Arthritis is a chronic disease characterized primarily by joint inflammation, affecting hundreds of millions of people worldwide. It not only causes pain and mobility impairment but can also lead to systemic health issues. There are dozens of types of arthritis, with the most common being degenerative osteoarthritis and rheumatoid arthritis. Understanding its pathophysiology, clinical presentation, and treatment options is key to delaying disease progression and improving quality of life.
Modern medical treatments for arthritis have shifted from symptom relief to comprehensive management, including medication, physical therapy, and surgical interventions. Early diagnosis and lifestyle modifications can effectively slow joint destruction, yet many underestimate its severity. This article systematically analyzes the causes, clinical features, diagnostic procedures, and the latest treatment strategies for arthritis to help readers develop a correct understanding of the disease.
The natural wear and tear of joint cartilage is the core cause of degenerative osteoarthritis. As age increases, proteoglycans and collagen fibers in the cartilage gradually decrease, leading to the loss of the protective surface of the joint. This physiological degeneration typically occurs in the knees, hips, and spine, resulting in osteophyte formation and joint space narrowing. Repetitive mechanical stress (such as obesity) accelerates this process, creating a vicious cycle.
The development of autoimmune arthritis is associated with specific genetic polymorphisms, such as the HLA-DR4 gene, which has up to a 60% association with rheumatoid arthritis. When the immune system is abnormally activated, T cells and B cells mistakenly attack the synovium, leading to synovitis and neovascularization, ultimately damaging joint structures. This chronic inflammatory process releases enzymes like matrix metalloproteinases (MMPs), which accelerate tissue breakdown.
Patients often complain of morning stiffness, which in degenerative osteoarthritis usually lasts less than 30 minutes, whereas in rheumatoid arthritis it can extend for several hours. Joint swelling is often related to synovial proliferation and effusion, with increased skin temperature and tenderness upon palpation. In osteoarthritis, crepitus during joint movement is a characteristic auscultatory finding.
Juvenile rheumatoid arthritis may be accompanied by fever and lymphadenopathy, while gouty arthritis often presents as an acute monoarthritis with redness and swelling of the affected joint. Spondyloarthritis (such as ankylosing spondylitis) primarily affects axial joints (spine and sacroiliac joints), with morning stiffness.
The diagnosis begins with a detailed medical history, including symptom duration, pain patterns, and family history. Physical examination assesses joint range of motion, tenderness points, and swelling, such as using Geberth's test for wrist evaluation. Physicians combine clinical features with auxiliary tests based on criteria from the American College of Rheumatology for comprehensive assessment.
X-rays can reveal osteophyte formation and joint space narrowing, while MRI can detect cartilage damage and bone marrow edema earlier. Rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies are significant for diagnosing rheumatoid arthritis. Elevated inflammatory markers like erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) indicate active inflammation.
Non-steroidal anti-inflammatory drugs (NSAIDs) relieve pain and inflammation but require caution due to gastrointestinal side effects with long-term use. Disease-modifying anti-rheumatic drugs (DMARDs), such as methotrexate, suppress immune responses. Biologic agents (e.g., TNF-α inhibitors) target specific inflammatory pathways and are suitable for patients unresponsive to traditional therapies.
Physical therapy, including aquatic exercises and muscle strengthening, maintains joint mobility and reduces stress. Patients with patellofemoral osteoarthritis can use assistive devices to reduce load, and custom braces can stabilize unstable joints. Weight loss in obese patients by 5% can significantly reduce knee joint load; such lifestyle modifications are considered foundational treatments.
Total joint replacement is the standard treatment for end-stage osteoarthritis, restoring joint function and improving quality of life. Arthroscopic surgery is used to remove loose bodies or repair cartilage damage, with minimally invasive techniques greatly reducing recovery time. Autologous stem cell transplantation shows potential in experimental treatments for severe rheumatoid arthritis.
Regular low-impact exercise (such as swimming and cycling) can strengthen muscles around the joints. It is recommended to perform 150 minutes of moderate-intensity exercise weekly. Maintaining a healthy weight reduces biomechanical stress on lower limb joints; for every 1 kg of weight loss, knee joint load decreases by approximately 4 kg. Avoiding repetitive heavy lifting or squatting is advised.
Omega-3 fatty acids (found in fish oil) have anti-inflammatory effects; daily intake of 1-2 grams can alleviate mild symptoms. Vitamin D deficiency is associated with increased risk of arthritis; maintaining serum 25(OH)D levels above 30 ng/mL is recommended. Glucosamine and chondroitin sulfate supplements have shown potential in some studies to relieve osteoarthritis pain.
If joint pain persists for more than two weeks without relief, or if morning stiffness exceeds 30 minutes daily, seek medical attention immediately. Joint swelling with increased skin temperature and redness may indicate acute inflammation. If symptoms interfere with daily activities (such as difficulty climbing stairs), professional assessment can prevent permanent joint damage.
Rheumatoid arthritis patients experiencing unexplained weight loss or fatigue may have increased disease activity. Children with persistent joint swelling for more than three weeks should be evaluated for juvenile idiopathic arthritis. Elderly individuals with unexplained decline in mobility should be assessed for spinal spondyloarthritis or spinal stenosis.
Low-impact aerobic exercises such as swimming, water aerobics, or cycling can strengthen muscles and reduce joint stress. Yoga and Tai Chi can improve flexibility and balance. High-impact activities like jumping should be avoided, and exercise intensity should be adjusted during pain episodes.
How does diet help alleviate arthritis inflammation?Foods rich in Omega-3 fatty acids, such as fatty fish (salmon), nuts, and flaxseeds, can reduce inflammation. Increasing antioxidant-rich foods like blueberries and spinach, while reducing refined sugars and saturated fats, can lower systemic inflammatory factors.
Does long-term use of painkillers worsen arthritis?NSAIDs may cause gastrointestinal irritation or kidney issues but do not directly worsen arthritis. Over-reliance on medications can lead to misjudging disease severity; they should be used in conjunction with medical advice, physical therapy, or other treatments.
Does weather change really affect arthritis pain?Some patients subjectively report increased pain with cold and damp weather, but scientific studies have not conclusively proven a direct link between weather and arthritis. Managing symptoms through regular treatment and keeping warm is recommended rather than attributing pain solely to weather changes.
Can young people develop rheumatoid arthritis?While rheumatoid arthritis is more common between ages 40-60, it can occur at any age. Early diagnosis and treatment are crucial, especially if symmetrical joint swelling (such as in both small joints of the hands) occurs in young individuals, to prevent disease progression.
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