Dr. Kreuzer talks about arthritis and new techniques in surgical management of Arthritis.
From learning about the importance of exercising regularly to fully understanding your Arthritis medications, the information contained in this section is meant to provide you with insights, information and tips that can be used by you to help make living with Arthritis a little bit more manageable.
Click on the links below to take you to the particular section.
Click on the links below to take you to the particular section.
Arthritis is a general term covering more than 100 different conditions.
The term Arthritis literally means inflammation of a joint, but is generally
used to describe any condition in which there is damage to the cartilage.
Inflammation is the body's natural response to injury. The warning signs that
inflammation presents are redness, swelling, heat and pain.
The cartilage is a padding that absorbs stress. The proportion of cartilage
damage and synovial inflammation varies with the type and stage of Arthritis.
Usually the pain early on is due to inflammation. In the later stages, when the
cartilage is worn away, most of the pain comes from the mechanical friction of
raw bones rubbing on each other.
What are the different types of Arthritis?
There are over 100 different types of Arthritis. The most common are:
Also called degenerative joint disease, this is the most common type of
Arthritis, which occurs most often in older people. This disease affects
cartilage, the tissue that cushions and protects the ends of bones in a joint.
With osteoArthritis, the cartilage starts to wear away over time. In extreme
cases, the cartilage can completely wear away, leaving nothing to protect the
bones in a joint, causing bone-on-bone contact. Bones may also bulge, or stick
out at the end of a joint, called a bone spur.
OsteoArthritis causes joint pain and can limit a person's normal range of
motion (the ability to freely move and bend a joint). When severe, the joint may
lose all movement, causing a person to become disabled. Disability most often
happens when the disease affects the spine, knees, and hips.
This is an autoimmune disease in which the body's immune system (the body's
way of fighting infection) attacks healthy joints, tissues, and organs.
Occurring most often in women of childbearing age (15-44), this disease inflames
the lining (or synovium) of joints. It can cause pain, stiffness, swelling, and
loss of function in joints. When severe, rheumatoid Arthritis can deform, or
change, a joint. For example, the joints in a person's finger can become
deformed, causing the finger to bend or curve.
Rheumatoid Arthritis affects mostly joints of the hands and feet and tends to
be symmetrical. This means the disease affects the same joints on both sides of
the body (like both hands or both feet) at the same time and with the same
symptoms. No other form of Arthritis is symmetrical. About two to three times as
many women as men have this disease.
This chronic disorder causes pain throughout the tissues that support and
move the bones and joints. Pain, stiffness, and localized tender points occur in
the muscles and tendons, particularly those of the neck, spine, shoulders, and
hips. Fatigue and sleep disturbances may also occur.
When a person has gout, they have higher than normal levels of uric acid in
the blood. The body makes uric acid from many of the foods we eat. Too much uric
acid causes deposits, called uric acid crystals, to form in the fluid and lining
of the joints. The result is an extremely painful attack of Arthritis. The most
common joint gout affects is the big toe. This disease is more common in men
than in women.
Arthritis can be caused by an infection, either bacterial or viral, such as
Lyme disease. When this disease is caused by bacteria, early treatment with
antibiotics can ease symptoms and cure the disease.
This is Arthritis that develops after a person has an infection in the
urinary tract, bowel, or other organs. People who have this disease often have
eye problems, skin rashes, and mouth sores.
Some people who have psoriasis, a common skin problem that causes scaling and
rashes, also have Arthritis. This disease often affects the joints at the ends
of the fingers and can cause changes in the fingernails and toenails. Sometimes
the spine can also be affected.
Systemic lupus erythematosus.
Also called lupus or SLE, this is an autoimmune disease. When a person has an
autoimmune disease, the immune system attacks itself, killing healthy cells and
tissue, rather than doing its job to protect the body from disease and
infection. Lupus can inflame and damage a person's joints, skin, kidneys, lungs,
blood vessels, heart, and brain. African American women are three times more
likely to get lupus than Caucasian women. It is also more common in Hispanic,
Asian, and American Indian women.
This disease most often affects the spine, causing pain and stiffness. It can
also cause Arthritis in the hips, shoulders, and knees. It affects mostly men in
their late teenage and early adult years.
Juvenile rheumatoid Arthritis.
The most common type of Arthritis in children, this disease causes pain,
stiffness, swelling, and loss of function in the joints. A young person can also
have rashes and fevers with this disease.
Because this disease involves tendons, muscles, ligaments, and tissues around
the joint, symptoms often include pain, aching, and morning stiffness in the
shoulders, hips, neck, and lower back. It is sometimes the first sign of giant
cell arteritis, a disease of the arteries characterized by inflammation,
weakness, weight loss, and fever.
Causing inflammation and weakness in the muscles, this disease can affect the
whole body and cause disability.
This condition involves inflammation of the bursa, small, fluid-filled sacs
that help reduce friction between bones and other moving structures in the
joints. The inflammation may result from Arthritis in the joint or injury or
infection of the bursa. Bursitis produces pain and tenderness and may limit the
movement of nearby joints.
Also called tendonitis, this condition refers to inflammation of tendons
(tough cords of tissue that connect muscle to bone) caused by overuse, injury,
or a rheumatic condition. Tendinitis produces pain and tenderness and may
restrict movement of nearby joints.
What causes osteoArthritis?
OsteoArthritis is caused by the wearing out of the cartilage covering the
bone ends in a joint. This may be due to excessive strain over prolonged periods
of time, or due to other joint diseases, injury or deformity.
Primary osteoArthritis is commonly associated with ageing and general
degeneration of joints.
Secondary osteoArthritis is generally the consequence of another disease or
condition, such as repeated trauma or surgery to the affected joint, or abnormal
joint structures from birth.
Uric acid crystal build-up is the cause of gout and long-term crystal
build-up in the joints may cause deformity.
Some people may have congenital abnormalities of the joints-for example,
Perthes' disease of the hips-that cause early degeneration and subsequently
Predisposing factors to osteoArthritis of hip
Some conditions may predispose the hip to osteoArthritis, It tends to affect
people as they get older and particularly affects joints that have to take a lot
of stresses and strains.
A previous fracture that involved the hip.
Growth abnormalities of the hip (such as a shallow socket) may lead to
Some childhood hip problems later cause hip Arthritis (for example, a type
of childhood hip fracture known as a Slipped Epiphysis; also Legg-Perthe's
Inactive lifestyle- e.g., Obesity (overweight) Your weight is the single
most important link between diet and Arthritis, as being overweight puts an
additional burden on your hips, knees, ankles and feet.
What are the symptoms of Arthritis?
There are more than 100 different forms of Arthritis, symptoms vary according
to the form of Arthritis. Each form affects the body differently.
Arthritic symptoms generally include swelling and pain or tenderness in one
or more joints for more than two weeks, redness or heat in a joint, limitation
of motion of a joint, early morning stiffness and skin changes, including
How can a doctor diagnose Arthritis?
Doctors diagnose Arthritis with a medical history, physical exam and x-rays
of the hip. There is no blood test for osteoArthritis.
What you can do?
Consult a doctor who will determine the type of Arthritis you have.
Rest the joint until the pain subsides to prevent further inflammation.
To ease the pain or stiffness of the joint, apply heat on the joint for
about 15 minutes once or twice a day using a hot water bottle, towel or an
Take painkillers or anti-inflammatories, as recommended by your doctor.
If you are overweight, try to reduce weight to lighten the load on
Participate in regular exercise.
What your doctor can do for you?
There is no cure for Arthritis, so beware of 'miracle cures'. Your doctor may
prescribe anti-inflammatory medicine. They may recommend occupational therapy or
physiotherapy, which includes exercises and heat treatment. In severe cases,
surgery may be suggested, such as a hip or knee replacement. The type of surgery
will depend on your age and severity of the disease. In the elderly with severe
Arthritis, joint replacement can give good results.
Initial treatment for osteoArthritis of the hip or knee is conservative,
consisting of rest, avoidance of vigorous weight bearing activities, and the
use of non-narcotic analgesic and or anti inflammatory medications. With
worsening symptoms a cane or a knee brace may be helpful.
For more severe symptoms, an injection of cortisone into the joint is
frequently advised and can be quite helpful. When conservative measures have
been exhausted and are no longer helpful, and the Arthritis has become
disabling, surgery may be recommended.
Treatment of osteoArthritis focuses on decreasing pain
and improving joint movement, and may include:
Exercises to keep joints flexible and improve muscle strength
Many different medications are used to control pain, including
corticosteroids and NSAIDs.
Glucocorticoids injected into joints that are inflamed and not responsive
For mild pain without inflammation, acetaminophen may be used.
Heat/cold therapy for temporary pain relief
Joint protection to prevent strain or stress on painful joints
Surgery (sometimes) to relieve chronic pain in damaged joints
Weight control to prevent extra stress on weight-bearing joints
Does exercise really help those who have 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. Also studies have shown that exercise helps people with Arthritis by
reducing joint pain and stiffness and increasing flexibility, muscle strength
and energy. It also helps with weight reduction and offers an improved sense of
Can special diets treat Arthritis?
But what if you have Arthritis - are diet and nutrition still such a
Can what you eat cure your Arthritis? Can food prevent it from occurring?
Are there foods that can cause your Arthritis to 'flare' or go into
What role do vitamins and nutritional supplements play in the treatment of
Will losing (or gaining) weight help ease your symptoms?
Will taking powerful anti-arthritic medications affect your appetite or
your ability to eat certain foods?
These are the sorts of questions that people with Arthritis often ask, and
they're valid questions. Some questions (Can what you eat cure your Arthritis?)
have simple answers (No). Some questions (Are there foods that can cause your
Arthritis to 'flare' or go into remission?) aren't so straightforward
Most of what you need to know about diet and nutrition is common sense;
healthy eating is pretty much the same for anyone, whether you have Arthritis or
not. But there are exceptions.
From learning about the importance of exercising regularly to fully
understanding your Arthritis medications, the information contained in this
section is meant to provide you with insights, information and tips that can be
used by you to help make living with Arthritis a little bit more manageable.
For people with Arthritis, learning to make it part of your life can be
difficult. But learning as much as you can about your particular type of
Arthritis and actively working with your Arthritis treatment team are two very
effective ways of regaining control over your life. There is plenty of
information, some specific to Arthritis and some not, that can be very helpful
to someone facing the challenges associated with having a chronic or lifelong
Our suggestion is - don't let Arthritis beat you. Take control. How? Arm
yourself with as much information as possible. Learn from the experiences of
others in similar circumstances. What we're presenting here is a virtual toolbox
of tips for living well with Arthritis. Some may work for you one day and not
the other. Some may work for you but not others. That's why we've tried to cover
several topics. There are plenty of tools or tips here. Use them or refer to
them when you need them. Call upon them when you require help.
Dr. Kreuzer talks about
arthritis and new techniques
in surgical management