By Samuel W. Ascioti, DC

Did you know that arthritis and other rheumatic conditions are the leading cause of disability in the United States? (4, p.1) One out of every five adults has doctor-diagnosed arthritis (4, p.1). Most of us probably know someone suffering from arthritis, but did you know that not all arthritis is created equal? Believe it or not, there are over 100 different types of arthritis, and it can sometimes be confusing trying to keep them all straight! For August’s Article of the Month, we’re going to take a closer look at 4 of the most common types of arthritis and compare the differences between them.

Osteoarthritis

By far the most common type of arthritis, osteoarthritis (OA), is the “wear and tear” associated with many years of joints being overused (4, p.221). It’s most commonly associated with age and may also be a result of traumatic joint injuries or even obesity, due to the extra stress on the joints in the skeletal system (1). Weight-bearing joints (spine, feet, hips, knees) are usually affected the most (1, 2).

OA is attributed to the breakdown of the body’s shock absorber – cartilage. Cartilage covers the ends of bones and slowly wears down over a lifetime of activity, eventually resulting in “bone on bone” which can cause pain and inflammation. Arthritic change in the facet joints of the spine can even cause signs and symptoms of spinal canal stenosis, causing pain into the legs or arms and sometimes numbness and tingling.

Symptoms include stiffness after resting, pain during motion of the affected joint, and difficulty performing activities of daily living (ADLs) such as gripping items, bending over, climbing stairs, or dressing. Sometimes the joint itself is warm to the touch or swollen (1,2).

Rheumatoid Arthritis (RA)

Another common type of arthritis, rheumatoid arthritis (RA) affects the lining of the joints as the body’s immune system begins to attack parts of the body. RA is more common in women than men (2), and about 1 out of 5 people with RA may develop lumps on the skin called rheumatoid nodules (1).

RA usually shows up with a clear and distinct pattern that can be recognized by a healthcare provider – symptoms usually occur on both sides of the body; for example, if the right foot swells up and becomes inflamed, the left foot will probably do the same (1).

The most common symptoms of RA include pain, stiffness, and swelling in the hands, wrists, elbows, shoulders, knees, ankles, feet, jaw, and neck, with smaller joints being more likely to be affected by RA than larger joints (1). Sometimes, the swollen joints can feel warm to the touch and painful to move; if left untreated, RA may even do so much damage to joints that the joint is no longer able to properly function (2). RA may also lead to other symptoms, such as fatigue, Raynaud’s phenomenon, dry eyes/mouth, and peripheral nervous system issues (4, p.133).

IMPORTANT FOR CHIROPRACTIC PATIENTS: RA may cause the ligaments of the body to become more lax, which can cause unforeseen consequences during spinal manipulation. Please inform your chiropractor beforehand if you’ve been diagnosed with RA, as the chiropractor will need to assess cervical spine stability with a special series of x-rays to determine if the neck is safe to adjust or not.

Gout

Gout is caused by the deposition of monosodium urate crystals in and around the tissues of joints (4, p.241). Most of the time, the big toe or other part of the foot is affected, although hands and other joints can be affected by gout, too (1). Gout attacks are characterized by intense joint pain, inflammation/redness and swelling, and stiff joints.

Gout attacks can be triggered by eating an excess of processed meats or drinking too much alcohol, and stress, drugs, and other illnesses can also contribute to gout. Gout attacks typically last between 3-10 days and can resolve without treatment; however, treatment for gout is very important, as the body’s joints and kidneys can become dangerously affected by gout (1).

To prevent gout attacks, several strategies can be employed. Avoid consuming too much alcohol and processed meat, and make sure your kidneys receive regular check-ups with your primary care physician. According to a 2012 study from Boston University Medical Center, those consuming at least 10 cherries a day were able to protect themselves from further gout attacks (3).

Psoriatic Arthritis

Individuals with psoriatic arthritis usually have both inflammation of the skin (psoriasis) and the joints. About 10-30% of those with psoriasis will go on to develop psoriatic arthritis. Psoriasis itself causes raised, patchy, red and white lesions on the skin with scales and usually affects the tips of the elbows and knees but can also affect the navel and scalp (1).

Symptoms for psoriatic arthritis include swelling around the fingers and toes along with pitted fingernails; for some, only one joint may be affected, while for others the entire spine and multiple other joints can also be affected.

For a physician, diagnostic tools for a patient with suspected arthritic change includes blood tests, imaging, and tissue sampling, all performed on the individual patient; medical treatments include rehab, pharmaceuticals, and (rarely) surgery (p2). Chiropractors utilize conservative care techniques, such as manipulation and soft tissue work, to ease symptoms in a patient.

If you or someone you know is concerned about a joint, make sure to schedule an appointment with your primary care physician or chiropractor!