Focus On ARTHRITIS; Causes, Treatments and Preventions

More than 50 million people around the world are currently suffering from this agonizing condition. 

One out of five adults suffer from arthritis
What is surprising is the fact that even children have succumbed to this disease.

World Arthritis Day has come and gone, but Nigerians have been advised to always visit rheumatologists for proper treatment of the ailment.

ARTHRITIS, also called Joint inflammation, is an infection or injury commonly associated with the joints, can exacerbate natural breakdown of cartilage tissue. The risk of developing osteoarthritis (OA) may be higher, if a patient has a family history of the disease.
Another common form of arthritis, rheumatic arthritis (RA) is an autoimmune disorder, which occurs, when the body’s immune system attacks tissues of the body.

Rheumatologists have explained that there are more than 100 types of arthritis, with different treatments. 
The public is, therefore, advised to go for screening at least once in a year, as there are misconceptions and myths that the ailment is caused by ‘juju’ or spiritual attack. However, it is treatable if presented early.

Femi Adelowo, a professor of medicine and Consultant Rheumatologist at Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos, who is also President, African League of Associations of Rheumatology (AFLAR) and Chairman, executive committee of World Body of Rheumatology (ILAR), said this year’s World Arthritis Day titled: ‘It is in your hands take action’ is to urge patients to go for treatments and screening.

Adelowo explained that arthritis is not a spiritual attack, and that patients should avoid self-medication; rather, they should seek specialists’ intervention for proper treatment.
He said: 
“Patients shouldn’t treat it at home, as they might not know the type of arthritis they suffer from. There are about 30 percent Nigerians going about their normal businesses, but who are having one type of arthritis or the other.”
Adelowo said avoiding lifting of heavy objects is one of the ways to prevent commonest types of arthritis, which include, rheumatoid, psoriatic and fibromyalgia.
He said: 
“People should avoid activities that could lead to damage of back bone, because lifting a heavy object must definitely cause back pains. Gout is not a common type of arthritis, which is mainly caused by excessive intake of alcohol.”
He stated that osteoarthritis (OA) is the most prevalent musculoskeletal disease and a leading cause of disability globally. 
The impact of OA across the globe has been described as immense, as it affects 40 per cent of individuals over the age of 70, and is a major cause of pain, associated with an increased risk of morbidity and death.

The commonest OA site is the knee, affecting one in five people over the age of 45. The health economic burden of OA is rising, commensurate with longevity and obesity rates. 
Adelowo said: 
“There is currently no treatment, as management of the disease targets main symptoms of pain and loss of function and culminates in joint replacement surgery. Thus, there is a large unmet need for therapeutic interventions to alter natural history of the disease. This review will outline established and emerging pathways to improving understanding of the disease’s aetiopathology through genetics and genomics studies.”

He explained that synovial joint is a complex structure, comprising articular cartilage, subchondral bone, synovial lining membrane, fibrous joint capsule and supporting ligaments. 
The articular cartilage, calcified cartilage and subchondral bone form the osteochondral unit, a bio composite that is uniquely adapted to transferring loads during weight bearing and joint motion.

The osteochondral unit provides tensile strength, compressive resilience and a low-friction articulating surface through the collagen network, proteoglycan aggregates and layer of lubricants.
“Chondrocytes are the only cell type in articular cartilage, which is avascular and aneural. Under normal physiological conditions, the synovial membrane consists of a thin layer of cells with phenotypic features of macrophages and fibroblasts, and serves to produce synovial fluid that is responsible for maintaining nutrition and lubrication of the articular cartilage.

 “The subchondral bone adapts its structural and functional architecture in response to its local mechanical environment through remodelling, regulated by osteocytes via interactions with osteoclasts and osteoblasts.
 “OA is a disease characterised by a gradual process of tissue destruction and remodelling that affects all of the structures of the synovial joint, with degeneration of articular cartilage, remodelling of the underlying bone, and synovitis as its hallmarks.
“The initiating signals that trigger development of OA remain poorly understood. However, established clinical risk factors include increasing age, female sex, obesity, occupational exposure to high levels of joint loading activity, previous joint injury and deformity, smoking status and family history of OA”.
“Histological changes in OA include synovial hypertrophy and hyperplasia, with macrophage and lymphocyte recruitment, angiogenesis, and fibroblast proliferation. Those within the osteochondral unit include loss of chondrocytes in the superficial zone with proliferation in deeper zones; loss of extracellular matrix; vascularisation and neuronal ingrowth across the tidemark between calcified and non-calcified cartilage; and remodelling of subchondral bone, resulting in sclerosis, cysts and osteophyte formation.”

Symptoms of Arthritis

The most common signs and symptoms of arthritis involve the joints. Depending on the type of arthritis you have, your signs and symptoms may include:
  • Pain
  • Stiffness
  • Swelling
  • Redness
  • Decreased range of motion

Causes of Arthritis 

The most common type of arthritis, osteoarthritis involves wear-and-tear damage to your joint's cartilage — the hard, slick coating on the ends of bones. Enough damage can result in bone grinding directly on bone, which causes pain and restricted movement. This wear and tear can occur over many years, or it can be hastened by a joint injury or infection.

Rheumatoid arthritis
In rheumatoid arthritis, the body's immune system attacks the lining of the joint capsule, a tough membrane that encloses all the joint parts. This lining, known as the synovial membrane, becomes inflamed and swollen. The disease process can eventually destroy cartilage and bone within the joint.
Risk factors

Risk factors for arthritis

Family history: Some types of arthritis run in families, so you may be more likely to develop arthritis if your parents or siblings have the disorder. Your genes can make you more susceptible to environmental factors that may trigger arthritis.
Age: The risk of many types of arthritis — including osteoarthritis, rheumatoid arthritis and gout — increases with age.
Your sex: Women are more likely than are men to develop rheumatoid arthritis, while most of the people who have gout, another type of arthritis, are men.
Previous joint injury: People who have injured a joint, perhaps while playing a sport, are more likely to eventually develop arthritis in that joint.
Obesity: Carrying excess pounds puts stress on joints, particularly your knees, hips and spine. Obese people have a higher risk of developing arthritis.

Severe arthritis, particularly if it affects your hands or arms, can make it difficult for you to do daily tasks. Arthritis of weight-bearing joints can keep you from walking comfortably or sitting up straight. In some cases, joints may become twisted and deformed.

Natural Supplements for Arthritis

When you are looking for supplements which would help you to manage your arthritis, you should take the opinion of your medical practitioner before you start taking these supplements. This should stop you from suffering from any side effects which might occur.

  • GINGER and GARLIC: The usage of ginger roots to treat arthritis can be traced to ancient times. Back then, the ginger root can be dried or consumed freshly. Regular use of ginger would considerably minimize the inflammation around your joints and decrease your joint pain. However, if you are taking any blood thinning medicines like warfarin, you should abstain from using ginger.
  • DEVIL'S CLAW: The origin of Devil’s Claw can be traced back to South Africa. It contains Harpagoside which has the power to reduce acute joint pain and inflammation. It reduces levels of uric acid among people suffering from gout. It also acts as a stimulant for appetite. After consulting your doctor, you can take up to 1000 mg of Devil’s Claw powder capsules three times a day.
  • VITAMIN C: A study undertaken in the UK revealed that people who have low levels of Vitamin C are more prone to develop rheumatoid arthritis in the near future. This study showed that a healthy intake of Vitamin C can reduce the development of inflamed joints and help maintain healthy joints among people suffering from osteoarthritis. Vitamin C has antioxidants which can help your body build healthy connective tissues. Fruits like Strawberries, Oranges, Lime, Cherry and Grapes are sources of Vitamin C
  • OMEGA-3 FATTY ACIDS: The fish oil extracted from cod, herring, mackerel and salmon is commonly known as Omega-3-Fatty Acids. It has been considered by many medical experts to be one of the best supplements for treating arthritis. It removes the presence of morning stiffness from the joints and this offers great relief to people suffering from severe joint inflammation and pain due to arthritis.You can introduce Omega-3 Fatty Acids into your diet by consuming them in the form of capsules, soft-gels and liquid. A natural way would be including fresh fish like tuna, mackerel, salmon and herrings in your daily diet at least three times a week.Avocado and walnut oil are also sources.
  • PROTEINS: Beans, kidney beans, pinto beans, soybeans and red beans

Foods to Avoid if you have Arthritis

  • ‘AGES’ (Advanced Glycation End products): a toxic by product resulting from fried, grilled, heated, or pasteurized foods.
  • CERTAIN VEGETABLES: Vegetables that contain Solanine (a type of compound that produces adverse physiological reactions in arthritis patients). Vegetables Like solanaceae, eggplant, peppers, potatoes, and tomatoes can worsen arthritis pain. Excluding Sweet Potatoes
  • REFINED CARBOHYDRATES: Mainly white flour products,



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