Welcome back to the "Thriving with Arthritis" podcast.
In our first episode, we discussed why this podcast exists and the importance of raising awareness about arthritis. Today, we're diving deeper and I will discuss
WHAT IS arthritis?
Arthritis is an epidemic of our century, affecting approximately 60 million people in the United States alone. It's important for everyone, whether you're a doctor, a patient, or someone interested in learning more, to understand arthritis and how to recognize, prevent, or help those suffering from arthritis
Let me share a story of one of my patients: John was a 52-year-old man tart started to have pain and swelling to his right foot. He woke up one morning with pain and swelling. He took some ibuprofen for a few week but his pain and swelling persisted. John was a little bit overweight and had a history of hypertension (high blood pressure). When he went to his primary care physician (PCP).
His PCP ordered laboratory tests and found that his uric acid levels were mildly elevated at about 7 mg/dl (for reference, less than 6 mg/dl is considered ‘normal’).
His PCP Thought that John was most likely suffering from gout and he put him on more anti-inflammatory medication and started him on allopurinol, a medication to decrease his uric acid levels.
John was told to come back in three months for repeat labs and sent on his way.
However, John continued to struggle with pain and swelling in his foot throughout those three months, despite taking his medications as prescribed.
Some days weren’t so bad—on these days, the pain was bearable. But, on others, he was in so much pain that he struggled to walk; the swelling extended to his other foot and it was so bad that he couldn’t put on his shoes in the morning.
Three months later, John returned to the doctor and told him that things weren’t improving—at least, not quickly.
His doctor prescribed him two weeks of prednisone, a much stronger anti-inflammatory and steroid medication.
He also increased his allopurinol dosage, thinking that this would help the so-called gout become more controlled.
Those next two weeks, John was feeling great! like a new man!
His swelling had decreased significantly, and he was able to walk normally again. However, when the prednisone stopped, his pain and swelling returned in full force. After another more months spent in pain, he went back to his PCP, and he referred him to a specialist—me.
I listened to John's story and noticed that the swelling in his feet was pronounced and severe. By this time, the swelling had spread to his hands, but they weren’t nearly as painful as his feet were, so he hadn’t mentioned them to his doctor.
I ran the necessary tests and X-rays, and diagnosed John with RA—not gout, as his PCP had believed. He was actually suffering from RA, an inflammatory form or arthritis and actually an autoimmune disease.
Like John, I see many patients that are seen and treated for arthritis, but the wrong kind of arthritis!
So coming back to the question : What Is Arthritis?
The word "arthritis" comes from the Greek roots "arthro," meaning "joint," and "-itis," meaning "inflammation."
This term arthritis broadly refers to over 100 conditions affecting the joints or spine.
Arthritis can manifest as acute or chronic.
Acute arthritis lasts days to weeks and is often related to a traumatic event or infection.
Chronic arthritis, on the other hand, persists for months to years and is commonly seen after years of inflammation or traumatic injury to the joints.
Who Does Arthritis Affect?
Contrary to popular belief, arthritis can affect people of all ages, including children.
You may be genetically predisposed to develop arthritis at a young age….
But you can also develop arthritis if you are a professional athlete and you surfer multiple injuries….
Or if you develop an autoimmune diseases…. Like RA, PsA
Or you hay develop arthritis related to an infection like HIV, Hep B/C or even TB
Or if you develop a metabolic disease like GOUT or pseudogout….
We will talk about these and dissect these in the next episodes…….
What Are The Most Common Symptoms?
Most patients refer to the symptoms that they experience. They dont come and say to me, I suffer from arthritis, but they rather tell me about
- Pain and tenderness (define)
- Swelling
- Stiffness
- Warmth
- Difficulty using the joints
Pain is often the trigger1 pain is the reason they come to be seen by a physician or a a rheumatologist
Pain can be different in intensity.
It can vary from person to person, with some experiencing severe pain and others only mild tenderness over the joints.
Swelling may also be present, especially in the knee due to fluid accumulation or inflammation of surrounding tissues.
Stiffness is a common symptom, particularly in the morning.
Stiffness can be for minutes to hours and this will make a bid difference in my mind as a rheumatologist.
If you surfer with arthritis for years, you are not going to pay attention to these little details. That is why I advise my patients to keep a diary of sympoms for about 2 weeks.
I teach patients to pay attention to their symptoms and write down
- What hurts in the am?
- If they have MS how long does it take?
- Is this MS influenced by moving? Exercise?
- Do they feel better exercising or do they feel worse?
Keeping a diary of your symptoms will help me and your doctor, your rheumatologist to differentiate between the types of arthritis, along with other clues…..
Yes we use labs, imagings like Xrays, MRIs, CT scans to evaluate your joints, but YOUR SYMPTOMS , your pattern of jonts that you have involved, will tell us so much more.
Let me give you some examples.
What Are The Most Common Types of Arthritis?
The most common types of arthritis treated in rheumatology include:
- Osteoarthritis (Degenerative Arthritis): Develops later in life due to overuse of joints, leading to "wear-and-tear" and low-grade inflammation.
- Inflammatory Arthritis: Affects young people and is caused by autoimmune diseases (e.g., Rheumatoid arthritis, Psoriatic Arthritis) or crystal-induced arthritis (e.g., gout, pseudogout).
- Reactive Arthritis: Triggered after an infection, often from the gut or urinary tract.
The best way to diagnose and treat arthritis EFFECTIVELY is to understand the TYPE OF ARTHRITIS .
Gout vs. RA
Gout, a metabolic disease, results from a buildup of uric acid. It primarily affects men and often presents with sudden, excruciating pain, commonly in the big toe. In contrast, RA is an autoimmune disease that predominantly affects women. It causes chronic joint inflammation and can lead to joint damage if untreated.
RA vs. Lupus
Lupus, another autoimmune disease, affects multiple body systems, including joints, skin, and organs. Both RA and lupus can cause joint pain and swelling, but lupus typically affects the skin more prominently, and joint damage in lupus is usually reversible.
RA vs. Psoriatic Arthritis
Psoriatic arthritis, an inflammatory disease, occurs in individuals with psoriasis. It affects joints asymmetrically and can lead to joint damage over time. Unlike RA, psoriatic arthritis commonly affects the knees, fingers, toes, neck, and lower back.
So if you are deling with these signs and symptoms the best way is to ask for help from your PCP or ask a consultation with a rheumatologist. We are the ones that know how to diagnose, we have the tools to treat arthritis.
Thanks for tuning in to the "Thriving with Arthritis" podcast. In my next episode I will discuss more in depth about what is RA.
Remember, you're not alone in this journey.
Until next time, stay strong, stay positive and keep thriving!