Arthritis

Arthritis is not a single disease but a broad term covering more than 100 conditions characterised by inflammation of one or more joints, causing pain, swelling, stiffness, and reduced range of motion. The most common forms are osteoarthritis (OA) — a degenerative condition caused by wear and tear of cartilage — and rheumatoid arthritis (RA) — an autoimmune disease in which the immune system attacks joint tissue. Other important types include gout, psoriatic arthritis, and reactive arthritis. Arthritis is a leading cause of chronic pain and disability worldwide, but with proper management most people can maintain an active and fulfilling life.

Symptoms vary by type but commonly include: • Joint pain — ranging from a dull ache to sharp or burning pain • Swelling and warmth around one or more joints • Stiffness — especially in the morning or after periods of inactivity; morning stiffness lasting more than one hour is characteristic of rheumatoid arthritis • Reduced range of motion — difficulty bending, gripping, or walking • Tenderness when pressing on or around the joint • Grating or crunching sensation (crepitus) when moving the joint • Visible joint deformity in advanced cases Gout-specific symptoms: • Sudden, intensely painful attack in one joint — most often the big toe, ankle, or knee • The joint becomes red, hot, swollen, and exquisitely tender • Attacks often begin at night and may be triggered by alcohol, rich food, or dehydration Rheumatoid arthritis may also cause: • Fatigue and low-grade fever • Nodules under the skin near joints • Symmetrical joint involvement (same joints on both sides)

Osteoarthritis (OA): Caused by the gradual breakdown of cartilage — the cushioning tissue at the ends of bones — due to ageing, repetitive use, previous injury, or obesity. Without cartilage, bone rubs on bone. Rheumatoid Arthritis (RA): An autoimmune disease in which the body's immune system mistakenly attacks the synovium (joint lining), causing chronic inflammation that damages cartilage and bone. The exact trigger is unknown; genetic and environmental factors are both involved. Gout: Caused by the accumulation of uric acid crystals in joints. Uric acid is a breakdown product of purines found in red meat, organ meat, beer, and seafood. When uric acid levels in the blood become too high, crystals deposit in joints, causing sudden painful attacks. Reactive Arthritis: Joint inflammation triggered by an infection elsewhere in the body (commonly urinary, gastrointestinal, or sexually transmitted infections).

• Age — osteoarthritis risk increases significantly after 50 • Sex — women are more likely to develop most types of arthritis, especially RA; gout is more common in men • Obesity — excess weight puts enormous strain on weight-bearing joints (knees, hips, spine) • Previous joint injury or surgery • Repetitive occupational stress on joints (e.g., kneeling, squatting, heavy lifting) • Family history of arthritis • Smoking — increases risk and severity of rheumatoid arthritis • Diet high in purines (red meat, alcohol, organ meats) — risk factor for gout • Dehydration — a trigger for acute gout attacks • Certain infections (can trigger reactive or septic arthritis)

• Permanent joint damage and deformity • Progressive loss of mobility and function • Chronic pain affecting sleep, mental health, and quality of life • Inability to work or perform daily activities (a major cause of disability in Nigeria) • In rheumatoid arthritis: inflammation can also affect the heart, lungs, eyes, and blood vessels • In gout: repeated attacks can lead to deposits of urate crystals (tophi) under the skin and in kidneys; chronic kidney disease • Psychological impact — depression and anxiety are significantly more common in people with chronic arthritis • Increased risk of falls and fractures in older adults with joint disease

Osteoarthritis prevention: • Maintain a healthy body weight — each kilogram of excess weight puts 4–6 kg of extra stress on the knees • Exercise regularly — strengthening muscles around joints protects cartilage • Protect joints during sports and physical work (appropriate footwear, knee pads) • Avoid repetitive joint strain where possible Gout prevention: • Drink plenty of water (2–3 litres per day) • Limit red meat, organ meats, shellfish, and alcohol (especially beer) • Maintain a healthy weight • For frequent gout attacks: urate-lowering therapy (allopurinol) taken daily as prescribed Rheumatoid Arthritis: • No proven prevention, but quitting smoking reduces risk significantly • Early treatment dramatically reduces joint damage General joint health: • Stay active — regular low-impact exercise (swimming, walking, cycling) maintains joint function and reduces stiffness • Avoid prolonged sitting or standing in one position