Definition

Arthritis is inflammation of one or more of the joints, such as knees or wrists, or a part of the spinal column. The two most common types of arthritis are osteoarthritis and rheumatoid arthritis.

Less common types of arthritis may be associated with conditions that also affect other parts of the body. For example, lupus can affect the kidneys and lungs, in addition to joints, while psoriasis is primarily a skin disease that sometimes also affects joints.

Symptoms

Joint pain and stiffness are the main symptoms of arthritis.  The most common signs and symptoms of arthritis involve the joints. Depending on the type of arthritis the patient has.

Joint symptoms may include:

• Pain
• Stiffness
• Swelling
• Redness
• Decreased range of motion

Some types of arthritis are accompanied by signs and symptoms involving other parts of your body. These symptoms may include:

• Fever
• Fatigue
• Rash
• Weight loss
• Breathing problems
• Dry eyes and mouth
• Night sweats

Causes

The pain associated with arthritis is caused by joint damage. Joints are made up of the following parts:

Cartilage. A hard, but slick, coating on the ends of bones, cartilage allows bones of the joint to slide smoothly over each other.

• Osteoarthritis. In osteoarthritis, wear-and-tear damage to cartilage can result in bone grinding directly on bone, which causes pain and restricted movement. This wear and tear can occur over many years, or it can be hastened by a joint injury or infection.
• Rheumatoid arthritis. In rheumatoid arthritis, the body's immune system attacks joints and inflames the synovium, causing swelling, redness and pain. The disease can eventually destroy cartilage and bone within the joint.

Treatments and drugs

Arthritis treatment focuses on relieving symptoms and improving joint function.

Medications

The medications used to treat arthritis vary, depending on the type of arthritis. Commonly used arthritis medications include:

• Analgesics. These types of medications help reduce pain, but have no effect on inflammation. Examples include acetaminophen (Tylenol, others), tramadol (Ultram) and narcotics like oxycodone (Percocet) and hydrocodone (Vicodin).
• Counterirritants. Some varieties of creams and ointments contain a substance such as menthol or capsaicin, the ingredient that makes hot peppers spicy. Rubbing these preparations on the skin over the aching joint may interfere with the transmission of pain signals from the joint itself.
• Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs reduce both pain and inflammation. Over-the-counter NSAIDs include aspirin, ibuprofen and naproxen. Some types of NSAIDs are available only by prescription. Oral NSAIDs can cause stomach irritation, and some may increase the risk of heart attack or stroke. Some NSAIDs are also available as creams or gels, which can be rubbed on joints.
• Disease-modifying antirheumatic drugs (DMARDs). Often used to treat rheumatoid arthritis, DMARDs slow or stop the immune system from attacking the joints. Examples include methotrexate (Trexall) and hydroxychloroquine (Plaquenil).
• Biologics. Typically used in conjunction with DMARDs, biologic response modifiers are genetically engineered drugs that suppress the immune system. Examples include TNF blockers such as etanercept (Enbrel) and infliximab (Remicade).
• Corticosteroids. This class of drug, which includes prednisone and cortisone, reduces inflammation and suppresses the immune system. Corticosteroids can be taken orally or be injected directly into the painful joint.

Therapy

Physical therapy can be helpful for some types of arthritis. Exercises can improve range of motion and strengthen the muscles surrounding joints. In some cases, splints or braces may be warranted.

Surgery

If more-conservative measures don't help, the doctor may suggest surgery, such as:

• Synovium removal (synovectomy). Rheumatoid arthritis causes the joint capsule's lining, called the synovium, to swell — particularly in the wrists, hands and fingers. Removing the synovium may slow joint deterioration.
• Joint replacement. This procedure removes the damaged joint and replaces it with an artificial one. Joints most commonly replaced are hips and knees.
• Joint fusion. This procedure is more often used for smaller joints, such as those in the wrist, ankle and fingers. It removes the ends of the two bones in the joint and then locks those ends together until they heal into one rigid unit.