What is arthritis, osteoarthritis and rheumatoid arthritis?
You are not wrong if you refer to pain arising from the joint as arthritis. Technically the right term for that is arthralgia. What exactly is arthritis? In this short piece, we will make an attempt to understand what do doctors mean when they refer to a patient suffering from arthritis?
What exactly is arthritis?
For a doctor, arthritis means inflamation of the joint. Whenever we get hurt, like when your hand hits the table accidentally, the area gets swollen, appears red and warm and is painful to touch. Doctors have a fancy word for it -- Inflammation. So arthritis is nothing but inflammation of the joints. Don't bones make up joints? Yes they do. The ends of the bones that make up the joint is lined by cartilage. Cartilage is softer than bone, very smooth and is well lubricated by a fluid. This allows easy movement across the joint like a well greased wheel. So the word arthritis implies, inflammation of the cartilage lining of the joints. In reality, however it is quite different. Cartilage doesn't show signs of inflammation at all. It is the soft tissue lining the joint (synovium) that gets inflamed. Before we get any further confused, let us nail this thing down. Cartilage can get damaged in various ways. And when it does get damaged, the underlying bone gets exposed. In the human body, bone rarely comes in contact with bone. So this results in inflammation of the lining of the joint, resulting in arthritis.
Is osteoarthritis the same as arthritis and how does it develop?
In the normal course of one's life, the cartilage lining of the joint starts to thin in a gradual manner. I often draw the attention of my patients to car tyres. As we drive the car more, the tyres wear out and become thinner over time. In a much similar fashion, the cartilage lining of the joints become thinner and thinner over time. Due to this there is undue pressure on the underlying bone surface leading to inflammation of the joint itself. This form of wear and tear arthritis is referred to as osteoarthirits and one of the common reasons for joint pain. Some people are genetically predisposed to developing early osteoarthritis of the joints, while others are not. Sometimes a fracture involving the bone may result in mis-alignment of the joint resulting in rapid wearing out of the cartilage. Your doctor will then refer to it as Secondary Osteoarthritis. If he or she cannot determine any particular reason for development of arthritis, then they will call it primary osteoarthritis or simply OA.
What is rheumatoid arthritis and how is it different from osteoarthritis?
Rheumatoid arthritis is a different ball game altogether. It is part of a disease process where the the joints are primarily affected. Unlike in osteoarthritis, several joints are often affected at the same time. As the joints get inflamed, the damage of the cartilage lining progresses rapidly. To give you a rough estimate of the time frame, in osteoarthritis damage to the cartilage lining takes about a year or two while in rheumatoid arthritis this can happen within a span of few months. Rheumatoid arthritis can affect young individuals. The good news is that rheumatoid arthritis can be brought under control with medicines, usually prescribed by a rheumatologist. However if the cartilage is damaged considerably, surgery may be required to restore mobility in the joints. Joint replacement surgery for damaged joints, especially for the hip and knee joints can make life comfortable for an young and active person.
I suffer from Chikungunya? Is that also arthritis?
Chikungunya is caused by a virus that is transmitted by mosquito bites. It starts as a fever of 2-5 days and is often followed by severe joint pains and sometimes a rash in the legs. Fortunately the joint problems are restricted to pain and swelling only. Cartilage damage from Chikungunya is unusual unless you were suffering from arthritis previously. Rest and NSAIDS are often prescribed for this. Unfortunately, in a few patients joint pain can persist for months together. Chikungunya is therefore more of arthralgia(pain) and less of arthritis(damage to cartilage lining).
I have gout. Is that also a type of arthritis?
Gout is a condition where uric acid gets deposited on the lining of the joint (synovium). The resulting inflammation causes severe pain. Most commonly, it affects the great toe and at times the knee joint. The degree of redness, warmth and swelling is greater than osteoarthritis. The good news is that if detected early it can be controlled with medicines (prescription drugs). Several attacks may follow unless you control uric acid in your diet (food that you consume on a daily basis). So to answer the question, yes gouty arthritis is also a type of arthritis. Several patients have approached me with high uric acid levels. Without pain in any joint, an increased blood level of uric acid does not require any treatment. Do visit your nearest doctor to have yourself examined and follow their advice accordingly.
For more on the following topics you can visit the websites listed below,
- Osteoarthritis: Arthritis Research UK
- Rheumatoid Arthritis: Arthritis Foundation on RA
- Chikungunya: WHO factsheet on Chikungunya
- Gout: Article on gout in WebMD
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