Avoid Joint Damage by Treating Early
Two common conditions in rheumatology are Arthritis and Gout.
There are many different types of arthritis, however they have many common symptoms such as:
- swelling in one or more joints
- stiffness around the joints that lasts for at least 1 hour in the early morning
- pain or tenderness in a joint
- reduced joint function
- warmth and redness in a joint
- reduced grip strength
Early diagnosis prevents joint damage. Arthritis can be very disabling and a prompt early diagnosis and effective management plan can help you live a normal pain free life. Combinations of effective medication can help relieve your pain. Joint injections can also be performed which are very effective in achieving fast pain relief for swollen joints.
Common types of arthritis include Osteoarthritis, Rheumatoid Arthritis, Gout& Psoriatic Arthritis.
This is the most common type of arthritis, affecting around 8 in 10 adults over the age of 50 in the UK. Osteoarthritis affects both the cartilage and the underlying bone. Osteoarthritis can cause joint pain and stiffness. Disability results most often when the disease affects the spine and the weight-bearing joints (the knees and hips).
A holistic approach is needed in the management of OA. Common treatment modalities include muscle strengthening, correction of biomechanics, joint injections, painkillers and weight management.
This inflammatory disease of the immune system targets the synovium, or lining of the joint, resulting in pain, stiffness, swelling, joint damage, and loss of function of the joints. Inflammation most often affects joints of the hands and feet and tends to be symmetrical. This symmetry helps distinguish rheumatoid arthritis from other forms of arthritis. Smoking has been found to be a risk factor. It is the second most common form of arthritis in the UK. Prompt diagnosis and treatment is essential to reduce pain swelling and stiffness, and hence reduce long term loss of function, and deformity.
Gout can be extremely painful. It results from deposits of needle-like crystals of uric acid in the joints. The crystals cause episodic inflammation, swelling, and intense pain in the affected joint, which is often the big toe. Medical data suggests that millions of people in the UK age 20 and older report having had gout at some time in their lives.
If you are diagnosed with gout, your treatment plan will have two goals:
- relieving symptoms of an acute gout attack
- preventing further attacks
During a gout attack, it is important to rest the affected area. Prompt diagnosis and treatment will reduce pain and restore function. The diagnostic test is joint fluid aspiration and looking for crystals. Anti inflammatories, colchicine and steroids (orally or by injection) can be used to abate an acute attack.
In the longer term a strategy for preventing or minimising the occurrence of attacks needs to be put into place as this will reduce destruction of the joints.
- making lifestyle changes to reduce uric acid levels – ↓ alcohol, ↓ red meat, ↓ shellfish etc
- medication to reduce uric acid levels (allopurinol, fubuxostat). Regular uric acid levels with titration of medications will be needed until target uric acid level reached.
New medications are emerging constantly and it is important that management is tailored to your specific needs. It is key for effective management that you engage with someone who is up to date with the latest guidelines and innovations in the treatment of these specific diseases. Prompt diagnosis is essential to reduce pain, deformity and loss of function.
Raynaud’s (cold dusky fingers)
Raynaud’s disease is a common condition that affects the blood supply to certain parts of the body, usually the fingers and toes.
The condition occurs because your blood vessels go into a temporary spasm which blocks the flow of blood. This causes the affected area to change colour to white, then blue and then finally red as the blood flow returns.
You may also experience pain, numbness and pins and needles in the affected body parts. In extreme cases it can cause necrotic finger tips leading to amputation. Symptoms can last from a few minutes to several hours. Raynaud’s is usually triggered by cold temperatures, vibrating tools, anxiety or stress. Beta Blockers and smoking can make the symptoms worse.
Raynaud’s can occur on its own, or secondary to other conditions such as Lupus and scleroderma. In many cases it may be possible to control the symptoms of Raynaud’s using self-care techniques such as avoiding the cold, wearing gloves and using relaxation techniques when feeling stressed. Quitting smoking can also help improve symptoms. If raynaud’s is due to an underlying condition, this also needs to be addressed.
If the above does not help with the symptoms, then there are medications that can be prescribed which prove effective with many people. It is important that the condition is accurately diagnosed for any treatment plan to be successful.