Types of Arthritis

Osteoarthritis (OA) is a degenerative joint disease that can affect the knee, hip, shoulder, and ankle joints. It occurs when the protective cartilage that cushions the ends of bones wears down over time. This leads to pain, stiffness, and reduced mobility. Several factors can contribute to the development of osteoarthritis.  These include patient age, family history (genetics), previous joint injury, and obesity.

Rheumatoid arthritis (RA) is an autoimmune disorder that primarily affects joints.  It causes inflammation, pain, and joint damage. While rheumatoid arthritis typically involves small joints of the hands and feet, it can also affect larger joints, including the knee, hip and shoulder. In rheumatoid arthritis, the synovial lining of the joint becomes inflamed.  This leads to pain, swelling, stiffness and eventually erosion of the joint.

Psoriatic arthritis occurs in some people with a chronic skin condition called psoriasis.  This is characterised by red, scaly skin patches. Psoriatic arthritis can affect various joints and can affect the knees, hips, shoulders, and ankles, leading to pain, swelling, and stiffness.

Post-traumatic arthritis (PTA) is a type of arthritis that develops in a joint following an injury or trauma. This could be due to a fracture, dislocation or other significant joint injuries. The trauma causes damage to the joint cartilage and over time this damage can result in arthritis symptoms.  The joint often becomes painful, swells, and stiffens, despite the initial injury healing.

Gout is a metabolic disorder caused by the buildup of uric acid crystals in the affected joints. Uric acid is a waste product normally found in blood and excreted through the kidneys. In people with gout, uric acid levels become elevated, and this can lead to the formation of joint crystals which in turns causes pain, swelling, and inflammation. Gout very commonly affects the joint at the base of the big toe, but it can also be found in the knee and less frequently in the ankle, hip and shoulder.

Anterior knee pain, also known as patellofemoral pain, refers to pain felt at the front of the knee, usually around or behind the kneecap (patella).  It is common in young women due to softening of the cartilage behind the patella, and eventually can result in longer-term arthritis at the front of the knee.  Anterior knee pain is often aggravated by activities that involve bending the knee.  These include climbing stairs or squatting, and walking or running up and down hills. Appropriate early management of anterior knee pain can help in preventing early onset of arthritis.

Rotator cuff tear arthropathy is a condition that occurs when severe and longstanding rotator cuff tears occur in the shoulder. The rotator cuff is a group of muscles and tendons that surround the shoulder joint and provide stability for the joint but still allow a wide range of motion. When a rotator cuff tear is extensive and longstanding, it can lead to changes in the shoulder joint that result in arthritis, causing pain and limited function.

Treatment Options

Treatment for arthritis aims to alleviate pain, improve joint function, and thereby enhance overall quality of life. Specific treatment options will depend on the type of arthritis, the affected joint, and the severity of the condition. Here is a list of common treatment options:

Medications

Dr Ward will discuss with you:

• Pain and Inflammation Reduction: Paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs) are the mainstay of treatment in reducing joint inflammation and managing pain.
• Joint Injections: Dr Ward will discuss the appropriate use of corticosteroid injections and platelet-rich plasma (PRP) injections which can help alleviate pain and inflammation.

Your GP or Rheumatologist will discuss with you:

• If you have gout, you may be prescribed medications that can either help lower uric acid levels or help the kidneys eliminate uric acid more effectively.
• If you have rheumatoid arthritis, you may be prescribed specific rheumatoid arthritis treatment, which can include disease-modifying antirheumatic drugs (DMARDs).

Lifestyle Changes

• Weight Management: Maintaining a healthy weight can reduce the load on the affected joint and decrease pain. Low-impact activities like swimming and cycling can help improve joint flexibility and strengthen the surrounding muscles. These activities can also help in maintaining a healthy weight.
• Physiotherapy: A physiotherapist can provide an exercise program to improve joint mobility, strengthen muscles, and enhance overall function. A Physiotherapist may also recommend joint support with taping to help with symptoms.
• Rest and Activity Modification: Avoiding activities that worsen pain and incorporating periods of rest can help reduce the stress on a joint.
• Walking Aids: A walking stick or cane, crutches or a frame may be recommended to help maintain mobility which reduces joint stress and improves biomechanical issues.

Surgery

• Joint Surgery: Dr Ward will discuss the different types of surgical procedures available to help with your case.
  • In the knee, joint preservation or cartilage-preserving surgeries may be a possibility. In more severe cases, partial or total joint replacement surgery may be considered to replace the damaged joint with an artificial prosthesis.
  • Dr Ward has particular expertise in Anterior Hip Replacement.
  • Specific to the shoulder, if rotator cuff function is severely compromised, a Reverse Total Shoulder Replacement (RTSR) may be considered.

Arthritis is a common condition, however, it can be managed effectively. If you’re concerned about potential arthritis, contact Dr Jason Ward for a diagnosis and access to the latest treatment options.