Arthritis is a common but complicated condition often surrounded by myths and misconceptions. The key to managing arthritis is having a good understanding of the condition1. Medical journalist Dr Kim Nolte, PhD, lifts the veil on this condition, offering scientifically based and up-to-date information.
What is arthritis?
Arthritis is the swelling and tenderness of one or more joints. The main symptoms are pain and stiffness2. There are more than 100 distinct types of arthritis3, but the most common are osteoarthritis and rheumatoid arthritis. Other examples of arthritis are gout, psoriatic arthritis, and ankylosing spondylitis2,3.
Arthritis is on the rise. Global statistics show that approximately 528 million people were living with osteoarthritis in 2018; in 2019, approximately 18 million people were living with rheumatoid arthritis4.
Types of arthritis
Osteoarthritis is the degeneration of cartilage in the joints. It most often develops in people in their mid-40s or older2,3. It is more common in women and those with a family history of the condition5. Rheumatoid arthritis is a systemic disease in which the immune system attacks the joints, beginning with the joint lining2,3. It often starts when a person is between 30 and 50 years old. It is also more common in women5.
Symptoms and signs of arthritis
The most common symptoms and signs of arthritis are joint pain, stiffness (reduced joint range of motion), swelling (inflammation), skin discolouration, tenderness or sensitivity to touch around the joint, and feeling heat near the joints. Where you experience symptoms depends on which type of arthritis you have and which joints are affected3.
Who is at risk?
Certain behaviours and characteristics increase an individual’s likelihood of developing specific types of arthritis or exacerbating their condition. Modifiable risk factors include being overweight or obese, infection, joint injuries or overuse, certain occupations that involve repetitive movements, and smoking. Risk factors you cannot control are ageing, gender, and genetics6.
Diagnosis and professional care
Primary care physicians or general practitioners, specialists (rheumatologists, orthopaedic surgeons, and dermatologists), and other allied healthcare professionals (physiotherapists, biokineticists, occupational therapists, dieticians, and psychologists) may all play a role in the management of arthritis. A general practitioner is usually a good starting point for someone who suspects they have arthritis. The general practitioner can refer a patient to the appropriate specialist if necessary to diagnose and treat the condition.
Diagnosing the condition is dependent on the type of arthritis that is suspected. However, clinical information and imaging studies are usually particularly important. For example, the diagnosis of osteoarthritis is predominantly based on a good patient history; physical examination and radiological procedures may confirm the diagnosis or rule out other medical conditions.
The diagnosis of rheumatoid arthritis includes similar assessments but also the direct palpation of the joint. Counting the number of swollen joints provides an indication of the amount of inflamed tissue, while laboratory tests can help with the diagnosis and determine whether the arthritis has affected major body systems7.
Treatment options
Arthritis treatment focuses on relieving symptoms and improving joint function. Often, a patient needs to try several treatments or combinations of treatments to determine what works best for them. Medications used to treat arthritis vary and depend on the type of arthritis. Commonly used medications include nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, disease-modifying antirheumatic drugs (DMARDs), and biologics.
Physical and occupational therapy to protect, increase the range of motion, and strengthen the muscles around the joint are especially important3,5,7. Dietary advice can be beneficial because certain foods help reduce inflammation in the body8. If conservative treatment is not effective, then surgery to address joint repair, replacement, or fusion may be necessary2.
Today, various therapies within the aesthetics medicine domain are being explored to treat arthritis, including stem cell therapy, growth factors, laser treatments, infrared radiation, and cryotherapy.
Stem cell therapy
Stem cell therapy is a new and experimental way of treating arthritis. It involves collecting stem cells from the patient’s bone or fat and injecting these into the affected joints. Stem cells are not specialised to perform a specific role; instead, they have the unique ability to develop into one of many diverse types of cells. Researchers are investigating ways of using stem cells to control inflammation and regenerate damaged tissues.
Some research is showing promising results with the use of mesenchymal stem cells (stem cells that can develop into cartilage and bone, and possibly reduce the body’s inflammatory response) in the treatment of osteoarthritis and rheumatoid arthritis9,10. Further research using stem cells to treat arthritis is warranted. The Arthritis Foundation advises patients to exercise caution and to educate themselves on the facts and considerations11.
Growth factor
Growth factors are proteins that stimulate the growth of specific tissues. Growth factors are being considered as therapeutic possibilities to modify the progression of degenerative arthritis. Insulin-like growth factor-1 (IGF-1) regulates cartilage metabolism during cartilage repair.
Currently, more in-depth studies are being performed to analyse IGF function and safety before its clinical application. However, with the advancement of IGF-1 delivery systems for treatment, IGF-1 could become an alternative cartilage repair strategy in the future12.
Laser treatments
Low-level laser therapy is a non-drug treatment used to decrease swelling and pain. Without producing heat, the laser emits very pure light that causes chemical reactions in cells where it is targeted. According to the results of numerous studies, low-level laser therapy can be considered for short-term pain relief and morning stiffness for patients with rheumatoid arthritis, especially since it has few side effects.
Regarding osteoarthritis, however, different studies have produced conflicting results. Outcomes may depend on features of the therapy, such as the wavelength, treatment duration, dosage, and site of application. Further research is required to investigate the effects of these factors13.
Infrared radiation
Infrared radiation is a promising complementary treatment for musculoskeletal conditions and chronic pain. The therapy uses certain wavelengths of light that are delivered to injured or painful sites of the body14. Infrared light is safe, natural, non-invasive, and painless. Research has shown that infrared radiation can relieve pain, stiffness, and fatigue associated with rheumatoid arthritis and ankylosing spondylitis15.
Cryotherapy
Cryotherapy involves the use of extreme cold temperatures to relieve pain and promote general wellness. Proponents of cryotherapy claim that it can help improve symptoms of a variety of pain conditions, including rheumatoid arthritis. There are two main types of cryotherapy: local and whole-body.
Results from a study showed that a single application of cold air therapy and ice massage equally provides immediate and significant pain alleviation in patients with active rheumatoid arthritis, which is maintained for one hour17.
Local and whole-body cryotherapy can be low-risk and easy treatment options to add in the management of chronic pain; however, patients should be screened prior to receiving such treatment18.
Conclusion
A diagnosis of arthritis can be overwhelming. The successful management of arthritis involves understanding the condition and knowing what options are available to you. Many innovative treatment options are showing encouraging results.
Seeking professional advice early and exploring all options available can make a significant difference in the treatment of arthritis and, subsequently, quality of life.
A valuable source of information regarding arthritis is the Arthritis Foundation of South Africa website.
References:
- Arthritis Organisation. ‘Arthritis Myths and Misconceptions’ (2020) at https://www.arthritis.org/getmedia/. (Website accessed on 24 January 2024).
- Mayoclinic. ‘Arthritis’ (2023) at https://www.mayoclinic.org/diseases-conditions/arthritis/. (Website accessed on 24 January 2024).
- Cleveland Clinic. ‘Arthritis: Symptoms, Causes, Types, Treatments and Prevention’ (2023) at https://my.clevelandclinic.org/health/diseases/12061-arthritis. (Website accessed on 25 January 2024).
- GBD 2019 Diseases and Injuries Collaborators. ‘Global Burden of 369 Diseases and Injuries in 204 Countries and Territories, 1990-2019: a Systematic Analysis for the Global Burden of Disease Study 2019’. Lancet. 2020;396(10258):1204-1222. https://doi:10.1016/S0140-6736(20)30925-9.
- NHS. ‘Overview Arthritis’ (2022) at https://www.nhs.uk/conditions/arthritis/. (Website accessed on 24 January 2024).
- Centres for Disease Control and Prevention. ‘Arthritis – Risk Factors’ (2023) at https://www.cdc.gov/arthritis/basics/risk-factors/. (Website accessed on 25 January 2024).
- Rangiah S, et al. ‘A Primary Care Approach to the Management of Arthritis’. S Afr Fam Pract. 2020;62(1), a5089. https://doi.org/10.4102/safp.v62i1.5089.
- Arthritis Foundation. ‘The Ultimate Arthritis Diet’ at https://www.arthritis.org/health-wellness/healthy-living/nutrition/anti-inflammatory/the-ultimate-arthritis-diet/. (Website accessed on 26 January 2024).
- Medical News Today – ‘Stem Cell Therapy for Rheumatoid Arthritis’ (2019) at https://www.medicalnewstoday.com/articles/1325583. (Website accessed on 27 January 2024).
- Loo SJQ and Wong NK. ‘Advantages and Challenges of Stem Cell Therapy for Osteoarthritis (Review)’. Biomedical Reports. 2021;15(67). https://doi.org/10.3892/br.2021.1443.
- Arthritis Foundation – ‘Stem Cell Guidance’ at https://www.arthritis.org/science/events-publications/stem-cell-guidance/. (Website accessed on 27 January 2024).
- Wen C, et al. ‘Insulin-Like Growth Factor-1 in Articular Cartilage Repair for Osteoarthritis Treatment’. Arthritis Res Ther. 2021;23(277), https://doi.org/10.1186/s13075-021-02662-0.
- Brosseau L, et al. ‘Low Level Laser Therapy for Osteoarthritis and Rheumatoid Arthritis: a Meta analysis’. J Rheumatol. 2010;27(8):1961-9.
- News – Medical Life Sciences – ‘Infrared Therapy: Health Benefits and Risks’ (2019) at https://www.news-medical.net/health/Infrared-Therapy-Health-Benefits-and-Risks.aspx. (Website accessed n 27 January 2024).
- Oosterveld FG, et al. ‘Infrared Sauna in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis. A Pilot Study Showing Good Tolerance, Short-Term Improvement of Pain and Stiffness, and a Trend Towards Long-Term Beneficial Effects’. Clin Rheumatol. 2009; 28(1):29–34. [PubMed: 18685882].
- Medical News Today – ‘Can Cryotherapy Help with Rheumatoid Arthritis Pain?’ (2022) at Does cryotherapy help rheumatoid arthritis pain? (medicalnewstoday.com). (Website accessed on 28 January 2024).
- Zerjavić NL, et al. ‘Local Cryotherapy, Comparison of Cold Air and Ice Massage on Pain and Handgrip Strength in Patients with Rheumatoid Arthritis’. Psychiatr Danub. 2021; 33(4):757-761.
- Garcia C, et al. ‘Use of Cryotherapy for Managing Chronic Pain: An Evidence-Based Narrative’. Pain Ther. 2021;10:81-100. https://doi:10.1007/s40122-120-00225-w.
Kim has a PhD in Biokinetics and is passionate about the health, wellness and beauty industry. She has an extensive background in conducting research and education. She believes in the power of following a healthy lifestyle and treating the body holistically. She loves writing and using her background, experience and research to write both scientific and plain-language articles. Kim has written and contributed to articles in numerous magazines and journals, both locally and internationally.