are more common in females, and 60 percent of all people with arthritis are female. Gout is more common in males than females.
- Genetic factors: specific genes are associated with a higher risk of certain types of arthritis, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and ankylosing spondylitis.
Modifiable arthritis 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 trigger the development of various forms of arthritis.
- Occupation: certain occupations that involve repetitive knee bending and squatting are associated with osteoarthritis of the knee.
In the United States, over half of adults with arthritis report high blood pressure. High blood pressure is associated with heart disease, the most prevalent comorbidity of arthritis among adults.
Around one in five U.S. adults suffering from arthritis are smokers. Smoking is associated with chronic respiratory problems, the second most prevalent comorbidity of arthritis in adults.
There are about 200 types of arthritis, or conditions in the musculoskeleton. These are divided into seven main categories:
- Inflammatory arthritis
- Degenerative or mechanical arthritis
- Soft tissue musculoskeletal pain
- Back pain
- Connective tissue disease
- Infectious arthritis
- Metabolic arthritis.
Inflammation is a common part of healing process in the body. The inflammation tends to occur as a defense against bacteria and viruses, or as a response to injuries such as burns. However, inflammation occurs in humans for no specific cause, with inflammatory arthritis.
Inflammatory arthritis is characterized by damaging inflammation, which does not occur as a normal injury or infection reaction. This type of inflammation is unhelpful, causing damage to the affected joints and leading to pain , stiffness and swelling.
Inflammatory arthritis can affect several joints, and the inflammation can damage both the joint surface and the underlying bone as well.
Examples include inflammatory arthritis:
- Rheumatoid arthritis (RA)
- Reactive arthritis
- Ankylosing spondylitis
- Arthritis associated with colitis or psoriasis
The word “arthritis” means “joint inflammation,” but inflammation may also affect the tendons and ligaments surrounding the joint.
Degenerative or mechanical arthritis
Degenerative or mechanical arthritis refers to a group of conditions that involve predominantly cartilage damage covering the ends of the bones.
The primary role of the smooth, flexible cartilage is to help the joints glide smoothly and move. That form of arthritis makes the cartilage thinner and rougher.
In an attempt to regain cohesion, the body begins remodeling the bone to compensate for the loss of cartilage and changes in joint function. This can trigger the production of undesirable bony growths, called osteophytes. The joint can become disfigured. That condition is commonly referred to as osteoarthritis.
Osteoarthritis can also result from previous damage to the joint such as a fracture or previous inflammation in the joint.
Soft tissue musculoskeletal pain
In tissues other than the joints and bones soft tissue musculoskeletal pain is felt. After injury or overuse, such as tennis elbow, the pain often affects a part of the body and originates from the muscles or soft tissues that support the joints.
Fibromyalgia can be characterized by pain that is more common and associated with other symptoms
Muscles, muscles , nerves, ligaments, bones, or joints may cause back pain. Back pain may be attributed to complications within the body with organs. Of example, it may also be the product of referred pain when an problem elsewhere in the body contributes to back pain.
There could be a particular cause, including osteoarthritis. When it occurs in the spine this is often called spondylosis. That can be detected by imaging tests or physical examination.
Another source of back pain is a “slipped” joint, as is osteoporosis, or bone thinning.
If a doctor is unable to determine the exact cause of back pain, this is sometimes referred to as “non-specific” pain.
Connective tissue disease (CTD)
Connective tissue supports, binds together or separates tissues and organs from other bodies. They are composed of tendons , ligaments and cartilage.
CTD involves pain and inflammation in the joints. Many tissues, including the skin , muscles, lungs , and kidneys, can also experience inflammation. Aside from painful joints, this may result in multiple symptoms and may require consultation with a variety of different specialists.
Examples of CTD include:
- SLE, or lupus
- scleroderma, or systemic sclerosis
A bacterium, virus, or fungus that enters a joint can sometimes cause inflammation.
Organisms that can infect joints include:
- Salmonella and Shigella, spread through food poisoning or contamination
- chlamydia and gonorrhea, which are sexually transmitted diseases (STDs)
- hepatitis C, a blood-to-blood infection that may be spread through shared needles or transfusions
An infection in the joint may also be cleansed with antibiotics or other antimicrobial drugs. However, the arthritis can sometimes become chronic, and if the infection has persisted for some time, joint damage may be irreversible.
Uric acid is a chemical that is formed by breaking down substances called purines. Purines are present in human cells, as well as in other foods.
Most uric acid is dissolved in blood and transported to the kidneys. It passes out into urine from there. Some people have high uric, acid levels because either they produce more naturally than they need or their bodies can not clear up the uric acid quickly enough.
In certain people uric acid builds up and accumulates needle-like crystals in the joint, resulting in unexpected bursts of severe joint pain or gout attack.
When uric acid levels are not decreased, gout can either come and go in episodes or become chronic.
This usually affects a single joint or a few joints, such as the broad toe and hands. The extremities are typically affected by it. One theory is uric acid crystals are formed in cooler joints, away from the body’s main warmth.
Below we describe some of the more common forms of arthritis.
Rheumatoid arthritis ( RA) occurs when the body’s immune system attacks the body’s tissues, particularly the connective tissue, leading to joint inflammation , pain and joint tissue degeneration.
Cartilage is a flexible, connective joint tissue which absorbs the pressure and shock produced by movement such as running and walking. Often it supports the joints and allows smooth movement.
Persistent inflammation within the synovia contributes to cartilage and bone degeneration. This can lead to deformity, pain , swelling and redness in the joint.
RA can appear at any age, and is associated with fatigue after rest and prolonged rigidity.
Early diagnosis of RA gives a better chance of learning how to successfully manage the symptoms. This may reduce the disease’s effect on quality of life.
Osteoarthritis is a severe degenerative joint condition affecting a joint’s cartilage, joint lining, ligaments and underlying bone.
The breakdown of these tissues eventually results in discomfort and stiffness in the joints.
The joints most commonly affected by osteoarthritis are those that undergo heavy use, such as hips , knees, hands, spine, thumb base and big toe joint.
That may refer to a number of arthritis types. The most common form is juvenile idiopathic arthritis (JIA) which is also known as juvenile rheumatoid arthritis (JRA).
Arthritis can cause permanent damage to joints during childhood, and there is no cure. Remission, however, is possible, during which time the illness remains inactive.
This may be due to problems with the immune system.
Within the general population, this is thought to affect between 2 and 10 people in every 100,000. It can affect 30 to 70 people per 100,000, including people with RA.
Septic arthritis is an inflammation of the joints caused by a bacterial or fungal infection. It most usually affects the hip and knee.
It can grow when bacteria or other micro-organisms that cause disease spread through the blood to a joint, or when the joint is directly infected with a micro-organism through injury or surgery.
Most cases of acute septic arthritis cause bacteria such as Staphylococcus, Streptococcus, or Neisseria gonorrhoeae. Organisms including Mycobacterium tuberculosis and albicans Candida cause chronic septic arthritis. This is less severe as compared to acute septic arthritis.
Septic arthritis can develop at any age. This can occur in infants before age 3. At this age the hip is a common infection site.
Septic arthritis from 3 years before puberty is rare. Children with septic arthritis are more likely to get diagnosed with Group B Streptococcus or Haemophilus influenzae than adults because they have been vaccinated.
Incidence of H-infection causing bacterial arthritis. Influenzae decreased from use of H by around 70 percent to 80 percent. Vaccine against influenzae b (Hib) has become widespread.
Subsequent conditions raise the risk of septic arthritis:
- existing joint disease or damage
- artificial joint implants
- bacterial infection elsewhere in the body
- presence of bacteria in the blood
- chronic illness or disease (such as diabetes, RA and sickle cell disease)
- intravenous (IV) or injection drug use
- medications that suppress the immune system
- recent joint injury
- recent joint arthroscopy or other surgery
- conditions such as HIV, that weaken immunity
- older age
Septic arthritis is an emergency in rheumatology, because it can lead to rapid joint destruction. It may be fatal.
Fibromyalgia affects an estimated 4 million people, or around 2 percent of the population, in the United States.
It usually begins during or after middle age, but may affect children.
Fibromyalgia can involve:
- widespread pain
- sleep disturbance
- problems with thinking and remembering
The person may experience an abnormal processing of pain, where they strongly react to something other people would not find painful.
Tingling or numbness can also occur in the hands and feet, jaw pain and digestive problems.
Fibromyalgia causes are unclear but certain factors have been strongly linked with the development of the disease:
- stressful or traumatic events
- post-traumatic stress disorder (PTSD)
- injuries due to repetitive movements
- illness, for example viral infections
- having lupus, RA, or chronic fatigue syndrome
- family history
It is more common among females.
Psoriatic arthritis is a joint disorder that also occurs with psoriasis, a skin disease. About 0.3 and 1 percent of the U.S. population, and between 6 and 42 percent of people with psoriasis are thought to be affected.
Most people with psoriatic arthritis and psoriasis experience first psoriasis and then psoriatic arthritis but sometimes joint problems may arise before skin lesions appear.
The exact cause of psoriatic arthritis is not clear but it seems to include an attack on healthy cells and tissue by the immune system. The abnormal immune response triggers joint inflammation, and skin cell overproduction. It can result in damage to joints.
Factors that increase the risk, include:
- having psoriasis
- family history
- being aged from 30 to 50 year
Individuals with psoriatic arthritis appear to have a higher number of cardiovascular disease risk factors compared to the population including increased BMI, triglycerides and C-reactive protein.
Gout is a rheumatic disease that occurs in body tissues and fluids when uric acid crystals, or monosodium urate, form in. It occurs when too much uric acid is released by the body, or not enough uric acid is absorbed.
Acute gout normally appears as a severely red, hot, and swollen joint and severe pain.
Risk factors include:
- overweight or obesity
- alcohol intake
- use of diuretics
- a diet rich in meat and seafood
- some common medicines
- poor kidney function
Long remission periods are possible, followed by flares which last from days to weeks. That can be chronic at times. Recurring acute gout attacks may lead to a degenerative form of chronic arthritis called gouty arthritis.
Sjögren ‘s syndrome is an autoimmune disease, which happens alongside RA and SLE at times. It involves destruction of the tears and saliva generating glands. This induces dryness in the mouth and eyes, and in other places that normally need moisture, such as the nose , throat, and skin.
The joints, lungs , kidneys, blood vessels, digestive organs, and nerves can also be affected.
Sjögren ‘s syndrome usually affects people aged between 40 and 50 years, and women in particular.
According to a study in Clinical and Experimental Rheumatology, the condition affects tissues other than the glands in 40 to 50 percent of people with primary Sjögren syndrome.
It may affect the lungs, liver, or kidneys, or it may lead to vasculitis in the skin, peripheral neuropathy, glomerulonephritis, and low levels of a substance called C4. These all indicate a link between the immune system and Sjögren’s.
If these tissues are impaired, the risk of developing lymphoma that is not Hodgkin’s is high.
Scleroderma refers to a category of diseases affecting the body’s connective tissue. The person will have hairy, dry skin patches. Many types may affect the small arteries and internal organs.
Scar-like tissue builds up and causes damage in the skin.
The cause is not yet understood. It often affects people between 30 and 50 years of age, and can occur with other autoimmune diseases, such as lupus.
Scleroderma affects people differently. The risks include skin issues, heart failure, damage to the lungs, stomach problems and kidney failure.
Systemic lupus erythematosus (SLE)
SLE, also known as lupus, is an inflammatory disease in which the immune system develops antibodies to cells in the body that cause widespread inflammation and damage to the tissues. The disorder is characterized by periods of recovery and sickness.
It can occur at any age but most likely it will start between the ages of 15 and 45. Between 4 and 12 women will do so for every single man who gets lupus.
Lupus has the potential to affect joints, skin, brain, lungs , kidneys, blood vessels and other tissues. Symptoms include fatigue, joint pain or swelling, rashes in the skin and fevers.
The cause remains unknown but it may be associated with genetic , environmental, and hormonal factors.
The arthritis symptoms that occur and how they occur differ greatly, depending on the condition.
They may increasingly or suddenly develop. Since arthritis is most commonly a chronic disease, symptoms can come and go, or may persist over time.
Anyone experiencing any of the following four key warning signs should see a doctor though.
- Pain: Pain from arthritis can be constant, or it may come and go. It may affect only one part, or be felt in many parts of the body
- Swelling: In some types of arthritis the skin over the affected joint becomes red and swollen and feels warm to the touch
- Stiffness. Stiffness is a typical symptom. With some types, this is most likely upon waking up in the morning, after sitting at a desk, or after sitting in a car for a long time. With other types, stiffness may occur after exercise, or it may be persistent.
- Difficulty moving a joint: If moving a joint or getting up from a chair is hard or painful, this could indicate arthritis or another joint problem.
RA is a systemic condition, and the joints on both sides of the body are typically affected similarly. The most often affected are the joints of the wrists, fingers, knees, feet and ankles.
Joint symptoms may include:
- morning stiffness, lasting more than 1 hour
- pain, often in the same joints on both sides of the body
- loss of range of motion of joints, possibly with deformity
Other symptoms include:
- chest pain when breathing in, due to pleurisy
- dry eyes and mouth, if Sjögren’s syndrome is present
- eye burning, itching, and discharge
- nodules under the skin, usually a sign of more severe disease
- numbness, tingling, or burning in the hands and feet
- sleep difficulties
Osteoarthritis is typically the result of joint wear and tear. It will affect overworked joints more than others. Osteoarthritis sufferers can develop the following symptoms:
- pain and stiffness in the joints
- pain that becomes worse after exercise or pressure on the joint
- rubbing, grating, or crackling sound when a joint is moved
- morning stiffness
- pain that causes sleep disturbances
Some people may have osteoarthritis-related changes that occur in an x-ray but they do not feel symptoms.
Osteoarthritis is usually more likely to impact some joints than others, such as left or right knees, shoulder or wrist.
Symptoms of childhood arthritis include:
- a joint that is swollen, red, or warm
- a joint that is stiff or limited in movement
- limping or difficulty using an arm or leg
- a sudden high fever that may come and go
- a rash on the trunk and extremities that comes and goes with the fever
- symptoms throughout the body, such as pale skin, swollen lymph glands
- generally appearing unwell
Also, juvenile RA can cause eye problems, such as uveitis, iridocyclitis or iritis. When eye symptoms are present they can include:
- red eyes
- eye pain, especially when looking at light
- vision changes.
Symptoms of septic arthritis occur rapidly.
There is often:
- intense joint pain that becomes more severe with movement
- joint swelling in one joint
Symptoms in newborns or infants include:
- crying when the infected joint is moved
- inability to move the limb with the infected joint
Symptoms in children and adults include:
- inability to move the limb with the infected joint
- intense joint pain, swelling, and redness
Chills sometimes occur but are an uncommon symptom.
Fibromyalgia may trigger the following symptoms:
- widespread pain, often with specific tender points
- sleep disturbance
- psychological stress
- morning stiffness
- tingling or numbness in hands and feet
- headaches, including migraines
- irritable bowel syndrome
- problems with thinking and memory, sometimes called “fibro fog”
- Painful menstrual periods and other pain syndromes
Symptoms of psoriatic arthritis may be mild, affecting only a few joints, such as the finger or toe ends.
Severe psoriatic arthritis, including the spine, can affect several joints. Symptoms of the spinal cord are usually encountered in the lower spine and sacrum. These include stiffness, burning, and pain.
People with psoriatic arthritis also experience psoriasis changes in the skin and hair, and at the same time the skin gets worse as arthritis does.
Symptoms of gout involve:
- pain and swelling, often in the big toe, knee, or ankle joints
- sudden pain, often during the night, which may be throbbing, crushing, or excruciating
- warm and tender joints that appear red and swollen
- fever sometimes occurs
A person may develop tophi after having gotten gout for several years. Tophi are lumps below the skin , usually around the joints or visible on the fingertips and ears. Multiple, small tophis, or a large white lump, can form. That can cause the skin to bend and stretch.
Often, tophi spontaneously burst out and drain, oozing a thin, chalky substance. Tophi which start breaking through the skin may lead to infection or osteomyelitis. Many patients will require immediate surgery to get the tophus removed.
Symptoms of Sjögren’s syndrome include:
- dry and itchy eyes, and a feeling that something is in the eye
- dry mouth
- difficulty swallowing or eating
- loss of sense of taste
- problems speaking
- thick or stringy saliva
- mouth sores or pain
- change in color of hands or feet
- joint pain or joint swelling
- swollen glands
Symptoms of scleroderma may include:
- fingers or toes that turn blue or white in response to cold temperatures, known as Raynaud’s phenomenon
- hair loss
- skin that becomes darker or lighter than normal
- stiffness and tightness of skin on the fingers, hands, forearm, and face
- small white lumps beneath the skin that sometimes ooze a white substance that looks like toothpaste
- sores or ulcers on the fingertips or toes
- tight and mask-like skin on the face
- numbness and pain in the feet
- pain, stiffness, and swelling of the wrist, fingers, and other joints
- dry cough, shortness of breath, and wheezing
- gastrointestinal problems, such as bloating after meals, constipation, and diarrhea
- difficulty swallowing
- esophageal reflux or heartburn
Systemic lupus erythematosus (SLE)
The most common signs of SLE, or lupus, are:
- red rash or color change on the face, often in the shape of a butterfly across the nose and cheeks
- painful or swollen joints
- unexplained fever
- chest pain when breathing deeply
- swollen glands
- extreme fatigue
- unusual hair loss
- pale or purple fingers or toes from cold or stress
- sensitivity to the sun
- low blood count
- depression, trouble thinking or memory problems.
Many symptoms include mouth sores, unexplained seizures, hallucinations, frequent miscarriages and unexplained problems with the kidney.
Things to understand about the shoulder
The shoulder is a complex upper-body structure that connects the arms to the torso. It is made up of a number of parts that work together to offer stability and a wide range of motion.
The shoulder is a huge and complicated ball-and-socket joint with several bones, muscles, tendons, and ligaments. These structures work together to construct and support this very flexible joint, which allows the arms to move freely. However, because of this mobility, the shoulder can be damaged by overuse, instability, or injury.
The anatomy, function, and structures of the shoulder will be discussed in this article.
Because of the variety of structures that make up the shoulder, it is a complex part of the body that can move freely. The shoulder includes the body’s most mobile joint, allowing for a high range of motion but at the sacrifice of stability. It’s prone to getting hurt.
Three primary bones meet at the shoulder to form a 90-degree angle. The pectoral girdle is made up of two of these bones: the clavicle and scapula. The collarbone and shoulder blade are the common names for these bones. The humerus, which is the biggest bone in the arm, is the third bone.
The glenohumeral, acromioclavicular, and sternoclavicular joints are formed by the intersection of these bones and the sternum, or chest bone. The great range of motion of the shoulder is due to these joints.
The joints are subsequently surrounded by cartilage, ligaments, muscles, and tendons, which unite the bones and provide stability. Muscles also enable movement.
The primary purpose of the shoulder is to offer a wide range of motion for the arms. People who can raise, lower, and rotate their arms can accomplish a variety of actions, including tossing and reaching, as well as athletic movements like swimming.
The shoulder’s bones and joints
The shoulder is made up of three bones. These are the following:
- The clavicle: This bone, also called the collarbone, connects the arm to the chest and is located in front of the scapula. It is connected to the arm, the neck, and the chest through a number of muscles.
- The scapula: The shoulder blade is also known as the scapula. It’s triangular in shape. It primarily adheres to the body through muscle and “floats” off the rear of the chest. The acromion, a bony component of the scapula, connects it to the clavicle. On the scapula, the glenoid is a shallow socket.
- The humerus: The humerus is the bone in the upper arm. Between the elbow and the shoulder is a lengthy bone called the humerus. At the top of the arm, the humerus bears a spherical part that acts as a “ball” for the scapula’s “socket.”
The shoulder is made up of three joints. These are some of them:
- The glenohumeral joint: A ball-and-socket joint is what this joint is. It is the joint that links the humerus to the scapula. It is the body’s most movable joint. The shoulder can move in various planes, including arm rotation and moving the arm up and away from the body, thanks to the joint.
- The acromioclavicular joint: The clavicle is joined to the scapula by this. The clavicle joins to the scapula by a bone component known as the acromion. The shoulder is stabilized by this joint, which also aids movement such as elevating the shoulders.
- The sternoclavicular joint: The clavicle is connected to the sternum by this. The sternum is the flat bone in the center of the chest, often known as the breastbone. The clavicles can move thanks to the joint.
Muscles of the shoulder
Extrinsic and intrinsic muscles make up the shoulder. Extrinsic muscles come from the torso and attach to the shoulder’s bones, whereas intrinsic muscles come from the scapula or clavicle and attach to the humerus.
The following muscles make up the intrinsic muscles of the shoulder:
- The deltoid: The deltoid is a triangular-shaped muscle on the outside of the shoulder. It connects the clavicle to the scapula. The deltoid muscle permits you to move your arm forwards, backwards, sideways, and away from your body. It also helps to keep the shoulder stable while carrying and lifting.
- Teres major: The scapula gives rise to this muscle, which joins to the humerus. Internal rotation of the arm is possible because to Teres major.
- Supraspinatus: This muscle originates from the scapula and attaches to the humerus. It helps to support the glenohumeral joint and allows the arm to move out from the body.
- Infraspinatus: The scapula gives rise to this muscle, which joins to the humerus. It turns the arm externally and stabilizes the glenohumeral joint.
- Teres minor: The teres minor stems from the scapula and connects to the humerus. It rotates the arm laterally while also stabilizing the glenohumeral joint.
- Subscapularis: The scapula gives rise to this muscle, which joins to the humerus. It permits the arm to rotate towards the body while also stabilizing the glenohumeral joint.
The rotator cuff muscles are the supraspinatus, infraspinatus, teres minor, and subscapularis muscles. All of them come from the scapula and connect to the humerus. These muscles work together to raise and rotate the arm.
The following muscles make up the extrinsic muscles of the shoulder:
- The trapezius: The trapezius is a muscle that runs from the base of the head to the clavicle and scapula. The scapula is raised.
- Latissimus dorsi: The humerus bone is attached to this muscle, which originates in the lower spine. It assists with pull-ups and rowing exercises by bringing the arm backwards and towards the torso.
- Levator scapulae: This is a long, narrow muscle that aids in scapula elevation. It also aids in glenoid cavity rotation, spine stabilization, and neck extension and lateral flexion.
- Rhomboid major and rhomboid minor: The rhomboid muscles help rotate the glenoid cavity by stabilizing the scapula and maintaining it in place.
While the shoulder is incredibly mobile, its suppleness leaves it vulnerable to injury and instability. These injuries can limit your range of motion and cause shoulder pain. The following are some of the most prevalent shoulder ailments:
Rotator cuff injuries
Trauma to any of the muscles and tendons that make up the rotator cuff is referred to as a rotator cuff injury. The following are some of the most common rotator cuff issues:
- Tears: When a tendon is torn, it no longer fully adheres to the bone, which is a common injury. Injury and age-related deterioration are the most common causes of rotator cuff tears. While treatment varies depending on the severity of the condition, it usually include rest, pain medication, and rehabilitation activities. Surgery may be required in more severe situations.
- Bursitis: The bursa, which are fluid-filled sacs that cushion and protect tissues by decreasing friction, is inflamed. The bursa can be irritated and inflamed by infections or too much friction from repetitive movements or injuries. Antibiotics, rest, corticosteroid injections, and surgery may be used as treatment options in more severe cases.
- Tendinitis: This is an inflammation of the tendons that might cause it difficult to lift the arms. It usually happens as a result of tendons irritation or damage caused by sports or repetitive overhead movements. It’s also known as a shoulder impingement by certain people. Rest, physical therapy, and injections are common treatments, but if these don’t work, surgery may be required.
Arthritis is a condition in which the joints become inflamed. The cartilage in people with arthritis is destroyed, and the joint no longer has a smooth surface.
Arthritis can cause pain, decreased range of motion, and a clicking sounds in the shoulder joints, especially the acromioclavicular and glenohumeral joints.
The following are examples of arthritis that can affect the shoulder:
- rheumatoid arthritis
- avascular necrosis
- rotator cuff tear arthropathy
- post-traumatic arthritis
Treatment will vary depending on the type and severity of the arthritis, but it will usually start with nonsurgical options including rest, physical therapy, and pain relievers. When these methods fail or the pain becomes incapacitating, a doctor may recommend surgery.
Broken bones are also known as fractures. As a result, a shoulder fracture develops when the scapula, clavicle, or head of the humerus breaks. Fractures can occur as a result of:
- car accidents
Shoulder fractures can often be treated without surgery by a doctor. This usually entails wearing a sling to immobilize the shoulder and allowing it to heal. However, if the bone is entirely out of place, surgery may be required. This usually entails placing plates, screws, or rods inside the bone to stabilize the fracture.
When the humerus comes partially or completely out of the glenoid, it is referred to as a shoulder dislocation. The shoulder is the most often displaced joint due to its mobility, with forward, or anterior, dislocations accounting for roughly 97 percent of all occurrences.
A doctor will most likely conduct a closed reduction to repair a shoulder dislocation. This is a process in which the humerus is reinserted into the joint socket. After that, a doctor may recommend resting or immobilizing the shoulder before beginning rehabilitation exercises once the pain and swelling have subsided.
A dislocation can sometimes be so severe that it necessitates surgery. If the shoulder becomes unstable following a dislocation, surgery may be required to prevent recurrent dislocations.
Shoulder health advice
The following steps can be taken to ensure that a person’s shoulder is healthy and has a decent range of motion:
- before exercising, make sure you extend your shoulder muscles properly
- when working or playing sports, avoid overusing the shoulder muscles
- using an exercise program to strengthen the shoulder muscles
- shoulder pain should not be ignored, and if the pain persists, a doctor should be consulted
- attempting to stay away from activities that could result in a fall or accident
The shoulder is a complex structure with numerous bones, muscles, and tendons. These components come together to form a movable joint that allows the arms to move freely.
The shoulder, however, is prone to instability and injury since it is a mobile joint that many people utilize regularly. Rotator cuff injuries, shoulder arthritis, fractures, and dislocations can all cause pain and interfere with shoulder function. Treatment, rest, stretching, and exercising as soon as possible might assist to strengthen the shoulder and speed up healing.
Secondary osteoarthritis: What is it?
Osteoarthritis (OA) is a type of arthritis in which joint cartilage breaks down. There is no known cause of primary OA. Secondary OA, on the other hand, develops as a result of a pre-existing medical condition, joint injury, or abnormality.
Although primary and secondary OA are the same condition, they are caused by different causes.
OA can affect any joint in the body, causing pain, stiffness, and a restricted range of motion.
The symptoms and causes of secondary OA are discussed in this article. We also talk about treatment choices and the outlook for people who have the condition.
What is osteoarthritis (OA)?
OA is the most common type of arthritis, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), and it typically affects elderly people.
OA is a joint condition in which the cartilage in the joints breaks down. It can occur in every joint of the body, however it most commonly affects the:
- lower back
According to the NIAMS, OA symptoms can range from mild to severe and may include:
- limited range of motion in the affected joint
- a loose or unstable-feeling joint
- swelling around the joint, which may worsen after activities that require using that joint
- joint pain, which may get worse at night
- stiff joints, which may occur after periods of rest or after sleeping
Primary vs. secondary OA
People with OA might have either primary or secondary OA. The symptoms of these illnesses are the same, but the causes are not.
There is no known cause of primary OA. Secondary OA, on the other hand, comes as a result of an existing medical condition, abnormalities, infection, or injury.
Secondary OA can be caused by a variety of causes, including:
- hemoglobinopathies, which are conditions affecting red blood cells
- Ehlers-Danlos syndrome
- Marfan syndrome
- inflammatory arthritis
- an existing joint abnormality
- injury or trauma to the joint
- metabolic disorders
- a joint condition present from birth
- infectious arthritis
- osteochondritis dissecans, where bone underneath joint cartilage dies due to a lack of blood supply
- Paget’s disease
- avascular necrosis, where bone tissue dies from a lack of blood supply
Secondary OA treatment seeks to alleviate pain, reduce stiffness, and improve range of motion and joint function. It may also assist to keep the condition from worsening.
Among the treatment options are:
According to research, combining aerobic and resistance activities can help reduce pain and enhance physical function.
Exercise can also assist to build muscle, enhance endurance, and increase flexibility. An OA workout regimen may include:
- Stretching exercises can help you enhance your range of motion.
- Strengthening muscles using weights or exercise bands, which then aids to support joints.
- Exercising to increase balance and agility, which can assist people maintain daily activities
- Exercise in water to alleviate joint tension, or engage in low-impact exercises such as walking, tai chi, or cycling.
People must avoid any activities that aggravate their symptoms or put additional strain on their joints.
Getting rid of excess weight
Losing additional weight can help alleviate joint tension.
In people with knee OA, decreasing one pound (lb) of body weight can ease four pounds of pressure on the knees.
Losing excess weight may also be beneficial:
- slow down progression of OA and cartilage breakdown
- decrease inflammation
- relieve pain and improve physical function
Braces, splints, and walking canes can assist stabilize joints and remove excess pressure.
Furthermore, if joints are misaligned, remedial equipment such as orthotics or knee braces may be beneficial.
Certain drugs may aid with pain relief and inflammation reduction. These could include:
- Anti-inflammatory and pain relievers taken orally
- To reduce pain, administer topical ointments to affected joints.
- Corticosteroids are pain relievers that a doctor may inject into the joint.
- Hyaluronic acid injections into the knee to promote joint lubrication are used to treat knee OA.
- Long-term pain relief with oral selective serotonin and norepinephrine reuptake inhibitors.
If other therapies are ineffective, a person is suffering from serious joint degeneration, or OA is interfering with a person’s daily life, surgery may be required.
An osteotomy is a surgical procedure in which a physician removes a portion of bone near the injured joint in order to redistribute weight away from that joint.
A partial or whole joint replacement is another surgical option for OA, depending on the level of joint deterioration. This entails removing a portion or all of the joint and replacing it with a synthetic joint composed of plastic, ceramic, or metal.
Secondary OA risk factors include:
- having an abnormal joint structure or unusually aligned bones
- having muscle weakness
- being female
- having a family member with OA
- being over the age of 50 years
- having had a bone fracture, ligament or cartilage tear, or other joint injury
- overly using the same joints, which may happen as a result of certain occupations or sports
- having obesity, as excess body weight can put extra stress on joints and increase inflammation
The prognosis for OA varies from person to person and is determined by which joints are affected, the severity of symptoms, and level of physical function.
OA may be minor in some people, and they may be able to effectively manage their symptoms with treatment.
In other circumstances, people with OA may suffer from significant disability. For some people with severe OA, joint replacement surgery may be the best long-term option.
OA is a joint condition in which joint cartilage degrades, resulting in pain, stiffness, and reduced range of motion in the joints.
Secondary OA is caused by an existing condition, injury, or infection, whereas primary OA has no clear cause.
Treatment may help relieve pain, reduce inflammation, and prevent the condition from progressing.
Exercising, losing excess weight, using support equipment, and taking drugs are all possible treatment strategies. In some circumstances, surgery may be required to relieve joint stress or to replace a damaged joint.
What you should know about babies born with spina bifida
Spina bifida is a spine condition that is usually detected at birth by doctors. It is a neural tube abnormality that appears early in the development of a fetus and can occur anywhere along the spine.
The backbone, which normally protects the spine, does not form and seal properly in spina bifida. As a result, people with spina bifida frequently suffer from spinal cord and nerve damage.
Every year, around 1,500 babies in the United States are born with spina bifida. Although specialists are unaware of the exact causes of the condition, they advise females of childbearing age to ingest folic acid to lower the chance of neural tube defects.
This page discusses baby spine issues, such as spina bifida. It also discusses symptoms, diagnosis, and treatment options.
Infant spine problems
The spine is made up of tiny bones called vertebrae that are piled on top of each other with discs in between. A healthy spine should have moderate bends from front to back to help absorb movement stress, but it should run straight down the center of the back.
Infants may have a variety of spine disorders that cause their back to twist or rotate. These are some examples:
- lordosis, an excessive inward curve of the spine
- spina bifida
- scoliosis, an abnormal sideways spinal curve
- kyphosis, an abnormal forward bending of the spine
The most frequent crippling congenital condition is spina bifida, which means “divided spine.” Doctors categorize the condition as a form of neural tube defect (NTD), in which the neural tube of a growing embryo does not develop or close as predicted. This causes nerve and spinal cord damage.
These complications appear throughout the first 28 days of pregnancy and may occur before a woman realizes she is pregnant.
Spina bifida is commonly referred to as the “snowflake condition” because no two cases are alike. Depending on the size and location of the incision, the condition might range from minor to severe.
Spina bifida is classified into three types:
- Myelomeningocele: This is the most common and severe type of spina bifida. It is also known as spina bifida cystica. Some vertebrae do not form normally in babies with this condition and do not properly encase the spinal cord. As a result, some of the spinal cord, nerves, spinal fluid, and other tissues push through the spine, forming a sac on the baby’s back. An individual may suffer from moderate to severe handicap as a result of nerve involvement.
- Meningocele: The baby with this kind of spina bifida has a bag bulging from the back. However, because the sac does not contain parts of the spinal cord and there is minimal nerve involvement, the individual may only endure modest problems.
- Spina bifida occulta: This is the least severe kind of spina bifida. Because there is merely a gap in the spine and no opening in the back, a person may be unaware that they have this problem. Babies that have spina bifida occulta may have a birthmark, dimple, or hair patch at the base of their spine.
Doctors are unsure what causes spina bifida. However, it appears to run in families, implying that genetics have a role in the condition.
Taking folic acid when pregnant lowers the chances of having a child with spina bifida. As a result, people who may get pregnant should take this B vitamin on a daily basis. Females of reproductive age should take 400 micrograms (mcg) of folic acid daily, according to the Centers for Disease Control and Prevention (CDC).
Spina bifida symptoms vary depending on the severity of the condition and may differ between individuals.
Myelomeningocele symptoms include:
- bowel and bladder issues
- curved spine
- open spine
- a skin-covered sac protruding from the back
- learning disabilities
- physical disabilities
A person with a meningocele may have no symptoms other than the sac protruding through their back.
Individuals with spina bifida occulta may be unaware of their condition until late childhood or adulthood. It may not cause any symptoms and, in most cases, does not cause in disability.
To detect spina bifida before birth, doctors can perform one of three tests:
- A blood test: During weeks 16–18 of pregnancy, doctors can obtain a blood sample from a woman. The level of alpha-fetoprotein (AFP) in the sample is then measured in a laboratory. AFP is a protein produced by the unborn baby and passed to the mother. If the fetus develops spina bifida, around 80% of pregnant people have high levels of AFP.
- Ultrasound: An ultrasound, often known as a sonogram, is a type of imaging that takes photos of the fetus in the uterus. Ultrasound is widely used by doctors to detect indications of spina bifida, such as an open spine.
- Amniocentesis: This test involves extracting a little amount of fluid from the uterus using a fine needle. Doctors can examine the sample for AFP levels, which may suggest that the fetus has spina bifida.
Spina bifida has no known cure. There are, however, various therapeutic options available for infants with spina bifida.
- Myelomeningocele: In the case of open spina bifida, a surgeon can seal the hole before or after the infant is born.
- Hydrocephalus: If a newborn has hydrocephalus, or water on the brain, a surgeon can insert a tube to drain the fluid. This tube, also known as a shunt, aids in the relief of head pressure and related symptoms.
- Tethered spinal cord: The spinal cord adheres to the spinal canal in this condition, limiting proper movement. The spinal cord extends unnaturally as the kid grows. A surgeon can untether or detach the spinal cord from the surrounding tissue, allowing the patient to resume normal movement. Doctors anticipate that up to 50% of children who have surgery for spina bifida shortly after birth will need surgery to untether their spinal cord later on.
- Catheterization: Individuals with open spina bifida may have nerve damage that prohibits them from having normal bladder function. A doctor may advise the child’s carers to catheterize the bladder and enable it to drain completely. This is accomplished by putting a small plastic tube known as a catheter into the bladder many times per day. Children with spina bifida must be evaluated on a regular basis by a urologist, a doctor who specializes in the urinary tract.
Furthermore, many people with spina bifida require mobility aids such as braces, crutches, or wheelchairs. Doctors may also advise patients to continue receiving physiotherapy.
The outlook of an infant with spina bifida is determined by the severity of their spinal abnormalities. For example, if an infant has full paralysis, hydrocephalus, and other congenital defects, his or her outlook may be bleak.
However, with proper care and medical attention, most infants with spina bifida survive into adulthood.
Spina bifida is one of various baby spine disorders that can occur during the development of a fetus in the uterus. There are three major varieties, with varying degrees of severity. Myelomeningocele is the most dangerous condition, in which a fluid-filled sac containing the spinal cord and other tissues protrudes through the infant’s back.
Meningocele is characterized by the presence of a sac but the absence of the spinal cord or nerves, and the patient may not feel severe symptoms. Spina bifida occulta is the mildest form of spina bifida, in which no sac protrudes through the back yet there is a breach in the spine. Individuals with this type of spina bifida may be unaware of their condition until they reach maturity.
Spina bifida has no cure because the nerve damage is irreversible. Surgery and other therapies, on the other hand, can help people manage their disability and mobility issues.