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Arthritis

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What is Arthritis?

Arthritis is characterized by the inflammation of one or multiple joints. Its main symptoms are joint pain and stiffness that worsen over time. Though it is most prevalent in older people aged 65 and above, this joint disorder can also develop in younger adults, sometimes even affecting children and teenagers. It has been found to affect more women than men, as well as those who are overweight.

Contrary to what many people think, arthritis is not a single disorder; in fact, it has over 100 types, each having different causes and treatments. The most common types, however, are osteoarthritis, in which the cartilage deteriorates, and rheumatoid arthritis, a disorder where the body’s immune system attacks the joints.

Damage done to the joints are irreversible, but their progression can be stopped and their symptoms relieved through targeted treatments, which vary depending on the type and stage of the arthritis.

What Causes Arthritis?

With more than a hundred variations of arthritis, the cause greatly depends on its specific type. The different causes are generally:

  • Hereditary Factors – Having a close relative with some form of arthritis can increase the risk of one developing the condition.
  • Environmental Factors – Exposure to toxic substances and excessive heavy lifting may trigger or worsen the condition.
  • Infections – Certain variations of the illness, such as septic joint inflammation, are caused by bacterial, fungal or viral infections. Some infections also result in the thinning and deterioration of the cartilage, which lead to joint pain and arthritis.
  • Injury – In some cases, arthritis is caused by damage due to past trauma and injury to the joints.
  • Metabolic Disorders – Gout, for instance, is caused by unhealthy levels of uric acid in the blood, which results in swollen joints and tenderness.
  • Autoimmune Diseases – Lupus and rheumatoid arthritis or rheumatism are caused by an overactive immune system that mistakenly attacks the joints, resulting in pain and inflammation.

    • What Are the Risk Factors for Arthritis?

    There are certain risk factors involved when it comes to the joint disorder, and while some can be controlled (modifiable, others cannot (non-modifiable).

    Typical modifiable risk factors include:

    Diet
    DietCertain types of food are unhealthy and can lead to obesity or metabolic complications like gout.
    Injury
    InjuryBone fractures or trauma to the ligaments and cartilage in the joints could lead to pain and inflammation.
    Sedentary Lifestyle
    Sedentary lifestylePhysical inactivity leads to metabolic disorders, which in turn may result in arthritis.
    Smoking
    SmokingIt increases the chances of developing rheumatoid arthritis and lupus, and worsens their symptoms as well.
    Weight
    WeightBeing overweight or obese increases the risk of developing knee and hip osteoarthritis.
    Work Environment
    Work environmentSome occupations involve placing excessive pressure on the joints, be it through constant standing or heavy lifting.

    Risk factors that are non-modifiable include:

    Age
    AgeThe chances of getting arthritis increase with age.
    Gender
    GenderWomen are more likely to have rheumatoid arthritis or rheumatism, while men are more inclined to have gout, lupus and ankylosing spondylitis.
    Genetics
    GeneticsA close genetic link to someone with the disease can make one more likely to develop the joint disorder.

    What Are the Symptoms of Arthritis?

    Depending on the type of arthritis, symptoms can vary. Common symptoms include:

  • Joint pain
  • Joint stiffness
  • Joint swelling and redness
  • Joint tenderness
  • Joint warmth
  • Limited joint movement
  • Limping
  • Locking of joint
  • Weakness

    • Symptoms are said to be much worse in the morning, upon waking up. In some cases, the joint condition may trigger uncommon symptoms such as fever, swollen lymph nodes, weight loss and malaise.

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    How Is Arthritis Diagnosed?

    The first step in diagnosing arthritis and identifying its specific variation is through a thorough physical examination. During this stage, the doctor or rheumatologist will check for the presence of fluid, warmth, tenderness and limited motion around the joints. Depending on the prognosis and the suspected type of arthritis, the specialist may recommend further testing, such as:

  • Laboratory Tests – Drawing and analysing blood, urine and fluid from the affected joint can help the doctor determine the type of arthritis.
  • X-rays – Usually, X-rays are conducted to determine the severity of damage done to the cartilage and bone.
  • Computerized Tomography (CT) Scan – A CT scan can show an image of the affected area in various angles, giving the physician a clearer look at the bone and soft tissues.
  • Magnetic resonance imaging (MRI) – An MRI scan can give a detailed view of the cartilage, ligaments and tendons.
  • Ultrasound – Aside from being used as a guide during injections and aspirations, ultrasound can also be used to produce images of soft tissues, bursae and cartilage.

    • From the results of these tests, the physician will then give a final diagnosis and recommend a customised treatment for arthritis.

    How to Treat Arthritis?

    Arthritis treatment is focused on managing pain and discomfort, and preventing further damage to the joints. Home remedies like hot or cold packs, assistive walking devices and physiotherapy can help relieve pain, and strengthen and restore flexibility and function to the joints.

    Treatment for arthritis also includes:

      Medications

    • Analgesics for pain management
    • Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation
    • Capsaicin or menthol creams to block the transmission of pain signals
    • Immunosuppressants to control inflammation
    • Corticosteroids or disease-modifying anti-rheumatic drugs (DMARDs) suppress the immune system (for those with rheumatoid arthritis or rheumatism).

      Surgery

    • In severe cases where arthritis has already severely damaged the joints to the point where mobility is significantly compromised, arthritis treatment may then involve surgery.

    Osteoarthritis treatment, for example, usually requires medicines to manage inflammation and pain, and very rarely necessitates surgery. For severe cases, however, surgery may be required, the most common of which are:

  • Joint repair – Typically done arthroscopically, this procedure involves smoothing or realigning the joints to improve joint function and reduce pain.
  • Joint replacement – Commonly used on the knees and hips, this procedure removes the damaged joint and replaces it with an artificial one.

    • Alternative options like acupuncture, massages and stretching exercises like yoga and tai chi, may also be considered alongside clinical treatments. Supplements such as glucosamine can be taken as well, but ideally do seek a rheumatologist’s assessment and recommendations first before trying these. This will ensure that your arthritis treatment is as effective, safe and tailored to your needs as much as possible.

    Our Services

    There are more than 100 different types of rheumatic disorders. Our team works together to diagnose and treat the full spectrum of these disorders, including autoimmune diseases, such as lupus, rheumatoid arthritis and psoriatic arthritis, as well as other forms of arthritis, such as osteoarthritis, gout and Arthritis. Treatments for the various conditions may include lifestyle changes, medication and surgery. A/Prof Leong will tailor each treatment plan to effectively manage the condition in each patient.

    Click on each service to find out more

  • Arthritis
  • Rheumatoid Arthritis (RA)
  • Systemic Lupus Erythematosus (SLE)
  • Ankylosing Spondylitis (AS)
  • Psoriatic Arthritis
  • Sjogren's Syndrome
  • Joint Pain
  • Scleroderma, Systemic Sclerosis
  • Gout
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