Arthritis in the elderly

What is Arthritis?

The term arthritis literally means “joint inflammation,” but it is generally used to refer to more than 100 different conditions which affect the joints and may also affect the muscles and other tissues

Osteoarthritis  is the most common form of arthritis is degenerative arthritis, or osteoarthritis, which happens due to the breakdown of the tissue inside the joints

Rheumatoid arthritis is an autoimmune disease. This is when your immune system, which usually fights infection, attacks the cells that line your joints, making them swollen, stiff and painful

What causes Osteoarthritis?

Despite the prevalence of the disease, the causes of osteoarthritis are not completely understood. There is no cure. Many different factors may play a role:

Age

Incidences of osteoarthritis increase with age due to simple “wear and tear” on the joints – the older you are, the more you have used your joints

However, it is not an inevitable part of aging, because not everyone gets it

Obesity

Increased body weight, which adds stress to lower body joints, is a well-established factor in the development of osteoarthritis

The knees carry the brunt of someone’s body weight and are particularly at risk

Every extra pound a person gains adds 4 pounds of pressure on the knees and six times the pressure on the hips

Gaining weight increases the likelihood of developing osteoarthritis

Injury or Overuse

Athletes and people whose jobs require repetitive motion (landscaping, typing or operating machinery) have a higher risk of developing osteoarthritis, due to injury and increased stress on certain joints

Soft tissue injuries can lead to osteoarthritis

It can also appear in joints affected by previous bone fractures and surgeries.

Genetics or Heredity

Genetics plays a role in the development and progression of osteoarthritis, particularly in the hands

Inherited bone abnormalities that affect joint shape or stability, or defects that cause cartilage to form abnormally

It is also more common in joints that do not fit together smoothly, such as those of people who are bowlegged or double jointed

Having these traits, however, does not necessarily mean Osteoarthritis will develop

Muscle Weakness

Studies show that weakness of the muscles surrounding the knee is associated with osteoarthritis, especially in women and makes the pain and stiffness worse after onset

Strengthening exercises for thigh muscles are important in reducing the risk

Symptoms of Osteoarthritis

• One of the main symptoms of Osteoarthritis is its effect on the cartilage of a person’s joints
• Cartilage acts as a sort of cushion, or hinge in between the joints. When everything is working well, the cartilage protects the bones of the joint from rubbing together
• In someone with Osteoarthritis, the cartilage around the affected joints begins to die and go away
• This, in turn, causes the bones in the joint to begin to rub directly against one another, which can be incredibly painful
• It is also common for this to result in small bone fragments to break away, which can cause infection and disability.
• In the body, any joint can fall victim to the effects of Osteoarthritis. It is most often found in joints such as the hip and knee, which are weight-bearing but it can also be found in smaller joints, such as the hand
• In most cases, only one joint in a pair will be affected by this disease, for example, in someone with knee osteoarthritis, if the right knee were infected, the left knee would typically not be affected. This is referred to as an asymmetrical arthritis.

Sufferers will generally have:

• Pain, swelling or stiffness in one or more joints
• Pain or stiffness in the back or neck
• Pain and stiffness after heavy activity, such as gardening or housework or long walks and on getting up in the mornings
• Light activity might actually relieve some of the symptoms

Rheumatoid Arthritis

Rheumatoid Arthritis is also classified as a autoimmune disorder, which means that it causes the body’s own immune system to attack itself

The immune system is used to fight infection, but in someone with rheumatoid arthritis, the body thinks that the joint is actually an infection

As a result, the cells in the body begin to attack and break down the joint, causing rheumatoid arthritis

The exact trigger of this auto-immune disorder is not known

Rheumatoid arthritis shares a number of similarities with Osteoarthritis, but it is considered to be symmetrical arthritis. i.e. usually joints are affected uniformly

Symptoms of Rheumatoid Arthritis

• Pain -This is usually a throbbing and aching pain, often worse inthe mornings and is often felt while  resting, rather than after activity
• Stiffness -joints affected can feel stiff, especially in the morning and can last longer than  half an hour.
• Warmth and redness – As the lining of the affected joint becomes inflamed, it can cause the joints to swell, become hot, tender to touch and painful
• Inflammation. The condition can also cause inflammation of your tear glands, salivary glands, the lining of your heart and lungs, and your blood vessels

What is the treatment for arthritis?

There is no cure, but there are many ways to make life more comfortable and keep you mobile and independent:

Diet

Keep weight down to avoid unnecessary wear on the joints

No particular diet has been proved to cause, or improve, Osteoarthritis

Exercise

Keep a good balance of adequate rest with sensible exercise (such as walking, cycling and swimming), but stop any exercise, or activity that increases the pain

Heat

Arthritis responds better to warm conditions

A hot-water bottle, warm bath or electric blanket ormicrowave heated wrap can soothe the pain and stiffness

Avoid getting too cold

Physiotherapy

This can be helpful in improving muscle tone, reducing stiffness and maintaining mobility

Walking aids

Shoe inserts, good footwear and a walking stick can help painful knees, hips and feet.

Medication

• Aspirin, Ibuprofen and Paracetamol are effective pain-killers
• The doctor may prescribe special anti-arthritic medication, such as anti- inflammatory drugs

Special equipment to help elderly arthritis

It is possible to increase your ageing parent’s independence at home

There is a wide range of inexpensive equipment and tools that can help with cooking, cleaning and other household chores

These can be discussed with the doctor,  physiotherapist, or occupational therapist

Surgery

Modern surgery can give excellent results with relief of severe pan for most joints

The new techniques and artificial joints are improving all the time and so there is no need to suffer with severe pain

Osteoarthritis of the hip

Replacement of your worn-out joint with an artificial hip made of a combination of metal, or plastic is a very common operation

More than 90 per cent of these are most successful.

Osteoarthritis of the knee

Modern knee replacements are also giving excellent results, and if you have crippling knee pain, this operation can give great relief

www.arthritis.org

www.nhs.uk/conditions/Rheumatoid-arthritis