FAQ’s on Extremity Arthritis

What is extremity arthritis?

Arthritis is a painful condition that affects the musculoskeletal joints. It refers to the swelling and inflammation of the joints, causing pain, loss of function, and loss of range of motion. In some cases, especially in rheumatoid arthritis, the disease can progress to cause deformities to the affected extremity.

There are numerous kinds of arthritis that can affect your extremities, each with its own presentation and underlying cause. Among the most common forms of arthritis are:

  • Osteoarthritis: This occurs when the cartilage that lines the joint surfaces loses its elasticity. When this becomes too stiff, it loses its capacity to act as a shock absorber, causing progressive irritation and damage to the joint muscles, tendons and ligaments. This wear and tear will cause pain to the affected joint.
  • Rheumatoid arthritis: This refers to a chronic, inflammatory condition that affects the synovial membrane. Most damage affects the joint lining and the cartilage, and fingers, wrists, knees and elbows are most commonly located. The disease can lead to severe deformity if not treated. Impairment in sexual function has been noted in women with this condition.
  • Gouty arthritis: This condition occurs when uric acid crystals are deposited in the joint, leading to inflammation and severe pain. The attack lasts for hours, and most often affects the big toe (a condition known as podagra).

What causes extremity arthritis?

The exact cause of extremity arthritis will depend on the form of arthritis affecting the patient. However, it is enough to note that the pain is usually secondary to the inflammation of the joints.

  • Osteoarthritis: this is most common among the elderly, and risk factors include obesity, prior trauma to the joint, and a sedentary lifestyle.
  • Rheumatoid arthritis: the exact cause of rheumatoid arthritis has not been identified, although this disease is of autoimmune origin (i.e., when the body’s immune system attacks its own tissues).
  • Gouty arthritis: this follows elevated blood levels of uric acid, which lead to deposition in the joints and other affected areas.

The final diagnosis will only follow a complete medical history and physical examination. Additional imaging studies such as X-rays, Computerized Tomography (CT) scans, Magnetic Resonance Imaging (MRI) scans may also be requested. Laboratory examinations such as blood uric acid, can be requested to differentiate the diagnoses.

How is extremity arthritis treated?

Treatment of extremity arthritis varies with the specific underlying cause. However, it has been generally demonstrated that physical therapy and rehabilitation can lead to positive outcomes. Movement of the affected joint is recommended to maintain functionality of the affected joint. Medications may also include NSAIDs for the treatment of inflammation and pain relief.

While there is no cure for rheumatoid arthritis, treatments such as Disease Modifying Anti-Rheumatic Drugs (DMARDs) and pressure massage therapy have been shown to provide improvements. Novel treatments, such as the use of wedged insoles, herbal medicines and acupuncture can be used in addition to pharmaceutical drugs for the treatment of osteoarthritis. Gouty arthritis can be managed by controlling the blood uric acid levels through medications.

References:

Conrozier T, Mathieu P, Bonjean M, et al. (2014). A Complex of Three Natural Anti-inflammatory Agents Provides Relief of Osteoarthritis Pain. Alternative Therapies in Health and Medicine. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/24473984

Hatef MR, Mirfeizi Z, Sahebari M, et al. (2014). Superiority of laterally elevated wedged insoles to neutrally wedged insoles in medial knee osteoarthritis symptom relief. International Journal of Rheumatic Diseases. doi: 10.1111/1756-185X.12036