Joint Disorders
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Of the some 206 bones in our bodies, the joints – most notably our knees, hips and shoulders – see the most action. They are our body’s ultimate shock absorbers, cushioned by cartilage and supported by muscles, tendons and ligaments.
Over time, the stress of everyday activity causes these important supporting structures to wear down, placing additional burden on the joints. Aging, injury, obesity and repetitive motion also contribute to the process.
Osteoarthritis, also referred to as OA, is the most common joint disorder, affecting some 27 million Americans. Osteoarthritis is characterized by the breakdown of cartilage – the part of a joint that cushions the ends of the bones and allows easy movement. As cartilage deteriorates, bones begin to rub against one another. Osteoarthritis can also damage ligaments, menisci and muscles.
The pain and stiffness of osteoarthritis can make every day activities difficult. That’s why many people with osteoarthritis eventually pursue a joint replacement. To manage symptoms, however, self management is important – learn all you can about the disease, how it affects you, and how to live with it.
There are two types of osteoarthritis – primary and secondary. Primary osteoarthritis is generally associated with aging and the "wear and tear" of life. Symptoms generally appear in middle age and almost everyone has symptoms by the age of 70. However, since osteoarthritis is a disease and not part of the normal aging process, not everyone gets osteoarthritis. The disease seems to strike both men and women proportionately before the age of 55, but it appears more women are affected by the disease than men after the age of 55.
While primary osteoarthritis appears later in life, secondary osteoarthritis tends to develop relatively early in life, typically 10 or more years after a specific cause, such as an injury or obesity.
Osteoarthritis occurs most often in the knees, hips, and hands. Other joints, particularly the shoulders, can also be affected. Osteoarthritis rarely affects other joints, except as a result of injury or unusual physical stress.
Although some people have no symptoms of osteoarthritis, others experience the following:
• Pain that worsens after exercise or bearing weight, but is relieved by rest
• Pain that worsens upon engaging in activities after a period of inactivity
• Pain that is present and persistent even at rest
• Grating of the joint caused by motion
• Increased joint pain during humid or moist weather
• Swelling of the joint
• Limited movement
• Muscular weakness surrounding the painful joint
It is important to remain as physically active as possible with osteoarthritis. Exercise keeps joints moving, which helps them stay lubricated. It also builds strength in the muscles surrounding the affected joint, offering increased support. Try different joint-friendly exercise opportunities; water-based programs, walking or low-impact activities.
Rheumatoid arthritis (RA) is another common cause of joint pain. To understand RA, you must first understand autoimmune disease. In an autoimmune disease, the body’s immune system confuses healthy tissues for foreign substances and subsequently attacks itself. While the causes of RA are unknown, it is considered an autoimmune disease.
RA leads to inflammation of the joints and surrounding tissues, causing pain that is often felt simultaneously in both sides of the body, most notably in the wrists, fingers, knees, feet and ankles. It can also affect other organs.
It can strike at any age. When present in children, it is called juvenile rheumatoid arthritis (JRA). Just as symptoms of RA vary from adult to adult and even from day to day, the same goes for children with JRA. This unique feature of the disease is something parents, caregivers, and teachers need to consider when working with children who have JRA.
Symptoms of both RA and JRA include fatigue, loss of appetite, low fever, swollen glands, and weakness. Joint pain appears in the form of morning stiffness, which lasts more than one hour, and stiffness that occurs when the joints have not been used. The swollen joints can even feel warm to the touch.
While there is no single test to diagnose JRA, RA can be diagnosed through an anti-CCP antibody test. This specific blood test not only diagnoses RA, but also distinguishes it from other types of arthritis.
In JRA, the diagnosis is made when there has been persistent arthritis in one or more joints for at least six weeks. Other possible illnesses must have been ruled out as well. To make a firm diagnosis, a variety of tests is often ordered. Care for a child with JRA often goes to a pediatric rheumatologist, a physician who specializes in the treatment of children with arthritis or arthritis-related conditions.
There are three major types of JRA: pauciarticular, which affects four or fewer joints; polyarticular, which affects five or more joints; and systemic onset JRA, which affects at least one joint but causes inflammation of internal organs as well.
Known as a chronic disease, RA and JRA cannot be cured. Since joint destruction may occur within one to two years after the disease appears, an early diagnosis and aggressive treatment is very important to put the disease into remission. Evidence shows that doing so is the best means of avoiding joint destruction, organ damage and even disability.
Most people with RA experience intermittent bouts of intense disease activity, called flares. Fortunately, some people enjoy long periods of remission, experiencing no disease activity or symptoms at all. Still, for others there is no reprieve as they experience continuous disease activity that worsens over time.
Septic arthritis, which is a bacterial infection that spreads to the joints, also causes joint pain, as do injuries such as strains, sprains and fractures. In tendonitis, the tendons become inflamed, irritated and swollen, either from an injury, overuse, or aging from loss of tendon elasticity. Bursitis, yet another cause of joint pain, refers to the inflammation of the fluid-filled sac located between the tendon and the skin that reduces friction between moving parts.
