Types of Arthritis
Where to start?
There are over 100 types of Arthritis, all different conditions whereby a patient is experiencing painful, swollen joints. Arthritis: “arthro” = Joint “itis” = Inflammation The most common types of Arthritis seen in clinics include: Osteoarthritis, Rheumatoid Arthritis, Psoriatic Arthritis and Gout.
But what’s the difference? Based on a physical examination and case history alone we can narrow down which type of arthritis you could potentially be suffering from. Read about the signs and symptoms below to shed some light on your condition. Osteoarthritis Osteoarthritis typically affects the older generation, and is known as “wear and tear”. Osteoarthritis occurs as joints “wear out”. The repetitive pressure put through a joint can cause thinning of the structures within it, leaving pain sensitive structures exposed, and so causing you pain. However, whilst it’s rarer, Osteoarthritis can also be seen in younger patients. This could be down to genetic predisposition, a compromised joint because of previous injury or infection, or due to abnormal/poor loading of a joint.
Signs and Symptoms
- Painful joint (s), usually affecting only one joint in particular, or a group of joints that show no pattern. - Stiffness of the painful joint - No swelling of the painful joint - No skin changes around the painful joint - No fever around the painful joint - Increased pain during or after movement, and in the morning - Decrease in pain with rest Diagnosing Osteoarthritis This can be done for the most part by a physical exam and case history, however, should your chiropractor be concerned that other structures are compromised an X-ray may be taken for a more conclusive diagnosis. Rheumatoid Arthritis Rheumatoid Arthritis is an auto-immune disease. This means that the body’s immune system does not recognise the material within the joints capsule as being “self”, and instead respond to is as a foreign entity, attacking it as if it were a harmful invader, such as an infection. This means that Rheumatoid Arthritis affects a wider range of the population (unlike osteoarthritis which is more common in the ageing population).
Signs and Symptoms
- Painful and swollen joints - Distribution of painful joints are typically symmetrical, meaning that the same joints are affected on both sides of the body. - Decrease in pain on or during movement - Increase in pain during inactivity - Loss of appetite - Low grade fever - Symptoms are intermittent (meaning that they can come and go over several days or weeks). - Morning stiffness in the affected joints Diagnosing Rheumatoid Arthritis As Rheumatoid Arthritis is an auto-immune disease the symptoms may not always be present, for example, you may experience swelling of a painful joint for 2-3 weeks at a time and then have a period of several months with no symptoms. Again Rheumatoid Arthritis can be diagnosed from a case history and physical exam alone, although for certainty a blood test is required to test for markers in your blood. This can be carried out by your GP, and is something your chiropractor can refer you for. Psoriatic Arthritis Psoriatic Arthritis is also an autoimmune disease, and is linked with the skin disorder Psoriasis. Approximately 30% of those who suffer with Psoriasis will go on to develop Psoriatic Arthritis, and so swollen and painful joints in someone diagnosed with Psoriasis should always be checked. However, the joint pain can pre-cede any skin symptoms, making the diagnosis difficult and time consuming.
Signs and Symptoms - Swollen and painful joints - Asymmetrical distribution of joints affected (most commonly there is no pattern to the joints that are affected). - Skin changes, including red rashes or flaky skin, and changes in the fingernails. - Stiffness in the morning, or after rest. - “Sausage digit” Whereby all the joints of one finger become swollen. - Symptoms can be intermittent. Diagnosing Psoriatic Arthritis Psoriatic Arthritis can be detected from a good physical examination and case history, however, for a formal diagnosis of Psoriatic Arthritis a blood test is needed, to check for the presence of inflammatory markers, and a lack of Rheumatoid markers, as this rules out the possibility of suffering from Rheumatoid Arthritis. Your Chiropractor may also refer you for an x-ray, to better visualise the structures involved in an affected joint, as this will help them to tailor your treatment plan. Gout Gout is caused by a build-up of uric acid within the blood, a condition called Hyperuricemia, this accumulates over several years. Uric acid occurs naturally in the body, as a bi-product of the breakdown of other substances in the body. The problem arises when a person's body either cannot get rid of the uric acid, or produces too much. Uric acid forms needle type crystals that accumulate in the capsule of a joint, most commonly the big toe.
Signs and Symptoms - Hot, swollen and painful joints - Big toe joint is most commonly affected, although can involve any joint. - Pain may last for a week then begin to subside. Diagnosing Gout As with the other types of arthritis mentioned in this blog, Gout can be determined from a physical exam and case history. However, for confirmation of the condition, you may be referred for blood tests, to determine the levels of uric acid in the blood, or an x-ray may be taken. An x-ray shows how the structures within the joint are involved, and how progressed any condition may be.