Dr Olasode Akinmokun is a trauma and orthopaedic surgeon at the Orthopaedics and Trauma Unit, Department of Surgery, College of Medicine, University of Lagos. Akinmokun, an honorary consultant orthopaedic surgeon in the Department of Orthopaedics, Lagos University Teaching Hospital, tells ALEXANDER OKERE about the causes and management of arthritis
How would you define arthritis?
Arthritis is the swelling of one or more joints in the body. The main complaints are the pain, swelling and stiffness of the joints. This stiffness usually occurs in the morning or after a prolonged period of inactivity. What eventually leads to arthritis is the damage to the cartilage in the joint.
What are the types of arthritis?
There are two main types of arthritis: osteoarthritis and rheumatoid arthritis.
How are they different from each other?
Osteoarthritis is the most common type of arthritis. In osteoarthritis, it occurs following wear and tear damage to the joint cartilage. The cartilage is the whitish coating/cap on the end of the bone that forms the joint. The cartilage cushions the ends of the bones and allows for almost frictionless motion in the joint. Once the cartilage is damaged enough (from wear and tear from aging, family history, joint injury, infection, etc.), there would be bone grinding directly on another bone, which would cause pain and movement restrictions.
The second type is rheumatoid arthritis. Here, the part of the body’s immune system attacks the lining of the joint capsule. The joint capsule is a tough membrane that surrounds and encloses all the structures that form the joint. The lining that is attacked is called the synovial membrane. Once the immune system attacks the lining, the lining becomes swollen, painful and stiff. This disease process will eventually destroy the cartilage and bone around the joint.
Is it true that arthritis could be infectious?
Arthritis is not infectious and it is not a communicable disease. However, there is a form of arthritis called septic arthritis. It is caused by an infection in the joint.
What are the symptoms of the different types of arthritis?
For most types of arthritis, the symptoms are usually found in the joint and they include pain, swelling, stiffness and decreased range of motion. Additional symptoms will be based on the type of arthritis.
Which among them is common among men and women?
Arthritis is generally more common in women than men. One cannot explain exactly the reason why women are at a higher risk of developing most types of arthritis.
What are the other risk factors for arthritis?
The risk factors for arthritis include family history. Some types of arthritis run in families, meaning that an individual in that family is likely to develop such arthritis, especially if parents, siblings or relatives have the disorder. In some people, it may be that the genes that were acquired would make them more susceptible to factors that may trigger arthritis. The risk of developing arthritis increases with age. Previous joint injury – people who had injured a joint are likely to develop arthritis in that joint.
Also, obese people have a higher risk of developing arthritis, especially in the joints. The joints that are prone are the knees, hips or the spine. Individual lifestyle choices affect all aspects of physical well-being, and joints inclusive. Obese patients are at risk of developing arthritis. Reduction in weight will help to reduce that risk. Smoking is linked to the development of rheumatoid arthritis, especially people who had a long history of smoking for 20 years or longer. It is, therefore, important that one takes a critical look at one’s lifestyle and change if necessary.
Is the working class more susceptible to arthritis?
Being in the category of the working class is not a risk factor for the development of arthritis.
How can arthritis be diagnosed?
Arthritis can be suspected from the complaints that the patient presents with. Most patients will present with one or many symptoms as stated earlier. The risk factors would also be reviewed by the doctor during the consultation. The patients will be examined and various tests (blood, tissue and/or radiographs) would be requested, depending on the type of arthritis. However, the most common test that most patients with arthritis would be asked to conduct is the plain radiograph (X-ray) of the affected joint. After going through these processes, Arthritis can be diagnosed.
Is arthritis curable?
Arthritis develops from destruction of the cartilages that are in the joints. The only cure is when surgery is done, in the form of joint replacement, which will replace all the destroyed components of the joints. The procedure is, however, reserved for those with the worst form of arthritis; that is, very severe. For those with mild to moderate forms of arthritis, there is no cure, but it can be managed very well. The most important thing is to prevent arthritis. The next most important thing is for the person with joint pain to visit the hospital for proper review and test. The earlier the diagnosis is made, the better the possibility of slowing the rate of degeneration into the severe form of arthritis.
What are the different treatment options and how are they applied?
For mild to moderate arthritis, medications are given to relieve pains and inflammation. Disease-modifying antirheumatic drugs are given to those with rheumatoid arthritis. Sometimes, medications may be injected into the joint. Physical therapy, especially physiotherapy, is also very important. Surgery may be necessary when the above method is not helping or for the severe type of arthritis
How can physical exercises help?
Physical exercises will result in weight loss which will help in the prevention of arthritis.
Is it advisable for arthritis patients to restrict themselves to certain kinds of diet?
Those with gouty arthritis should avoid red and organ meats, seafood (e.g. shrimps and lobster) and alcohol. There is no food restriction for other types of arthritis. Food that will cause weight gain should be avoided.
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