How to beat Arthritis

Ahead of World Arthritis Day, Pioneer Health brings to you a low down on the latest developments in treatment of different types of Arthritis

What is arthritis?

Arthritis is a commonly misunderstood disease. It is not a single condition but is associated with different diseases. It can be seen in people of all ages even in children, though some types of arthritis are common in elderly.

It is the wearing off of cartilage – the click, cushioning surface between joints which lubricate and make joint movement comfortable.  Once the cartilage starts wearing off, the bones rub against each other creating friction that causes inflammation and pain. Over time, the joints lose its strength and start wearing off causing severe pain, swelling, and stiffness.

Shoulder arthritis

The shoulder joint is a ball and socket joint consisting of the upper of the arm bone which forms the ball and the socket being formed by a portion of the shoulder blade; the joint is lined by a smooth structure called cartilage. Around the shoulder joint, there is a group of muscles called the rotator cuff which allows for movement of the shoulder as well as stabilises the joint during the movement. The muscles slide under an extension of the shoulder blade called the acromion.

Shoulder arthritis is a process of wear and tear of the joint cartilage. There are multiple scenarios in which the shoulder can develop arthritis. After the knee and the hip, the shoulder is the third most common joint in the body to be affected by arthritis.

Treatment: Unfortunately, there is no medicine that can reverse arthritis by stimulating the cartilage cells to grow. The treatment options are restricted to pain control with anti-inflammatory medicines and physiotherapy but the outcomes with the same are decent only in early arthritis.

Take away points: Its prevalence in the community is increasing; Shoulder arthritis is a treatable condition and with the latest technology available here we are able to give good results which are sustained over a period of time.

Early diagnosis and correct treatment can prevent this.

— Dr Aditya Sai Kadavkolan, Consultant Arthroscopy, Sports Medicine & Shoulder Surgery

Psoriatic arthritis

Research indicates that one-fourth of psoriasis patients are likely to suffer from psoriatic arthritis.

Symptoms

• Some of the key symptoms of psoriatic arthritis include:
• Swelling in fingers, toes, knees and spine
• Inflammation
• Joint pain and stiffness
• Pitted or discoloured fingernails
• The pain could further get severe if not diagnosed and treated within adequate time.

Types

There are more than 100 different types of arthritis. Most common of those are:

• Degenerative: It usually affects people above age of 45 and more common in women and obese people. Also known as osteoarthritis, it is due to wear and tear of joint which causes damage by roughening of cartilage. As repair process to make up for the loss our body forms — tiny bits of extra bones, and thickens the joint fluid and stretches the joint capsule which alters the shape of joint. Usually treated by painkillers and keeping the joint active will also reduce pain, stiffness and swelling. If all the treatment options are tried and there is still pain in the joint, surgery might be required.
• Infectious: It not very often known that arthritis is caused Post-infection, commonly known as reactive arthritis. This type of arthritis usually follows a urinary tract infection or gastroenteritis or genital tract infections and also may be due to viral fevers like dengue. The symptoms usually last few months and is often relieved by its own but a small percentage of people may experience recurrence or long-term symptoms who usually require medication.
• Autoimmune: It is commonly seen in people aged 40 to 60 years. This type of arthritis may be due to genes inherited from parents or grandparents or acquired conditions. Most common type is rheumatoid arthritis. Here, our immune system, which normally protects us from infections and illness, mistakenly attacks the joints causing pain and swelling. They usually have stiffness of joints in the morning that lasts for longer than an hour. These conditions are treated usually by disease modifying drugs or steroids.
• Metabolic: It is due to excessive compounds like uric acid, which forms crystals in joint fluid causing increased thickening of fluid and local inflammation typically involves the Toe joints. The skin around the joint looks red, which feels hot on touching. Eating excessive protein and drinking alcoholic drinks can cause more production of uric acid. It is treated by drugs and diet modifications with reduced protein intake.

— Dr Srividya Kalavagunta, Consultant, Family Physician, Mfine

Treatment

Conventional treatments focus on pharmacological management of pain and inflammation. But, this does not stop the progression of the condition. A few treatments that can help are:

Regenerative medicine and cell-based therapy: Regenerative medicine and cell-based therapy are gaining momentum. Autologous cellular therapy with mesenchymal stem cells is one such therapeutic modality in the treatment of several conditions, including musculoskeletal and autoimmune disorders. This therapy utilises the body’s potential to repair the damage. These cells have multi-differential potential, immune-regulatory, anti-inflammatory and tissue repairing properties. Treatment is a minimally-invasive, safe, and promising treatment modality for patients with any form of arthritis. The presence of co-morbid conditions doesn’t affect the outcome of cell-based therapy. Multiple conditions can be treated simultaneously.

Shockwave therapy: Another approach is by the use of shockwave therapy. This adjunctive modality stimulates the healing response of the body, by inducing microtrauma where applied, thereby relieving pain and inflammation.

Cryotherapy: It may also be used to relieve pain through lowering skin temperature, reducing the activity of nerve fibers along with the reduction of swelling. A combination of cell-based therapy with physiotherapy gives good results. The protocol is minimally invasive; hence good for patients. Regenerative medicine addresses the core pathology of a condition. The results are long-lasting,

Dr Pradeep Mahajan, Regenerative Medicine Researcher, StemRx Bioscience Solutions Pvt Ltd, Mumbai