4) Health Care -Arthritis



This is one of the great challenges of our age with major cost and service implications for the development or re-modelling of existing services and facilities to address the needs of an ageing population.

Arthritis literally means “joint inflammation” and refers to a group of more than 100 rheumatic diseases and related conditions that are associated with joint pain, joint stiffness and swelling. Certain arthritic conditions can affect parts of the body other than the joints. For example, tendons, muscles, and skin can become inflamed and painful. Some rheumatic conditions can affect internal organs and result in debilitating or even life-threatening complications.

The two most common types of arthritis are osteoarthritis and rheumatoid arthritis. While they are both classified as arthritis, osteoarthritis and rheumatoid arthritis are very different and must be distinguished.Arthritis can affect anyone at any age, including children. The incidence of arthritis increases with age, but nearly 3 out of 5 people with arthritis are under age 65. If left undiagnosed and untreated, many types of arthritis can cause irreversible damage to the joints, bones, organs, and skin. It is essential to be diagnosed early in the course of the disease and treated appropriately. Knowing your type of arthritis is essential.


Osteoarthritis, also known as degenerative joint disease, results from wear and tear on the joint. Cartilage damage develops which can lead to decreased joint function. The first signs of osteoarthritis are:

  • joint pain
  • joint tenderness
  • joint swelling
  • decreased range of motion

Usually, osteoarthritis onset is subtle and gradual, involving one or only a few joints. The joints most often affected are the:

The risk of developing osteoarthritis increases with age. Other risk factors include: joint injury, obesity, and repetitive use of the joint.

Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease which occurs when the body’s own immune system mistakenly attacks the synovium (cell lining inside the joint). Rheumatoid arthritis is an inflammatory type of arthritis, chronic and potentially disabling. The first signs of the disease are:

  • joint pain
  • joint stiffness
  • joint swelling
  • loss of joint function

While the cause remains elusive, doctors suspect that genetic factors play some role in predisposition to the disease. But there is more than genetic predisposition. It is thought that there are also environmental triggers for rheumatoid arthritis.

Juvenile Arthritis

Juvenile arthritis is a general term for all types of arthritis that occur in children, 16 years old or younger. Juvenile rheumatoid arthritis is the most prevalent type of arthritis in children. There are three major types of JRA:

Signs and symptoms of juvenile rheumatoid arthritis vary from child to child. No single test can conclusively establish a diagnosis. Juvenile arthritis must be present consistently for six or more consecutive weeks before a correct diagnosis can be made.

Psoriatic Arthritis

Psoriatic arthritis is similar to rheumatoid arthritis. About 5% of people with psoriasis (a chronic skin disease) also develop psoriatic arthritis. In psoriatic arthritis, there is inflammation of the joints and sometimes the spine.


Fibromyalgia syndrome is a painful condition characterized by:

Fibromyalgia is characterized by pain in the muscles, ligaments and tendons. Fibromyalgia is a type of soft tissue or muscular rheumatism and does not cause joint deformities.


Gout is a painful type of arthritis that causes sudden, severe attacks of pain, tenderness, redness, warmth, and swelling in the joints, especially the big toe. The pain and swelling associated with gout are caused by uric acid crystals that precipitate out of the blood and are deposited in the joint.

Pseudogout / CPPD

Pseudogout, which is also known as Calcium Pyrophosphate Dihydrate Deposition Disease (CPPD), is caused by deposits of calcium phosphate crystals (not uric acid) in the joints. CPPD is often mistaken for gouty arthritis. Since CPPD is a different disease than gout, treatment is not the same.


Scleroderma is a disease of the body’s connective tissue that causes thickening and hardening of the skin. It can also affect the:

  • joints
  • blood vessels
  • internal organs

There are two types of scleroderma: localized and generalized (systemic).


Systemic lupus erythematosus (SLE) is an autoimmune disease that can involve the:

  • skin
  • kidneys
  • blood vessels
  • joints
  • nervous system
  • heart
  • other internal organs

Symptoms vary, but may include skin rash, arthritis, fever, anemia, fatigue, hair loss, mouth ulcers, and kidney problems. Symptoms usually first appear in women of childbearing age, but, can occur in children or older people. About 90% of people affected are women.

Carpal Tunnel Syndrome

Carpal tunnel syndrome is caused by pressure on the median nerve at the wrist which causes tingling and numbness in the fingers. It can begin suddenly or gradually and can be associated with other diseases, such as rheumatoid arthritis — or it may be unrelated to other disorders.

Ankylosing Spondylitis

Ankylosing spondylitis, a chronic inflammatory disease of the spine, can cause the vertebrae to fuse, producing a rigid spine. Other joints, besides the spine, may become involved.

Spondylitis is a result of inflammation which usually starts in tissue outside the joint. Common, early symptoms of spondylitis involve low back pain and stiffness The exact cause is still unknown, but, most people with spondylitis have a genetic marker known as HLA-B27. Having this genetic marker does not mean a person will develop spondylitis, but people with the marker are more likely to develop the disease. Ankylosing spondylitis usually affects men between the ages of 16 and 35, but it can also affect women.

Bursitis / Tendinitis

Bursitis is a condition caused by inflammation of the bursa sacs. Bursae are the fluid-filled sacs located in the areas where muscles and tendons glide over the bones. Tendinitis, also spelled tendonitis, is characterized by inflammation of a tendon. Tendons connect muscles to bones.

Infectious Arthritis

Infectious arthritis is a form of joint inflammation caused by bacteria, viruses or fungi. Diagnosis is made by culturing the organism from the joint.

Lyme Disease

Lyme disease is a serious tick-borne disorder. Lyme disease can affect the:

  • joints
  • nervous system
  • heart
  • skin
  • eyes

Reactive Arthritis

Reactive arthritis, also called Reiter’s syndrome, involves inflammation in the joints, and sometimes where ligaments and tendons attach to bones.

Sjogren’s Syndrome

Sjogren’s syndrome is characterized by dysfunction of the moisture-producing glands causing dryness of the mouth and eyes. Other parts of the body may also be affected, resulting in a wide range of symptoms.


Osteoporosis results in loss of bone tissue, leaving bones less dense and prone to fracture. Osteoporosis is a silent disease that can often be prevented.

Other Conditions

Joint Pain

If you are experiencing joint pain, details matter.When you consult with your doctor, you will be asked if joint pain developed suddenly or gradually and how long the joint pain has persisted. Your doctor will want to also know if the pain worsens with physical activity or if the pain goes away completely when resting. Be prepared to discuss what you do to effectively relieve the pain.

Joint Tenderness

Joint tenderness refers to exactly that — tenderness around a joint. Often this occurs in combination with other signs — joint pain, joint effusion, joint swelling, warmth, redness. Your doctor will ask you what may have caused the tenderness — and once again, unless you can point to a specific incident or injury, you must consider arthritis as a possibility.

Joint Stiffness

Joint stiffness can be one of the earliest signs of arthritis. Joint stiffness is defined as discomfort after a period of inactivity (such as waking up in the morning or sitting for an extended period of time), decreased range of motion or a loss of range of motion in a joint.

With osteoarthritis, joint stiffness after waking may last up to 30 minutes. With inflammatory types of arthritis such as rheumatoid arthritis or systemic lupus erythematosus, the stiffness typically lasts more than one hour (referred to as morning stiffness). You should consult a doctor about persistent joint stiffness even if there is no obvious redness or swelling around the joint.

Redness around a Joint

Joint redness usually indicates there is some sort of inflammatory process occurring. After observing the joint redness, your doctor will perform tests (sedrate, CRP) to help determine the cause of joint inflammation, which can be caused by many conditions including rheumatoid arthritis and infection. Treatment for any of these conditions should not be delayed.

Warm Joints

Similar to the situation with redness, warmth is a sign that something is wrong. Redness and warmth typically go together and serve as indicators of inflammation or infection. This sign is not to be ignored. There can be serious consequences if you ignore warmth and redness around your joints.


The initial onset of arthritis can be associated with fever. This is a symptom that is linked to many different conditions — but don’t forget that arthritis is one of those conditions. A fever develops as the body raises its temperature to fight infection or in response to some forms of arthritis.

If you have taken your temperature using a thermometer, don’t be misled by a normal result after using Tylenol or other medications that can mask a fever. If fever occurs in combination with joint stiffness or tenderness — the clinical picture is developing and favoring a diagnosis of arthritis.


Malaise has been described as a general ill feeling or ill-at-ease feeling — a general feeling of discomfort, illness, or lack of well-being. Many conditions and drug side effects can cause malaise. By assessing other symptoms which are present with malaise, it is easier to determine the true cause of malaise. For example, the likely cause of malaise for arthritis patients is the combined effect of inflammation, joint pain and other joint symptoms.

Excessive Fatigue

Another sign related to arthritis is excessive fatigue. We all get tired from time to time, but excessive fatigue implies a deep-rooted fatigue that’s present even after sleeping 8 hours or following an afternoon nap. You feel fatigued at times when you normally would expect not to feel fatigued.

Lumps and Bumps

Certain types of arthritis are associated with nodules, or lumps that commonly develop near a joint. At first, you may not recognize them for what they really are. Don’t ignore the lumps or nodules. Let a doctor evaluate the nodules because certain characteristics — such as their location, size, and composition — are useful during the diagnostic process. For example, did you know that firm, non-tender, subcutaneous nodules develop in about 25% of rheumatoid arthritis patients?

Usual Activities Have Become Difficult

We have discussed physical signs of arthritis, especially some of the ones that appear early in the course of the disease. There’s one other sign that you must honestly assess. Are your usual daily activities becoming much more difficult? If the answer is yes, this too may be an arthritis sign.

Arthritis signs tend to snowball: joint pain and stiffness can lead to fatigue and malaise. Joint stiffness also affects normal range of motion which, in turn, cause you to have more difficulty performing usual daily activities. And so it goes, each arthritis sign impacts another.

So if you would like us to provide a tailor made package for your community group or organisation or arrange specific training or simply discuss the issues please contact us. Our discussions are free and as always confidential. Please contact John Brennan on 01803852270 or email john@caracommunity.co.uk.