Arthritis – no age restriction

“Causing pain and loss of movement in the joints, it cannot be cured, but is treatable,” says Pretoria Rheumatologist Dr Elsa van Duuren, who adds that children as well as adults can suffer from one of the more than 100 varieties of the disease.

“Arthritis usually presents with pain in the joints, but there may be swelling of joints or loss of joint function. There may be a feeling of stiffness of the joints after sitting still for a while or first thing in the morning. When these symptoms are frequent or continuous, it is time to seek medical help,” she says.

“The most common form of arthritis is osteoarthritis, which is a disease of cartilage that causes damage to the surface of a joint.”

The ends of joint bones are covered by cartilage and both are surrounded by a membrane (the synovium) that produces synovial fluid, which lubricates the surfaces and feeds the cartilage.

“Osteoarthritis occurs when the cartilage covering the ends of bones, which act as natural ‘shock absorbers' for the joint becomes thinner and the surface is roughened. The bone beneath the cartilage becomes thicker and grows out of the side of the joint. The synovium becomes inflamed and extra fluid forms, making the joint swell,” Dr Van Duuren explained.

Changes can be mild or more severe. In severe cases, when the cartilage is damaged extensively, the bone beneath may be exposed and movement of the joint causes a lot of pain.

“Whatever the severity, the result is a disease that impacts on a person's normal use of joints with adverse effect on one's quality of life.” Dr Van Duuren said.

Although the causes of osteoarthritis have not yet been isolated, a number of factors have been identified that contribute to its prevalence. These include ageing, injury to the joints and heredity.

Osteoarthritis of the neck and back, referred to as spondylosis, is very common in both men and women, and presents with pain in the back and neck. In this instance, bone grows out from the sides of the vertebrae and around the joints in the back and neck and may affect the nerves of the spinal column.

“Following osteoarthritis, the most common forms of arthritis seen by doctors are generally rheumatoid arthritis and gout,” Dr Van Duuren said. “Rheumatoid arthritis is a systemic disease that can impact on general health as well as a variety of joints.”

“Gout is a disease in which urate crystals can cause episodes of a severely painful arthritis. It usually affects the feet, ankles or knees, for a few days at a time with long periods between attacks. As the disease progresses, the attacks become more frequent and affects more joints. It can cause a lot of damage to the joints and in more severe cases it can affect other parts of the body including the lungs, eyes and blood vessels”.

“In some people, the onset of rheumatoid arthritis can be acute with sudden pain and swelling in several joints, and severe stiffness on rising in the morning. Others have a slow onset and it can take several months for the symptoms to develop. It is important that rheumatoid arthritis is identified and treated as soon as possible”.

Moving to arthritis in children, Dr Van Duuren said that although no reliable statistics on the subject existed in South Africa, it had been found, however, that children of any age can suffer from arthritis.

“Among early signs for parents to look out for are a tendency by a child to cradling an arm, or walking in a way that removes the weight off one leg. If this is the case then the child should see a doctor to be examined as soon as possible.”

Treatment for the various forms of arthritis includes treating the underlying disease process and controlling the symptoms. Drugs commonly used are analgesics to reduce pain, anti-inflammatory drugs to reduce swelling and stiffness and disease modifying drugs.

Disease modifying anti-rheumatic drugs (DMARDs), sometimes called “second-line drugs” are also commonly prescribed. There is also a new group of drugs called “biologics” that can be very effective in the treatment of rheumatoid arthritis and other types of inflammatory arthritis.

“Lifestyle can also be a major contributing factor to developing arthritis. Therefore lifestyle modifications such as regular exercise, healthy diet and weight loss and avoid smoking are recommended in avoiding or management of the disease.”

“The healthier your lifestyle, the better equipped you are to fight these diseases if they should strike,” she concluded.