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Arthritis And Stiffness
Dr Kau Chung Yuan (许医生)
MBBS (S’PORE)
MRCS (Ireland)
MMed (Ortho)
FRCSEd (Ortho)
What is Arthritis and Stiffness?
Arthritis, a term commonly used to describe joint inflammation, encompasses a range of disorders affecting the joints and surrounding tissues. It is characterised by pain, swelling, and a notable limitation in joint motion, which often manifests as stiffness.
Stiffness in the context of arthritis refers to reduced ease and range of motion in a joint. It is typically more pronounced after periods of inactivity or rest, such as in the morning.
Types of Arthritis Related to Stiffness
Several types of arthritis are specifically associated with stiffness as a prominent symptom:
- Osteoarthritis (OA): The most common form of arthritis, OA, is characterised by the breakdown of cartilage that cushions the ends of bones in the joints. Stiffness in OA typically occurs after periods of inactivity or overuse and is commonly accompanied by pain during movement.
- Rheumatoid Arthritis (RA): RA is an autoimmune disorder where the body’s immune system attacks the lining of the joint capsule, causing inflammation, pain, and stiffness. Morning stiffness lasting longer than an hour is a symptom of RA.
- Psoriatic Arthritis: Associated with the skin condition psoriasis, this type of arthritis causes joint swelling, stiffness, and pain. Stiffness can be particularly severe after a period of rest or upon waking in the morning.
- Ankylosing Spondylitis (AS): This type of arthritis primarily affects the spine, leading to significant stiffness and pain in the back and neck. Over time, AS can cause the vertebrae to fuse, further restricting movement.
- Juvenile Arthritis: This condition affects children and encompasses several autoimmune and inflammatory conditions that cause joint pain, swelling, and stiffness.
Causes
Arthritis and the accompanying stiffness can arise from various causes, each related to the specific type of arthritis.
- Age-Related Wear and Tear
In osteoarthritis, stiffness often results from the wear and tear of cartilage, a process that is typically age-related. As the cartilage deteriorates, bones begin to rub against each other, leading to stiffness and pain. - Autoimmune Response
Conditions like rheumatoid arthritis and psoriatic arthritis are driven by an autoimmune response, in which the body’s immune system mistakenly attacks the joint tissues, causing inflammation, pain, and stiffness. - Genetic Factors
Certain types of arthritis, such as ankylosing spondylitis and rheumatoid arthritis, have a genetic predisposition. Individuals with a family history of these conditions are at a higher risk of developing them. - Childhood Joint Disorders
Juvenile arthritis, affecting children, may result from autoimmune responses, genetic factors, or unknown causes, leading to joint stiffness and swelling.
Symptoms
The symptoms of arthritis and related stiffness can vary depending on the type of arthritis but generally include a range of signs indicating joint inflammation and degradation:
- Joint Pain
A common symptom in all types of arthritis, pain often accompanies stiffness, especially during movement or after a period of inactivity. - Swelling
Inflammation within the joint can lead to noticeable swelling, contributing to stiffness and discomfort. - Redness and Warmth
Some types of arthritis, particularly those involving inflammation, can cause the affected joint area to become red and feel warm to the touch. - Decreased Range of Motion
Stiffness can limit the joint’s ability to move through its full range, affecting daily activities and reducing quality of life. - Morning Stiffness
Particularly in conditions like rheumatoid arthritis, individuals may experience stiffness that is most pronounced in the morning and may last for several hours. - Joint Deformity
Over time, chronic arthritis can lead to changes in the shape of joints, further limiting movement and causing significant stiffness. - Fatigue and General Discomfort
Systemic types of arthritis, like RA, can also cause general feelings of malaise and fatigue, contributing to the disease’s overall impact.
Diagnosis
Diagnosing arthritis and assessing the severity of stiffness involves a combination of clinical evaluation, patient history, and various diagnostic tests:
- Medical History and Physical Examination
The first step in diagnosing arthritis involves discussing symptoms, medical history, and a physical examination of the affected joints to assess for pain, swelling, redness, warmth, and range of motion. - Blood Tests
Certain blood tests can help identify markers of inflammation (such as ESR and CRP) or autoimmune disorders (like RF and anti-CCP antibodies in rheumatoid arthritis). - Imaging Tests
X-rays, MRI, and ultrasound imaging provide detailed pictures of bones and soft tissues, helping to identify joint damage, cartilage loss, and inflammation. - Joint Fluid Analysis
In some cases, a fluid sample from the affected joint (arthrocentesis) is analysed to rule out infection or gout, which can cause similar symptoms.
Non-Surgical Treatment Options
The management of arthritis and the alleviation of stiffness typically involves a combination of non-surgical treatments tailored to the individual’s condition and symptoms:
Medications
Pain relievers like acetaminophen or NSAIDs for pain and inflammation, DMARDs for autoimmune arthritis types like RA, and corticosteroids for quick inflammation relief.
Physical Therapy
Exercises to improve range of motion and strengthen muscles, along with heat and cold therapies for pain relief and swelling control.
Occupational Therapy
Suggestions for performing daily tasks to reduce stress on affected joints.
Weight Management
Reducing stress on weight-bearing joints can decrease pain and improve mobility.
Assistive Devices
Braces, splints, or walking aids can be used to help reduce joint stress and improve function.
Surgical Treatment Options
For some patients with severe arthritis or when non-surgical treatments fail to provide sufficient relief, surgical options may be considered:
- Arthroscopy
A minimally invasive procedure used to diagnose and treat joint problems. It involves inserting a small camera and instruments through tiny incisions to repair joint tissues. - Joint Replacement Surgery
In cases of severe damage, joint replacement (arthroplasty) involves removing the damaged joint surfaces and replacing them with artificial parts. This is commonly performed for hips and knees. - Osteotomy
This procedure involves cutting and repositioning bones to relieve pressure on the joint. It is often used for knee or hip arthritis. - Synovectomy
This procedure involves removing part or all of the joint lining (synovium) when it is inflamed and causing pain or limiting motion. - Joint Fusion (Arthrodesis)
Fusing a joint’s bones can relieve pain for smaller joints, such as those in the wrist, ankle, or fingers.
Dr. Kau Chung Yuan
MBBS (S’pore)
MRCS (Ireland)
MMed (Ortho)
FRCSEd (Ortho)
Dr Kau (许医生) is a Fellowship trained Orthopaedic Surgeon with a subspecialty interest in Hip and Knee surgery and has been in practice for more than 15 years.
He is experienced in trauma and fracture management, sports injuries, and joint replacement surgery.
- Fellow of the Royal College of Surgeons Edinburgh, Orthopaedics (FRCS, Edin) 2014
- Master of Medicine (Orthopaedics), Singapore (MMed) 2013
- Member of the Royal College of Surgeons Ireland (MRCS, Ire) 2009
- Bachelor of Medicine and Surgery (MBBS, Singapore) 2004
Prevention Strategies
While not all forms of arthritis can be prevented, there are strategies that can reduce the risk and mitigate the severity of arthritis-related stiffness:
- Maintain a Healthy Weight: Excess weight puts additional stress on weight-bearing joints, increasing the risk of developing arthritis and joint stiffness.
- Regular Exercise: Activities that strengthen muscles, improve flexibility, and maintain joint mobility can help prevent stiffness.
- Balanced Diet: A diet rich in antioxidants, omega-3 fatty acids, and nutrients can reduce inflammation and support joint health.
- Avoid Joint Injuries: Using protective gear during sports and learning proper techniques can prevent joint injuries that may lead to arthritis.
- Good Posture and Ergonomics: Proper posture and ergonomic practices, especially in work settings, can reduce joint stress.
- Regular Health Check-Ups: Regular visits to the orthopaedic surgeon for check-ups can help detect early signs of arthritis, allowing for early intervention.
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Frequently Asked Questions (FAQs)
What Are the Early Signs of Arthritis?
The early signs of arthritis often include persistent joint pain, stiffness more pronounced in the morning, and joint swelling. A decreased range of motion may accompany these symptoms and can progressively worsen without treatment.
Can Arthritis Be Cured?
Most types of arthritis, including common forms like osteoarthritis and rheumatoid arthritis, cannot be cured. However, with appropriate medical treatment and lifestyle modifications, the symptoms can be effectively managed to maintain quality of life.
How Do I Know If My Joint Pain Is Arthritis?
Identifying arthritis involves more than just persistent joint pain. Key indicators include joint stiffness that improves with activity but worsens after rest, swelling in one or more joints, and joint tenderness or warmth.
These symptoms, particularly when occurring in multiple joints or consistently over time, differentiate arthritis from other causes of joint pain, such as injury or overuse.
Can Arthritis Lead to Disability?
Severe arthritis can potentially lead to significant discomfort and disability, affecting the ability to perform everyday tasks. However, early detection and effective management strategies, including medical treatments and lifestyle adjustments, can reduce the risk of disability.