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Osteoarthritis and Rheumatoid Arthritis

Many people get confused between these 2 conditions so I would like to talk about the signs and symptoms of each.

Osteoarthritis is a degenerative joint disorder commonly referred to as “Wear and Tear”. It is more common in older people as it takes time for it to develop though it can occur in younger people after a joint disorder or damage.

The pain starts slowly and gradually increases. It is usually worse with exercise and relieved by rest though with time rest does not totally ease it. Stiffness is worse after periods of rest. As the condition worsens swelling and deformity can occur. This may become quite obvious with a superficial joint such as the knee whereas hip osteoarthritis may be masked by changes to the pelvis and spine creating postural changes. Local tenderness is common. Movement of the joint becomes restricted and maybe be accompanied by creaking. Later on the joint can become unstable. It frequently occurs in a single joint such as the hip. Heberden’s nodes can appear on the final finger joints. This is very common in post-menopausal women.

In early osteoarthritis pain relief can be obtained by periods of rest and behaviour modification. Pain relief can be obtained from analgesics and anti-inflammatories however there are other alternatives such as Glucosamine Sulphate or Chondroitin which are mineral supplements. Ice-packs may also help. Joint mobility can be improved by Osteopathy so that even small increases in range and power can improve function. Increasing the strength of associated muscles can help by reducing the load on the joint. Weight reduction can also help in this way.

Rheumatoid Arthritis

This is one of a group of conditions which cause chronic pain, swelling and tenderness of joints and tendons. It tends to occur in the 4th or 5th decade and affects women 3 times more often than men. It is a chronic inflammatory condition in which the body produces antibodies which fight against the body’s own immune defences.

The main pattern is of a symmetrical arthritis affecting more than one joint, mainly the hands and feet, with morning stiffness and feeling of lack of well-being. It starts with swelling, increased warmth and tenderness commonly in the proximal finger joints or “knuckles” and wrists as well as in the groups of tendons in this area. It may later on start to affect the elbows, shoulders, knees, ankles and feet. The second stage occurs when joint movements are reduced and tendon ruptures occur. This leads to deformities especially in the hands where some of the joints become dislocated or out of place and joints have reduced mobility and get fixed in abnormal patterns. There may be severe muscle wasting. One of the feature of RA is the rheumatoid nodule under the skin but over bony prominences, on tendons, in the sclera and in viscera.

Other systemic feature are lymphadenopathy, vasculitis, muscle weakness and visceral disease affecting the lungs, heart, kidneys, brain and gastro-intestinal tract.

When the joints are inflamed they must be rested, however, it is still important that they be mobilized every day and when the active disease subsides active exercise of the joints is helpful.