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Arthritis: the different forms it can take

Arthritis is the biggest cause of disability in Ireland, affecting more than 1 in 5 adults. While we may think of it as simply chronic inflammation of the joints, there are actually around 120 different types of the disorder.

For practical purposes, it is helpful to understand the three most common forms of arthritis. Although there is crossover in characteristics, they can vary in causes, symptoms, severity and – crucially – how best to approach treating them to make your life as pain-free as possible. 

Osteoarthritis

By far the most common type of arthritis, osteoarthritis typically affects the hands, knees, hips or spine. Seen as the result of “wear and tear”, the root cause is not known but age, family history, joint injury and obesity can all play a part. 

Osteoarthritis occurs when a joint’s cartilage (the shock-absorbing tissue lining the ends of bones) breaks down, causing pain and stiffness and hindering movement.

People may also experience swelling, tenderness and grating sounds when moving the joints. As the cartilage thins, bony growths can develop, further inflaming joints.

Osteoarthritis often starts to develop after a person reaches their mid-40s. Although it is uncommon before that age, young people can develop it. Injury and other joint conditions may bring it on prematurely. It is also more likely to affect women.

While there is no cure, there are a number of treatments that offer relief.

Regular exercise is particularly important for building muscle, strengthening joints and maintaining a healthy weight. Physiotherapy and stretching techniques can keep joints flexible. Hot and cold packs can be very effective in soothing affected areas. You can also discuss medication to manage pain with your GP.

Rheumatoid arthritis

The second most common form of arthritis. Rheumatoid arthritis occurs when the immune system mistakenly attacks the cells lining your joints, causing stiffness, swelling and pain.

Onset generally occurs between the ages of 40 and 50 and it is three times more common in females. Smoking can also increase your risk.

Again, it is not curable but very treatable. Early diagnosis and the right treatment can help people go for months or even years without a flare-up.

Aside from lifestyle changes, there are a number of medications available. These are divided into disease-modifying anti-rheumatic drugs (DMARDs), which are tablets that block immune system chemicals to ease symptoms and slow the disease’s progress, and biological treatments, which are given by injection if DMARDs alone have not been successful.

Gout

Gout causes sudden and painful inflammation and swelling in one or more joints. It can usually be found in the big toe, but has also been known to crop up in fingers, wrists, elbows and knees. Red, peeling or itchy skin can accompany it.

It is caused when uric acid builds up in the body, forming crystals in the joints. Uric acid is a waste product of metabolism and is usually excreted by the kidneys. 

Males between the ages of 40 and 60 are most at risk, though some post-menopause females can suffer from gout. High blood pressure can also increase uric acid levels. 

There are a variety of lifestyle risk factors involved, including drinking alcohol (beer especially), and eating purine-rich food such as seafood, red meat and organ meat.

Anti-inflammatory medicines like ibuprofen are often used to treat bouts of gout, with steroids employed if the problem persists. It is helpful to keep the joint cool with an icepack, elevate and rest the limb, and drink plenty of water.

Maintaining a healthy diet can prevent gout from returning. This includes eating plenty of vegetables and low-fat dairy. Cut down on sugary drinks and snacks, as well as red meat, liver, kidneys and seafood. Have at least 2 alcohol-free days per week and, if you smoke, make a concerted effort to quit.

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