Why are your joints hurting?
If you haven’t experienced it yourself, you probably know someone who experiences pain in their joints on a daily basis. It’s just arthritis, it’s not a big deal…it’s a normal part of aging is often what is implied. Basically, it seems like it is something that you just have to deal with forever once you get it. Is this really true? What causes arthritis? Can anything be done to prevent it?
Arthritis is inflammation of one or more joints and it typically gets worse as you age. There are several types, but the three that most people know are osteoarthritis, rheumatoid arthritis and gout. Osteoarthritis is the most common and usually involves wear & tear damage to the joint’s cartilage (the hard, slippery tissue that covers the ends of bone where they form a joint). This damage causes the cartilage to break down and lead to bone grinding directly on bone when arthritis is severe. This damage results in pain and restricted movement. It can also be caused by an injury or infection to a joint. Rheumatoid arthritis is caused by an autoimmune (when immune cells attack healthy tissue instead of protecting it) disorder that targets the lining of joint capsules (synovium) causing it to become inflamed and swollen. This process can eventually destroy not only the cartilage, but the bone as well, in the affected joints. Gout is urate crystals accumulation in your joint and this causes sudden inflammation with intense pain. The crystals form when you have high levels of uric acid in your blood. Uric acid is needed to break down purines (substances that are found naturally in your body). You also ingest purines from your diet. Some foods, such as steak, organ meats, seafood, alcoholic beverages and drinks sweetened with fruit sugar, have a high purine content causing higher levels of uric acid. Uric acid usually dissolves in your blood and passes through your kidneys into your urine. The problem is sometimes your body produces too much uric acid or your kidneys excrete (get rid of) too little uric acid. This causes a buildup and it forms sharp, needlelike urate crystals in a joint or surrounding tissue which leads to inflammation/swelling and pain.
Overall, symptoms for any of the types of arthritis include pain, stiffness, redness and decreased range of motion of affected joints. In terms of gout, the symptoms usually appear suddenly, whereas, osteoarthritis and rheumatoid arthritis symptoms take years to develop. Gout usually comes in the form of flare-ups and most often occurs in the large joint of the big toe, but can present in any joint. If not the big toe, it usually is seen in the ankles, knees, elbows, wrists and fingers. The pain is most severe within the first 4-12 hours. There are risk factors that will increase the possibility of you getting arthritis. Some of these include family history of arthritis (certain types can be genetic), age (chances increase with age), gender (women usually get rheumatoid arthritis versus men who get gout), previous joint injury and obesity (puts extra stress on joints). Your diet can greatly affect your chances of getting gout.
Unfortunately, there is no cure for arthritis. The main focus of treatment is to reduce the symptoms and improve overall quality of life. There are several ways to do this. The first is taking medications to help control pain and inflammation. Analgesic medications can help decrease pain. Some of these are acetaminophen (Tylenol), tramadol (Ultram, Ultracet) or narcotics (oxycodone – Percocet, Oxycontin or hydrocodone – Norco, Vicoprofen). Non-Steroidal Anti-Inflammatory Drugs, or NSAIDs, are typically available over-the-counter and help reduce inflammation and pain. Ibuprofen (Advil), naproxen (Aleve) and various different gels/lotions are good examples of this. Some people try counterirritants to interfere with the transmission of pain signals. This is done by placing ointments/creams made from menthol or capsaicin on the skin of the affected joint. Disease-Modifying Antirheumatic Drugs, or DMARDs, are used specifically for rheumatoid arthritis to help decrease your immune systems attacks on your joints and include methotrexate (Trexall) or hydroxychloroquine (Plaquenil). Biologic Response Modifiers are used in concurrence with DMARDs by focusing on proteins that are involved in your immune response. The two best known are tanercept (Enbrel) and infliximab (Remicade). Another medication option are corticosteroids, which work by reducing inflammation and suppressing your immune system. Prednisone and cortisone are some good examples.
A non-medicinal treatment option is physical therapy. This helps to increase your range of motion and strengthen the muscles around your joints. Also, the use of assistive devices (canes, walkers, raised toilet seats, grab bars) can help make daily living easier. Apply either hot or cold packs to your affected joints to provide relief. Some people have found that acupuncture, massage, and/or yoga/tai chi have improved their arthritis symptoms. In worst case scenarios, surgery is option to do joint repair, joint replacement or joint fusion. Particularly for gout, it is important to monitor your diet.
While there is no guarantee that you will be able to prevent arthritis, there are things you can do to decrease the chance of getting it. The first, and most important, is to prevent obesity or follow a safe weight loss program approved by your doctor. You can do this by exercising and eating healthy. Swimming or water aerobics are good exercises that do not put a significant amount of stress on your joints. Staying hydrated by drinking plenty of water is beneficial. All of these apply to most types of arthritis. Specifically, for gout, limit the number of sweetened/alcohol beverages you ingest and know where your protein is coming from (limit the amount of meat, fish and poultry you eat). Instead, try low-fact dairy products as they are a good source of protein with a small amount of healthy fats that your body needs.
Arthritis can make life challenging on a daily basis. Now, you have the information you need to make it less of a burden and hopefully prevent it, if possible. If you have any questions about arthritis, please speak with your doctor. If you would like more information about it, please visit the Center for Disease Control’s arthritis page at https://www.cdc.gov/arthritis/basics/faqs.htm