Arthritis is a chronic disease characterized primarily by inflammation of the joints, affecting hundreds of millions of people worldwide. It not only leads to pain and mobility issues but can also trigger systemic health problems. There are dozens of types of arthritis, with the most common being osteoarthritis and rheumatoid arthritis. Understanding its pathological mechanisms, symptom manifestations, and treatment methods is key to delaying disease progression and improving quality of life.
Modern medicine has shifted the treatment of arthritis from merely alleviating symptoms to comprehensive management, including pharmacotherapy, physical rehabilitation, and surgical intervention. Early diagnosis and lifestyle adjustments can effectively delay joint destruction, yet many people still underestimate its severity. This article will systematically analyze the causes, clinical manifestations, diagnostic processes, and the latest treatment strategies for arthritis, helping readers establish a correct understanding of the disease.
The natural wear and tear of joint cartilage is the core cause of osteoarthritis. As age increases, the concentration of proteoglycans and collagen fibers in the cartilage gradually decreases, leading to a loss of the protective layer of the joint surface. This physiological degeneration typically occurs in the knee joints, hip joints, and spine, resulting in bone spurs and narrowing of the joint space. Repeated mechanical stress (such as being overweight) can accelerate this process, creating a vicious cycle.
The onset of autoimmune arthritis is associated with specific gene polymorphisms, such as the HLA-DR4 gene, which has a correlation of up to 60% with rheumatoid arthritis. When the immune system is abnormally activated, T cells and B cells mistakenly attack the synovial membrane, causing synovitis and angiogenesis, ultimately destroying the joint structure. This chronic inflammatory process releases proteases such as matrix metalloproteinases (MMPs), accelerating tissue breakdown.
Patients often complain of morning stiffness, with stiffness in osteoarthritis typically lasting less than 30 minutes, while morning stiffness in rheumatoid arthritis may extend to several hours. Joint swelling is often related to synovial proliferation and effusion, with increased skin temperature and tenderness detectable upon palpation. In osteoarthritis, crepitus (joint grating sound) during joint movement is a typical auscultation finding.
Juvenile rheumatoid arthritis may be accompanied by fever and lymphadenopathy, while gouty arthritis often presents as acute monoarticular attacks, with localized skin showing purplish congestion. Spondyloarthritis (such as ankylosing spondylitis) primarily affects axial joints (spine and sacroiliac joints) and is accompanied by morning stiffness.
The diagnosis begins with a detailed medical history collection, including the duration of symptoms, pain patterns, and family history. Physical examination assesses joint range of motion, tenderness points, and swelling severity, such as the Geberth's test used to evaluate the wrist joint. Physicians will integrate clinical features and auxiliary examinations based on the standards of the American College of Rheumatology for comprehensive judgment.
X-rays can show bone spur formation and joint space narrowing, while MRI can detect cartilage damage and bone marrow edema earlier. Positive rheumatoid factor (RF) and anti-citrullinated protein antibody (anti-CCP) are indicative for the diagnosis of rheumatoid arthritis. Inflammatory indices such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) elevation suggest the presence of active inflammation.
Non-steroidal anti-inflammatory drugs (NSAIDs) can relieve pain and inflammation, but long-term use requires attention to gastrointestinal side effects. Disease-modifying antirheumatic drugs (DMARDs) such as methotrexate can suppress immune responses. Biologics (such as TNF-α inhibitors) target specific inflammatory pathways and are suitable for patients who do not respond to traditional treatments.
Physical therapy, including aquatic exercises and strength training, can maintain joint mobility and reduce stress. Patients with patellofemoral arthritis may use assistive devices to reduce burden, and custom braces can stabilize unstable joints. Obese patients can significantly reduce knee joint load by losing just 5% of their body weight, and such lifestyle adjustments are considered foundational treatment.
Total joint replacement surgery is the standard treatment for end-stage osteoarthritis, restoring joint function and improving quality of life. Arthroscopic surgery is used to clean up debris or repair cartilage damage, and minimally invasive techniques have significantly reduced recovery time. Autologous stem cell transplantation shows potential in experimental treatments for severe rheumatoid arthritis.
Regular low-impact exercises (such as swimming and cycling) can strengthen the muscles around the joints, with a recommendation of 150 minutes of moderate-intensity exercise per week. Maintaining a standard weight can reduce biomechanical stress on lower limb joints; for every kilogram lost, the knee joint load decreases by 4 kilograms. Avoid prolonged repetitive motions, such as lifting heavy objects or repeated squatting.
Omega-3 fatty acids (such as fish oil) have anti-inflammatory effects, with a daily intake of 1-2 grams alleviating mild symptoms. Vitamin D deficiency is positively correlated with the risk of developing arthritis, and it is recommended to maintain a serum 25(OH)D concentration above 30 ng/mL. Supplementation with glucosamine and chondroitin sulfate has shown potential in some studies to relieve pain from osteoarthritis.
If joint pain persists for more than 2 weeks without relief, or if morning stiffness lasts more than 30 minutes daily, medical attention should be sought immediately. Joint swelling accompanied by increased skin temperature and redness may indicate an acute inflammatory response. If symptoms affect daily activities (such as difficulty climbing stairs), professional evaluation can prevent permanent joint function damage.
Patients with rheumatoid arthritis who experience unexplained weight loss or fatigue may indicate a worsening disease activity phase. In juvenile patients, persistent joint swelling for more than 3 weeks should rule out juvenile idiopathic arthritis. Elderly individuals experiencing unexplained decreases in mobility should rule out vertebral joint arthritis or spinal stenosis syndrome.
Low-impact aerobic exercises such as swimming, water aerobics, or cycling can strengthen muscles and reduce joint burden. Yoga and Tai Chi can also improve flexibility and balance; high-impact activities such as jumping should be avoided, and exercise intensity should be adjusted immediately if pain occurs.
How can diet help alleviate inflammatory responses in arthritis?Deep-sea fish rich in Omega-3 fatty acids (such as salmon), nuts, and flaxseeds can reduce inflammation. It is also recommended to increase antioxidant foods such as blueberries and spinach while reducing intake of refined sugars and saturated fats to lower inflammatory factors in the body.
Does long-term use of painkillers worsen arthritis?Non-steroidal anti-inflammatory drugs (NSAIDs) may cause gastrointestinal irritation or kidney function issues but do not directly lead to worsening arthritis. However, over-reliance on medication may misjudge the severity of the condition; it is essential to follow physician recommendations and combine physical therapy or non-drug treatments.
Does weather change really affect arthritis pain?Some patients subjectively feel that cold and damp weather exacerbates pain, but scientific studies have not clearly confirmed a direct correlation between meteorological factors and arthritis. It is recommended to manage symptoms through regular treatment and warming measures rather than attributing them solely to weather changes.
Can young people get rheumatoid arthritis?Rheumatoid arthritis is more common in individuals aged 40-60, but it can occur at any age. If symmetrical joint swelling and pain (such as simultaneous involvement of small joints in both hands) occurs, even if young, medical attention should be sought promptly to avoid delaying diagnosis and treatment during the critical period.
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