Arthritis: causes, symptoms, types, diagnosis, treatment

Arthritis

is an inflammatory disease of the joints, which can occur in an acute form or, in the absence of timely treatment, become chronic.
This is an extremely common disease in the CIS, which is especially common in women over 45 years of age
.
According to medical reports, among diseases of the musculoskeletal system, arthritis is one of the most common causes of temporary or permanent loss of ability to work, including severe disability
. Symptoms of arthritis can begin in a person of any gender and age - often even in children. According to statistics, every 100th person suffers from joint inflammation. And in the age group over 60 years, the incidence rate can reach 80%. What are the early symptoms of joint arthritis and the prerequisites for the development of the disease?

Arthritis is an inflammatory disease of the joints

Causes of Arthritis

Arthritis is a consequence of damage to the articular cartilage or the entry of microorganisms into the synovial fluid.
In the first case, the pathology occurs due to degenerative processes in tissues due to injury or osteoarthritis. The causes of inflammatory arthritis are infection and waste products of microorganisms when:

• migration of the pathogen through blood and lymphatic vessels from nearby tissues;
• infectious diseases affecting the entire body - tuberculosis or gonorrhea;
• toxic-allergic effects of by-products of microorganisms;
• an allergic reaction to the body’s own tissues after an infection or in the presence of a permanent focus of inflammation, accompanied by a disruption in the functioning of the immune system;
• injury to the joint and infection through the wound or aseptic inflammation.

The following factors contribute to the occurrence of the disease:

• hereditary predisposition;
• increased load on the musculoskeletal system;
• infectious diseases;
• consuming large amounts of caffeine;
• smoking;
• excess weight;
• allergic reaction;
• metabolic disorders;
• traumatic injury;
• hypovitaminosis and lack of nutrients;
• pathology of the nervous system;
• malfunctions of the immune system;
• improper diet, consumption of alcoholic beverages;
• hormonal disorders;
• stinging insect bites;
• hypothermia of the body.

Diet for rheumatic diseases - recommended foods

A diet for rheumatoid arthritis should be rich in omega-3 fatty acids.
They effectively relieve inflammation. Their source is fish, especially sea fish (for example, salmon, mackerel, herring, halibut, sardines). People suffering from RA should eat fish at least twice a week, 100 g each. It is worth remembering that this should be oven-baked or steamed fish, not fried. Other sources of omega-3 fatty acids are: flaxseed and rapeseed oil, hemp oil, walnuts. It is advisable to include foods in the menu in small portions every day.

However, keep in mind that foods such as pumpkin seeds, sunflower seeds, pumpkin seed oil, grape seed oil, sunflower oil and corn oil should be limited in the diet due to their high content of omega-6 fatty acids. Excessive intake of omega-6 fatty acids over omega-3 fatty acids increases arthritis symptoms.

Vegetables and fruits are also mentioned among the foods especially recommended for rheumatoid arthritis. They are high in antioxidants and dietary fiber to reduce inflammation. It is recommended to include 500-700 g of vegetables and 200-400 g of fruits in the diet.

When choosing cereal products, you should focus on whole grains. They contain more dietary fiber, which lowers CRP levels (an indicator of inflammation) than pure white flour products. Therefore, the following are especially recommended for consumption: thick cereals (buckwheat, pearl barley), cereals (oatmeal, spelt, rye), whole grain pasta, wholemeal bread, brown rice, bran. However, it is best to limit your consumption of potatoes, which have a high glycemic index and much less fiber than cereals or rice.

Vitamin D deficiency can also worsen symptoms. For this reason, you should not forget to include fish in your diet, and you should also add vitamin D in the fall and winter (and in some cases also in the spring and summer) and get outside.

Classification

Arthritis, depending on the cause and clinical form, is of the following types:

• rheumatoid arthritis associated with malfunctions of the immune system;
• rheumatic, with chronic connective tissue disease with predominant damage to the heart and joints;
• ankylosing spondylitis, or ankylosing spondylitis - inflammation of the joints of the spine;
• infectious, with direct penetration of infectious agents into the joint;
• reactive arthritis - an immune response to a previous infectious disease;
• psoriatic arthritis is a chronic immune-mediated inflammatory disease of the osteoarticular system that develops in patients with psoriasis;
• gouty – occurs due to the deposition of uric acid in the joints;
• inflammation in systemic connective tissue diseases, for example, systemic lupus erythematosus;
• arthritis due to diseases of the gastrointestinal tract, lungs and other organs and systems;
• traumatic, occurring after an injury;
• juvenile idiopathic arthritis in children under sixteen years of age.

Based on the number of joints affected, monoarthritis is distinguished with inflammation of only one, oligoarthritis, if two or three areas are affected, and polyarthritis - a disease of more than three joints.
The process can be acute or chronic. In the first case, it develops rapidly, accompanied by severe pain and inflammation in the tissues. Chronic disease progresses gradually, slowly turning into a serious disease.

Diet for rheumatic diseases - what to avoid

A diet for rheumatoid arthritis should exclude foods rich in saturated fats and trans fats. These include: fatty meat (pork, beef), fatty dairy products (milk 3.2%, yellow cheese, blue cheese, processed cheese, full-fat cottage cheese, cream) and sweets, salty snacks, fast food, fast food, soups and sauces.

All products high in preservatives, dyes, flavors and other enhancers are prohibited. You should rely on natural, unprocessed foods.

Sugar should also completely disappear from the diet. It is important to limit your salt intake, the excess of which leaches calcium from the body. Instead of salt, you should use spices such as turmeric, garlic, ginger, anise, cloves, savory, tarragon, basil, thyme, mint, marjoram. In this case, you should avoid hot spices - chili, hot pepper.

It is also very important to eliminate or at least significantly reduce alcohol consumption. All carbonated and non-carbonated drinks, flavored water, and syrups for mixing with water should also be excluded. It is necessary to reduce the consumption of strong coffee and tea. It should be replaced with water in an amount of at least 1.5-2 liters per day.

Arthritis symptoms

Manifestations of the disease depend on its clinical form and severity of the process. The main symptoms of arthritis include local manifestations of inflammation in the joint - pain, redness and swelling of surrounding tissues, limited mobility, deformation as pathological changes progress. There is also a local increase in temperature, the affected area becomes hot when touched.

Infectious

The course of the disease depends on the type of pathogen. Often there is a sharp increase in temperature, chills, headache, and weakness. Tuberculous arthritis occurs in a chronic form, is difficult to treat and leads to severe dysfunction of the affected joint. With gonorrhea, as a rule, acute serous inflammation develops. Viral lesions go away after the infection is cured.

Gouty

Gout is a metabolic disorder that is accompanied by the deposition of uric acid salts - urates - in the joints. They penetrate the tissues, forming gouty nodes or tophas. The metatarsophalangeal joints of the thumbs are usually affected first, followed by arthritis in other areas. During an exacerbation of the disease, acute inflammation develops with tissue swelling and severe pain. After several attacks of gout, the joint becomes deformed and its function is impaired.

Rheumatoid

An autoimmune reaction develops with damage to the body’s own tissues, including joints. The causes of the disease have not been precisely established, but it is known that inflammation is triggered by infection in the body. At the onset of the disease, there is an increase in body temperature, the patient is worried about morning stiffness - a gradually passing limitation of mobility after waking up, pain and swelling at the site of inflammation. Symptoms may spontaneously disappear for several months, followed by exacerbation and progression of the disease. Damage to the hand and fingers is typical, but there are cases of atypical reactive arthritis with inflammation of the knee or shoulder joint. Gradually, without treatment, articular cartilage is destroyed, connective tissue grows, subluxations and dislocations occur, leading to disability of the patient.

Traumatic

Develops after injury to large joints - hip, knee, shoulder and others. There is pain, swelling and crunching when moving. With a closed injury and aseptic inflammation, spontaneous recovery is possible. With an open wound, the infection penetrates deep into the tissue and can cause purulent inflammation.

Psoriatic

It is characterized by damage to the terminal interphalangeal joints of the fingers and nails with simultaneous asymmetric damage to several other areas. The course of the disease occurs with relapses and remissions.

Reactive

This form is associated with a toxic-allergic reaction to an infection that develops within a week after a bacterial, viral or fungal infection. It occurs acutely, affecting 1-3 large joints. Characterized by pain at the site of inflammation, redness, swelling of surrounding tissues, and limited mobility. Other symptoms of inflammatory damage to the eye mucosa and urinary tract may also be present.

Juvenile idiopathic

Arthritis of unknown cause in children under sixteen years of age. It is believed that the basis is the genetic predisposition of the child. Prolonged exacerbations alternate with remissions and lead to early disability of the patient.

Symptoms of joint diseases: when to sound the alarm

Joint problems are not only indicated by pain in the knee or shoulder. Sometimes a regular therapist can notice something is wrong during a general appointment. Joint lesions have systemic and non-systemic manifestations. Sometimes they are accompanied by disruption of the gastrointestinal tract, respiratory and cardiovascular systems.

Typical symptoms include:

• soreness and swelling;
• stiffness of movement;
• local redness of tissues;
• compactions and hard formations, for example, with arthrosis of the hand on the phalanges of the fingers;
• a crunching sound that is repeated and causes pain;
• violation of fine motor skills.

In addition, if the joints suffer, the person experiences weakness, may shiver, and general malaise appears. All of this indicates that it is time to seek help.

Joint pain is not the only warning sign

Diagnosis of arthritis

Timely detection and treatment of arthritis or arthrosis will help maintain normal joint function and the ability to lead an active lifestyle even in old age.
For successful treatment of the disease, it is important to establish its cause. In addition to analyzing complaints and symptoms, laboratory and instrumental diagnostic methods help determine the type of arthritis, as well as the severity of the inflammatory process.

• General clinical blood test. An acute process is characterized by an increase in ESR. When the disease is caused by microorganisms, leukocytosis is observed. In case of an allergic reaction, an increase in the number of eosinophils is possible.
• Blood chemistry. It is carried out to determine the cause of the disease, as well as the severity of inflammation.
• Immunological blood test. It is especially relevant in identifying rheumatoid and reactive forms of the disease. Indicates the presence or absence of specific antibodies to infectious pathogens or the patient’s own tissues.
• General urine analysis.
• Radiography. The main instrumental method for diagnosing arthritis. Allows you to determine the condition of the bones and identify changes caused by the inflammatory process.
• CT scan. Used to assess the condition of soft tissues - muscles, articular discs, ligaments.
• Magnetic resonance imaging. Allows you to more clearly examine the earliest changes in bone structures, articular and adjacent tissues.
• Ultrasonography. In case of arthritis, it helps to determine the degree of damage to large joints, the superficial location of which allows you to examine them from different sides, as well as to identify an increased volume of intra-articular fluid.
• Examination of synovial fluid. In the infectious form of arthritis, bacteriological analysis helps to identify the pathogen and select an effective antibacterial drug for treatment.
• Arthroscopy. An endoscopic method that involves inserting a special sensor into the joint cavity.
• Arthrography. Shows the condition of the cartilage and soft tissues that surround the joint.

What it is

Chronic arthritis is an inflammatory disease of the joints that lasts more than three months. In this case, exacerbations are replaced by remissions. After exacerbations, the inflammatory process gradually turns into a degenerative-dystrophic process with the destruction of cartilage, the proliferation of bone tissue and the gradual formation of ankylosis (immobility).

Initially, rheumatoid, psoriatic, gouty, and juvenile arthritis last for a long time. Whereas infectious and reactive arthritis, with proper, timely treatment, is acute with complete recovery. But these forms can gradually become chronic if the prescribed treatment is not timely or if the patient’s immunity sharply decreases.

Patients with this disease should be observed by a doctor and receive courses of anti-relapse therapy. This tactic is needed to suppress the progression of the disease. It is possible to achieve this with the current state of medicine. But the result will depend not only on the doctor, but also on the patient’s strict compliance with his instructions.

Codes according to the International Classification of Diseases, 10th revision:

• ICD code for rheumatoid seropositive arthritis - M05.8; seronegative – M06.0;
• ICD code for chronic juvenile arthritis – M0.8;
• ICD code for gouty arthritis – M10.0;
• psoriatic arthritis – M07.0;
• unspecified arthritis - M13.0.

Treatment

Treatment of arthritis is aimed at eliminating the cause of the disease and risk factors that contribute to the development of inflammation, relieving symptoms, improving metabolism in the affected joint, and preserving its function.
This can be achieved through the use of medications, physiotherapy, physical therapy and massage. In advanced cases, with purulent processes, dislocations and subluxations, surgical intervention may be required. If the joint is completely destroyed, it can be replaced with an artificial one - endoprosthetics.

Conservative therapy, depending on the form of arthritis, includes the use of tablets, ointments and injections of various groups of drugs:

• antibiotics for bacterial infections;
• non-steroidal anti-inflammatory drugs and hormones;
• chondroprotectors – agents that improve the quality of joint tissue;
• painkillers;
• vitamins, microelements and amino acids.

Author:

Pugonina Tatyana Alekseevna, Therapist

Localizations

Different clinical forms of the disease have their own favorite localization and other features.

Crunching in joints - when to worry

Intra-articular injections of hyaluronic acid

Inflammation of the joints of the lower extremities

Chronic arthritis of the leg joints has the following localizations:

• joints of the foot
  - in the gouty form there is severe inflammation, hyperemia, pain, in the rheumatoid form - all symptoms are initially mild, there is no redness of the tissues, the tips of the fingers thicken and look like hammers; when the ligamentous apparatus is inflamed, the heel hurts;
• ankle
  - affected in all forms of arthritis, but especially often in JCA; swelling and pain are not pronounced, all symptoms increase gradually;
• the knee
  is one of the most common locations for all forms of the disease; pronounced manifestations in gout and psoriasis, erased in RA and JCA;
• hip
  – inflamed with JCA; manifested by painful movements.

Read more about hip arthritis here.

Inflammation of the joints of the upper extremities

Localizations for chronic arthritis of the joints of the hands:

• joints of the hand
  - in RA, the interphalangeal joints are affected, in PsA - distal joints with necrosis and involvement of the nail plates;
• fingers
  – affected by gout, swell and have a characteristic sausage appearance;
• elbow
  – with psoriasis, signs of inflammation are clearly expressed; with JCA, the elbow is painful when moving, but there are no external changes for a long time;
• Shoulder
  – often involved in the pathological process in JCA and psoriasis.

Read our articles on inflammation of the joints of the upper extremities, “Elbow Arthritis” and “Arthritis of the Joints of the Hand and Fingers.”

Temporomandibular arthritis

In JCA, especially often in girls, it is combined with characteristic ocular symptoms (uevitis). Sometimes the same symptom occurs in RA. Chronic arthritis of the temporomandibular joint is manifested by pain and impaired movement when chewing.

Arthritis of the joints of the spine

In JCA and RA, chronic arthritis of the spinal joints sometimes develops, mainly in the cervical region. Gout may be accompanied by involvement of the cervical and lumbosacral spine. This manifests itself as pain and impaired mobility (difficulty turning the neck, bending).

Approach to treating the disease in our clinic

Many years of practice have allowed specialists from the Moscow Paramita clinic to develop their own approach to the treatment of chronic arthritis. It includes:

• thorough preliminary examination of the patient using all modern laboratory and instrumental diagnostic methods;
• prescribing a comprehensive course of treatment, including the most modern methods of drug and non-drug therapy, affecting directly the source of inflammation;
• application of a complex of individually selected procedures developed by ancient doctors in China and Tibet; treatment is aimed at general improvement of the body, leading to a gradual restoration of joint function; More information about these methods can be found here.

The clinic’s specialists will provide assistance to patients with chronic arthritis at any stage of the disease. They will relieve you of pain and restore the joy of life. Contact us!

Reflexology and electrophoresis are used to treat chronic arthritis

Clinical recommendations for patients with chronic arthritis

To avoid exacerbations and loss of joint function, the patient must be constantly under the supervision of the attending physician and follow all his recommendations:

• regularly conduct examinations and courses of preventive treatment prescribed by a doctor;
• monitor your health, promptly treat all acute and chronic diseases, foci of infection;
• lead an active lifestyle, do therapeutic exercises, swimming;
• avoid heavy physical activity, long periods of driving, stress, exposure to the sun;
• follow the rules of a healthy diet, monitor your weight; if you have gout, follow a diet;
• get rid of bad habits: smoking and alcohol abuse.

We combine proven techniques of the East and innovative methods of Western medicine.
Read more about our unique method of treating arthritis

Disease prevention

Preventive measures are especially relevant for people who have close relatives suffering from chronic arthritis. To avoid the disease, they should, as far as possible, eliminate exposure to provoking factors on the body. Recommendations for preventing the disease are no different from recommendations for preventing relapses of chronic arthritis.

Persons suffering from chronic arthritis should be very careful about their health. Self-medication should be completely excluded. Only an experienced specialist from a clinic with an impeccable reputation can help, improve the quality of life and stop the progression of the disease. Clinic "Paramita" is waiting for its patients!

FAQ

Is it possible to get disability?

It is possible if there is significant dysfunction of the joint.

Which doctor treats you?

Rheumatologist. For psoriatic arthritis, consultation with a dermatovenerologist is also required, and for gout, an endocrinologist.

What prognosis do doctors usually give?

It is possible to stop the progression of the disease and improve the quality of life at any stage.

Bibliography:

1. Comparative assessment of the information content of ultrasound markers of joint damage in chronic arthritis in children [Electronic resource] / Lukinskaya, Zharov, Sinelnikova // Ultrasound and functional diagnostics, 2015. - No. 5. - P. 59-59.
2. Nicola J. Kalk, Petra Schweinhardt et al. 'Functional magnetic resonance imaging of central processing of clinical and experimental pain in rheumatoid arthritis. Abstracts 11th world congress on pain August 21–26, 2005. Sydney, Australia 502-P108.
3. Schaible HG, Ebersberger A., ​​von Banchet GS Mechanisms of pain in arthritis // Ann NY Acad Sci. 2002: 966: 343–354.

Themes

Arthritis, Joints, Pain, Treatment without surgery Date of publication: 02/19/2021 Date of update: 03/15/2021

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Stages of rheumatoid arthritis of the knee joint

The disease develops gradually, so at first a person does not attach much importance to minor health problems. The course of the disease can be divided into 2 stages:

• Initial, when the victim is plagued by minor pain, and in the morning the knee joint is inactive. After a few hours, the victim forgets about the illness - exactly until its new manifestations.
• Transition to the stage of rheumatoid polyarthritis, which usually manifests itself symmetrically on the left and right limbs. The pain does not stop, and difficulties with movement appear.

Arthritis in severe cases is no longer just mild pain or inflammation. Destruction can affect muscles, affect the liver, heart, lungs and other internal organs. In this case, the patient’s life is at risk. The risk of disability increases.