Arthritis overview
What is arthritis?
Arthritis is a general term covering more than 150 different conditions.
Although arthritis is often thought of as a disabling condition of the elderly, 2 out of every 3 people with arthritis are under the age of 65 and mostly lead normal, or near-normal, lives.
Arthritis means inflammation in joints. The usual symptoms are pain and stiffness and sometimes swelling.
How are the joints affected?
Joints are places where one bone moves against another. The surface of the bone in these situations is covered with cartilage, a smooth 'gristly' material. The whole joint is contained in a capsule, which is lined with a tissue called the synovial membrane. This membrane secretes a fluid — synovial fluid — which lubricates the cartilages' surfaces as they move against each other, rather like oil lubricating the pistons in an engine, allowing them to slide smoothly. Arthritis occurs when something is wrong in this system.
Common forms of arthritis
Of the many types of arthritis, the most common is osteoarthritis. Sometimes called degenerative arthritis, this can be thought of as the 'wear and tear' form of the disease. It tends to affect people as they get older and particularly affects joints that have to take a lot of stresses and strains, such as the weight-bearing joints in the hips and knees. The lower back, neck and hands are also commonly affected. In osteoarthritis, the cartilage surfaces are damaged and worn, sometimes to the point where the underlying bone surfaces are in direct contact with each other.
In rheumatoid arthritis the main problem is inflammation of the synovial membrane, and in gout (which many people don't realise is a form of arthritis), inflammation occurs in the synovial fluid due to tiny crystals of uric acid.
The treatment of arthritis
There are many aspects to the treatment of arthritis.
Exercise is very important because it increases lubrication of the joints and strengthens the surrounding muscles, putting less stress on joints. Exercise in heated swimming pools — hydrotherapy — can bring enormous relief from pain and stiffness.
Medication is usually necessary for painful arthritis. Simple over-the-counter medications, such as paracetamol or aspirin, may be enough, but sometimes specific medicines, known as non-steroidal anti-inflammatory drugs (NSAIDs) are used. These can be very effective, but must be taken with care by those who are prone to indigestion and stomach ulcers.
Recently, a new generation of anti-inflammatory medications, called COX-2 inhibitors or coxibs, has been released, followed by a COX-2 selective inhibitor, meloxicam. These medications are said to cause less stomach irritation than NSAIDs. However, coxibs may be associated with an increased risk of cardiovascular events, such as heart attack and stroke, when taken in high doses. In February 2005, the Australian Therapeutic Goods Administration advised people taking more than 200 mg/day of celecoxib (Celebrex) or more than 15 mg a day of meloxicam (Mobic, Movalis) to review their treatment with their doctor. You can discuss the risks and benefits of these medications with your doctor, who will be able to tell you whether or not they are suitable for you.
Surgery now has an increasing place in the treatment of arthritis. Replacement of badly affected joints such as the hips and the knees can dramatically improve the outlook of people with arthritis, and techniques are continually improving the management of hand and shoulder problems.
Can special diets treat arthritis?
Because arthritis is a common, chronic, disease there are many misconceptions about effective treatments. In particular, special diets or particular foods may be recommended. There is little scientific evidence that diet can affect arthritis. Overweight people should try to lose some weight through dieting and exercise, but people should beware of paying high prices for special foods or supplements sold as 'cures' for arthritis.
Last Reviewed: 16 May 2005
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