One thing joint pain is trying to tell you

Pain in the joints is one of the most common complaints medical practitioners deal with. In most cases, the pain is short-lived and clears without major complications. In some cases, however, it can be disabling.

What is arthritis?

Arthritis is inflammation of the joints. It can affect any joint in the body. Often it affects one joint but it has been known to affect multiple joints. There are over 100 different types of arthritis, with different causes and treatment methods.

Causes of arthritis

Infection

Infection can affect any part of the body including the bones and joints. If it affects your joints, you get a painful, swollen, warm joint. Often, the onset of symptoms is sudden and you are unable to utilise the affected joint. Infection of the joint, medically known as septic arthritis tends to occur more often in children. It can also occur after minor injury or surgery to a joint.

It needs prompt medical intervention – failure to provide this has been associated with permanent damage to the affected limb. Although most cases of septic arthritis are caused by common environmental bacteria, one’s joint can also get infected with viruses and more long-term infections like tuberculosis (TB), fungus and rarely, cysts from parasitic worms.

Wear and tear

Larger weight bearing joints of the body, such as the hips, knees, and ankles can progressively be worn down as one ages. This wear and tear is the foundation for osteoarthritis - which is the most common form of arthritis. Usually, the symptoms of wear and tear include pain (which can lead to limping) and inability to stretch (fully utilise) your joint. If not, controlled, this form of arthritis can permanently destroy the joint resulting in the need to surgically replace the joint with metal prosthesis. Osteoarthritis can also affect the backbone and shoulder area as well.

Immunity problems

Occasionally, the immune system can inappropriately attack the body. This is known as an autoimmune disorder. If the joints are attacked by an autoimmune disease, they can develop arthritis.

Common types of autoimmune arthritis include rheumatoid arthritis and SLE (lupus). Rheumatoid arthritis tends to attack smaller joints (such as those of the hands) as opposed to osteoarthritis which affects large joints.

Unlike osteoarthritis which attacks older individuals, rheumatoid arthritis can affect children and teenagers. SLE is more common in women than in men.

Gout

Abnormal metabolism (breakdown) of particular substances in the body is the basis of gout. People with gout have a high level of uric acid in circulation and this is often harmful to the joints.

Gout has a predisposition for attacking the big toe (first digit) of the foot and presents with extreme pain in the affected joint.

Predisposing factors

Past injury:

Severe injury to a joint puts it at risk of developing arthritis in the future

Obesity: Being overweight accelerates the wear and tear of weight bearing joints like the knee. This significantly increases your chances of getting osteoarthritis (often at a younger age than expected).

Genetics

With the exception of septic arthritis, most other forms of arthritis have been known to run in families

Occupation

Jobs that involve repetitive movements can predispose to the development of arthritis and other musculoskeletal conditions.

Is there an arthritis diet?

Generally speaking, there isn’t a special ‘arthritis diet’. For most forms of arthritis, diets play little or no role in precipitating or exacerbating the condition. Foods that are rich in anti-oxidants and those thought to have some anti-inflammatory properties may be useful in patients with arthritis. These include garlic, fish oil and other omega-3 rich foods.

The only form of arthritis that has been found to benefit from diet change is gout.

Foods that may elevate the uric acid levels such as shell fish, red meat and alcohol should be deliberately reduced in one’s diet. One should also keep well hydrated as dehydration can worsen gout symptoms.

Safe exercising

Anyone with arthritis should always consult their doctor before embarking on an exercise program. This is because certain manoeuvres can worsen their condition. The safest form of exercise for someone with arthritis (especially, if it affects the large joints) is swimming.

Do we have arthritis specialists in Kenya?

A rheumatologist is a medical arthritis expert and we have several highly experienced ones in Kenya. They are, however, very few and most Kenyans with arthritis are managed by their family doctors/general practitioners.

Most cases of autoimmune arthritis, however, are best managed by rheumatologists. If you cannot get in touch with one, consult a physician (internal medicine specialist)— they are available in almost every major town in Kenya.