The term arthritis literally means inflammation of a joint, but is generally used to describe any condition in which there is damage to the cartilage. The cartilage is a padding that absorbs stress. The proportion of cartilage damage and synovial inflammation varies with the type and stage of arthritis. Usually the pain early on is due to inflammation. In the later stages, when the cartilage is worn away, most of the pain comes from the mechanical friction of raw bones rubbing on each other.

The most common forms of arthritis are osteoarthritis, rheumatoid arthritis, and traumatic arthritis.

Osteoarthritis, is a condition which is the result of either excessive wear/abuse of the joint when you were younger, trauma to the knee in the past or a resection of a torn cartilage years ago, or aging.  The smooth gliding surface of the joint, the cushioning cartilage layer, is worn away. This condition is made worse by increasing weight and imperfect alignment of the weight-bearing axis like knocked knees or pitched toes.

Rheumatoid arthritis, is a dysfunction of the immune system whereby a significant inflammation affects the capsule lining which makes the joint fluid.  This results in a slow destruction of the cushioning cartilage layer.

Post Traumatic Arthritis can follow a serious knee injury. A knee fracture or severe tears of the knee’s ligaments may damage the articular cartilage over time, causing knee pain and limiting knee function.

Predisposing factors to Osteoarthritis of hip.

Some conditions may predispose the hip to osteoarthritis,

It tends to affect people as they get older and particularly affects joints that have to take a lot of stresses and strains.

A previous fracture that involved the hip.

Growth abnormalities of the hip (such as a shallow socket) may lead to premature arthritis.

Some childhood hip problems later cause hip arthritis (for example, a type of childhood hip fracture known as a Slipped Epiphysis; also Legg-Perthe’s Disease).

Inactive lifestyle- Obesity (overweight) Your weight is the single most important link between diet and arthritis, as being overweight puts an additional burden on your hips, knees, ankles and feet.

What are the symptoms of osteoarthritis?

The most common symptoms of osteoarthritis include:

• painful joints, that usually worsen with exercise or repetitive use;
• swelling of the affected joint;
• creaking, pain and stiffness that restrict movement and occasionally disrupt sleep;
• weakened muscles surrounding the affected joint, due to disuse; and
• joint deformity—a formation of hard bony enlargements—for example, of the small joints of the fingers. Bony enlargement of the small joint at the end of the fingers is called a Heberden's node. Bony enlargement of the middle joint of the finger is called a Bouchard's node. Osteoarthritis of the joint at the base of the big toes leads to the formation of a bunion.

How can a doctor diagnose arthritis?

Doctors diagnose arthritis with a medical history, physical exam and x-rays of the hip. There is no blood test for osteoarthritis.

What you can do?

• Consult a doctor who will determine the type of arthritis you have. <
• Rest the joint until the pain subsides to prevent further inflammation.
• To ease the pain or stiffness of the joint, apply heat on the joint for about 15 minutes once or twice a day using a hot water bottle, towel or an infrared lamp.
• Take painkillers or anti-inflammatories, as recommended by your doctor.
• If you are overweight, try to reduce weight to lighten the load on weight-bearing joints.
• Participate in regular exercise.

  What your doctor can do for you?

There is no cure for arthritis, so beware of 'miracle cures'. Your doctor may prescribe anti-inflammatory medicine. They may recommend occupational therapy or physiotherapy, which includes exercises and heat treatment. In severe cases, surgery may be suggested, such as a hip or knee replacement. The type of surgery will depend on your age and severity of the disease. In the elderly with severe arthritis, joint replacement can give good results.

Treatment options

Initial treatment for osteoarthritis of the hip or knee is conservative, consisting of rest, avoidance of vigorous weight bearing activities, and the use of non-narcotic analgesic and or anti inflammatory medications. With worsening symptoms a cane or a knee brace may be helpful. For more severe symptoms, an injection of cortisone into the joint is frequently advised and can be quite helpful.

When conservative measures have been exhausted and are no longer helpful, and the arthritis has become disabling, surgery may be recommended.

Treatment of osteoarthritis focuses on decreasing pain and improving joint movement, and may include:

Exercises to keep joints flexible and improve muscle strength

Many different medications are used to control pain, including corticosteroids and NSAIDs. Glucocorticoids injected into joints that are inflamed and not responsive to NSAIDS. For mild pain without inflammation, acetaminophen may be used.

Heat/cold therapy for temporary pain relief

Joint protection to prevent strain or stress on painful joints

Surgery (sometimes) to relieve chronic pain in damaged joints

Weight control to prevent extra stress on weight-bearing joints

Does exercise really help those who have arthritis?

Yes, studies have shown that exercise helps people with arthritis by reducing joint pain and stiffness and increasing flexibility, muscle strength and energy. It also helps with weight reduction and offers an improved sense of well-being.