Arthritis is a condition in which joints become swollen and painful, causing much suffering and difficulty in working. Different types of arthritis involve different joints and occur due to various causes. Rheumatoid arthritis most commonly involves the small joints of the body mostly hands and feet. It is hereditary, common in young women, but can occur in other age groups and gender also. Along with pain, one has stiffness of joints more so in the morning. It is a multisystem disease. Heart, lungs, eyes, throat, among other various parts of the body are damaged by rheumatoid arthritis. Rheumatic arthritis is caused as a reaction to bacterial infection by Beta hemolytic streptococci. It occurs commonly in young adolescents more in males from poor socio-economic conditions. The involvement of joints is, “flitting,” that is to say, joints are affected one after another mostly affecting large joints like knee and shoulders. The sequel to it is permanent damage to heart. Ankylosing spondylitis, occurs because of a chromosomal defect during birth. The back bone bears the brunt of the disease. Initially there is pain the upper back with gradual stiffness. This increases progressively, thus aggravating the pain. As the disease progresses it cripples the sufferer. Gout is a variant of arthritis which involves the great toe earliest, followed by other toes, foot, ankle and knee. Young adults especially men are more affected. It occurs because of increased uric acid levels in the blood. Old people suffer from arthritis due to multiple reasons. As age advances stiffness of joints sets in, producing many problems. Softening of the bones augments the suffering. Shoulders become stiff in what is known as “frozen shoulder syndrome.” It occurs in both sexes. It is a degenerative change occurring because of wear and tear in the joint. The stiffness and pain increase gradually to the extent that one finds it difficult to do small things like combing or pulling up the zip at the back of the dress. Another joint to bear the brunt of degenerative changes with increasing age is the knee. Osteoarthritis affects the weight bearing joints of the body mostly the knees and hips and occurs mostly aged 60 or above. Infectious germs can affect the joints, producing pain, swelling and redness of the joint along with high fever. It can occur in any age or gender. This form of arthritis is acute, but responds well to suitable antibiotics. In any arthritis, pain killers provide only temporary relief. Relapses are common. The time interval between relapses is variable depending on various factors, like severity of arthritis, nature of physical work being done by the individual, nutritional level and osteoporosis, alcoholism, smoking, co-existing diseases like diabetes, amount of exercise and rest. Any pain relieving medicine if taken for long time leads to gastric ulcers and even kidney failure. Therefore, a person suffering from arthritis should be discouraged from taking pain killers. He should know that these medicines are not curative and not safe if used repeatedly, hence to be taken only if pain is severe. Analgesic ointments applied locally is a better choice than taking tablets. Surgical techniques are available to help in case of arthritis but they do not replace natural flexibility. Once acute pain is relieved, it is better to take due precautions to avoid exacerbation of pain and inflammation. These include avoiding heavy physical work, correct postures, among others. Specific exercises of the joints, done regularly, enhance the flexibility of joints and keep the pain and inflammation to minimum. Dr Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital
