Arthritis: understanding its cause, symptoms and treatment

What is arthritis? 

Osteoarthritis, arthritis and rheumatism are often confused.

Arthritis is an inflammation of the membrane surrounding a joint. It can be infectious, autoimmune or metabolic in origin.

There are several types of arthritis: gout, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, juvenile idiopathic arthritis, Behçet's syndrome, Sjögren's syndrome, polymyositis, scleroderma and systemic lupus erythematosus.

As for osteoarthritis, it is actually caused by damage to the cartilage that covers a joint. It is a degenerative condition and can lead to ankylosis (total or partial loss of movement in a joint). Osteoarthritis is not accompanied by any local signs of inflammation.

In a nutshell, arthritis is an inflammatory disease, whereas osteoarthritis is essentially mechanical, caused by damage to the cartilage.

The word rheumatism, on the other hand, is used to refer non-specifically to any condition affecting the musculoskeletal system, such as osteoarthritis, arthritis, osteoporosis and autoimmune diseases such as rheumatoid arthritis. These conditions are also known as rheumatic, or musculoskeletal diseases.

What are the causes and symptoms of arthritis? 

Arthritis can affect more than one joint and can be accompanied by damage to one or more other organs (the heart, skin, lungs or digestive tract). When only one joint is affected, it is known as mono-arthritis. When two or more joints are affected, it is called oligoarthritis, then polyarthritis.

It is important to remember that each type of arthritis has its own symptoms. The common factor is joint and musculoskeletal pain.

Arthritis can affect anyone, adults and children alike.

The causes of arthritis vary. Some forms are linked to genetic factors, while others can result from excess weight and obesity, joint injuries, bacterial or viral infections, or imbalances in the immune system.

Age, gender and certain lifestyles can also influence the risk of developing arthritis.

In all cases, an inflammatory reaction takes place in one or more joints. This reaction leads to the local secretion of substances that are toxic and cause swelling and stiffness in the joint. They can even damage the cartilage and cause bone demineralisation.

The symptoms of arthritis vary according to the type and severity of the disease. The most common are:

• Red, hot and swollen joint areas,
  
• Pain in a joint (or joints), which tends to occur at night and is not relieved by rest,
  
• Joint effusion,
  
• Symptoms are aggravated by rest, and can wake patients up at night,
  
• Morning stiffness that may persist for more than an hour,
  
• Joint deformities develop when the disease is advanced,
  
• Fever,
  
• Reduced mobility,
  
• In advanced stages, the appearance of skin nodules.
  

Most people with arthritis live with pain, chronic fatigue, restricted mobility and a significant impact on their mood. All these factors affect their quality of life.

How can arthritis be diagnosed and treated? 

Diagnosis of arthritis involves clinical examination of the joints and their mobility.

Medical imaging is then carried out to visualise and assess the degree of joint damage and calcification. This may include X-rays, ultrasound scans, MRI or CT scans. A complementary examination is arthroscopy, which allows direct visualisation of the inside of the joint. It is performed under local anaesthetic.

Finally, there are blood tests, such as uric acid levels for gout or antibodies for rheumatoid arthritis or ankylosing spondylitis. A synovial fluid sample is also taken to show the inflammatory nature of the fluid, and to look for the presence of a pathogenic germ, as well as for microcrystals.

Once diagnosed, treatment for arthritis may include medication, physical therapy, lifestyle changes and, in some cases, surgery. Surgery (joint replacement) is performed when the joint is severely affected.

Drug treatments 

They are usually prescribed to reduce joint pain: analgesics, or painkillers, non-steroidal anti-inflammatory substances and/or steroids.

Physical therapy 

Physical therapy is effective in relieving pain. It is a paramedical field that treats musculoskeletal disorders, with the aim of maintaining, restoring or improving the patient's physical capacity, as well as preventing and managing pain.

In addition to physiotherapists, you can seek help from osteopaths and chiropractors.

They use techniques based on movement, ultrasound technology, physical exercise and muscle strengthening. Physical activity helps reduce stiffness and pain, protects the joints and strengthens the muscles.

You should choose physical activities that have little impact on the joints, such as walking, cycling, swimming, yoga, tai chi, etc. However, these sports should be avoided if you have a joint flare-up.

Physical treatments also include:

• Transcutaneous electrical neurostimulation (TENS), a pain-relieving technique that uses low-current electrical impulses transmitted by electrodes placed on the skin,
  
• Hydrotherapy, which covers all treatments based on the use of water as a therapeutic medium,
  
• Acupuncture, derived from traditional Chinese medicine, is frequently used to relieve pain and is based on the principle of vital energy,
  
• Thermotherapy, the application of heat or cold on painful joints, splints or orthoses (in the hands, ankles, neck, etc.).

Psychological counselling

Seeing a psychologist or a psychiatrist helps us understand our behaviour and find ways of changing it, in order to reduce pain. There are different types of psychological therapy, for example CBT (Cognitive Behavioural Therapy) or mindfulness, that help relieve stress, anxiety and muscular tension.

Other alternative approaches exist to alleviate the symptoms of arthritis, such as relaxation, sophrology, hypnosis, phytotherapy and naturopathy.

It is also important to have a healthy diet. It provides nutrients and minerals necessary for improving the health of bones, tissues and the immune system, and thus reducing inflammation.

Living with arthritis can be a challenge, but there are ways to prevent it. That's why in our Health Magazine we shared tips on how to prevent this chronic condition: 10 tips to prevent arthritis!

Unfortunately, there is no definitive cure for arthritis, but current treatments are effective in relieving pain and slowing the development of the disease. Our understanding of the underlying mechanisms of the disease is improving, which offers hope for more effective solutions in the future.

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