Arthritis includes more than 100 diseases that damage joints. Degeneration or inflammation of joints, which enable the body to move, can cause pain, swelling, deformity and eventual disability. Some forms of arthritis also injureother parts of the body, such as the skin, eyes,Urinary tract or heart.

More than 46 million Americans, including over one-fifth of adults, have some form of arthritis, according to the Centers for Disease Control and Prevention (CDC). The majority of these individuals have osteoarthritis (OA), which involves degeneration of cartilage, usually due to gradual wear and tear related to aging.

Some forms of arthritis, including Rheumatoid Arthritis (RA), are autoimmune diseases, meaning the body's immune system mistakenly attacks healthy tissues. RA is a debilitating disease in which inflammation causes pain and eventually deforms joints. It can affect people of all ages. Juvenile rheumatoid arthritis is the most common form of arthritis in children.

Other arthritic conditions include:

• Gout and pseudogout, in which crystals form in joints
  
• Psoriatic arthritis, the joint pain and swelling that affect some people who have the skin disease psoriasis
  
• Reiter's syndrome, a reaction to an infection

Diagnosis of arthritis involves a physical examination, medical history, imaging tests such as x-rays or ultrasound, and sometimes blood or urine tests.

Arthritis is generally a chronic condition that cannot be cured. Some forms have periods of flare-ups and remission. Treatment plans focus on alleviating pain, preventing further degeneration and maintaining or improving joint mobility. Common treatments include exercises, physical therapy, occupational therapy and medications. In severe cases, surgery may be performed to remove growths or replace a joint (arthroplasty).

Some forms of arthritis may be prevented by avoiding infection or injury. Practices that minimize stress on joints, such as regular exercise and maintaining a healthy weight, may help avert or delay the onset of arthritis. Clinical studies are under way to determine the effectiveness of additional treatments for arthritic pain.

Arthritis is a painful condition that affects one or more joints. More than 100 conditions may be classified as arthritis.Most forms of arthritis are degenerative or rheumatic conditions, meaning they involve some sort of inflammation, usually of the soft tissue (cartilage) or membranes surrounding the body’s joints. Other arthritic conditions may primarily involve inflammation of supporting structures, such as muscles, ligaments or tendons. In time, the inflammation may also cause swelling, redness and difficulty moving the joints.

Arthritis comes from the Greek words for joint inflammation. However, the most common arthritic condition, osteoarthritis, involves degeneration of cartilage at the joints, but usually not inflammation.

Arthritis occurs primarily in the joints. In human anatomy, a joint is where two or more bones meet. There are several types of joints. Some joints do not move very much or at all, such as where bones in the skull meet. Arthritis   occurs mostly in cartilaginous and synovial joints, such as those in the knees, hips, hands and feet, which can move. The cartilaginous and synovial joints are formed by the juncture of bones and their surrounding ligaments. The space enclosed by the ligaments and adjoining bones forms a cavity called the joint capsule. The outer layer of the capsule is formed by a fibrous membrane that may include the ligament. The inside of the capsule is lined with synovial membrane (synovium). This membrane secretes synovial fluid, which fills the joint capsule and provides lubrication. The ends of the bones encased in the capsule are cushioned in soft cartilage.The cartilage and synovial fluid permit the bones to move without rubbing against each other.

Cartilaginous joints do not have a synovial cavity but have cartilage and fibrous discs between the bones to allow some movement. The vertebrae in the spine have cartilaginous joints.Joints affected by arthritis do not function smoothly. In some cases, the cartilage degenerates and irritates the bones.   Small bony outgrowths form, swelling the bone and decreasing the space within the joint capsule. In other cases, the synovial membranes or cartilage become inflamed and swell. As a result, the joint may swell and become painful to use. Regardless of the origin (degeneration or inflammation), joints can become stiff, painful and swollen, eventually impairing their function.

Arthritis develops in many ways. Osteoarthritis, the most common form, usually develops with age. Years of weight and repetitive stress on the joints cause the cartilage to degenerate. Sudden trauma to a joint, such as from a sports  injury, can ultimately lead to osteoarthritis. Other forms of arthritis develop at any age (even among children) as the result of causes including infection, such as Lyme disease, or as an autoimmune disorder, such as rheumatoid arthritis (RA), where the body mistakenly attacks its own tissues.

Some people experience arthritis as stiffness in a hip or knee joint. For others, the pain may start in one joint and  spread to others and include stiffness, swelling and redness. In some cases, arthritis causes stiffness upon rising in the morning. For other people, the pain worsens after they use the affected joint, such as during exercise. All these symptoms vary depending upon the kind of arthritis.

Types of Arthritis

• Osteoarthritis (OA). The most common form of arthritis, usually seen among older people. OA affects only the  joints, not any other systems in the body. The cartilage wears away or breaks down. The lack of cartilage and  new growth of exposed bones (bone spurs) causes the bones to rub together.OA occurs most often in the knees,  hips and spine, which bear much of the body's weight. It is also common in the hands and feet.

Rheumatoid arthritis (RA). Affects the membranes in the joint capsules and may attack other tissues and organs as well. RA inflames the synovial membranes (which cushion the joints) and causes joint swelling, pain and sometimes deformity. It is an autoimmune disorder, in which the body’s immune system attacks its own tissues.

RA usually occurs symmetrically (e.g., in both hands or both feet). RA inflammation may affect other body systems, such as the cardiac system, where it can be life-threatening. RA is much more common in women than in men. RA has periods of flare-ups followed by periods of remission.

• Juvenile arthritis. Several forms of arthritis occur in children. The most common is juvenile rheumatoid arthritis (JRA), which can affect one joint or many joints. JRA attacks the membranes of the joint capsules.   About half of the children with JRA have it in four or fewer joints.

For some children, JRA extends into adult life. Other children actually have adult RA that begins at an early age. The development of systemic JRA later in life is known as adult-onset Still’s disease.

                       How can physical therapy help me?

Physical therapy has one goal when it comes to arthritis. That goal is to help you to improve the use of your joint so that you can get back into doing the things that you like and need to do without pain. Since your joints are at a point that they are being attacked, it is important to give your joint the help it needs to strengthen your muscles and to help increase the range of motion you have. The process can include a number of different things, but it usually involves working with a practitioner who is skilled in improving those aspects of your joint health. With time and persistence, much of what you've lost can come back to you. For most, the need to get this back is well worth the work that it takes to get to that point.

You can benefit from many aspects of physical therapy. For example, if you are overweight, even slightly, with the right physical therapy you can shed the pounds and take stress off your joints by doing so. You'll increase your body's chances of dealing with the pain and inflammation better too if you are at a healthier weight. In addition to that, you also learn a lot about your arthritis. You get the benefit of being informed so you can make decisions daily that will encourage a healthy lifestyle with arthritis.

You also learn a wide range of techniques that will help you to monitor and improve your pain levels. By doing simple things such as using your muscles correctly to minimize pain, you can actually lessen the severity of the pain you feel. You also learn how to modify your activities to increase function of your joint or not to hurt it further.

Probably the most important aspect of physical therapy and arthritis is working on your muscles. By increasing the strength of your muscles in the area, you decrease the activity and workload of the joint. Muscles that are stronger can help to compensate for a weaker joint. You also get to improve the amount of movement you have with that joint. By increasing the range of motion you have, you lessen the impact that arthritis has had on your daily life.

Written by Greg Marsh

Reviewed By:
Vikas Garg, M.D., MSA

(c) 2000-2009 iVillage Inc.