As the days become shorter and the temperature lowers, many people may be starting to feel the aches and pain associated with their arthritis worsen.

Arthritis is a common term that most of us will quickly associate with joint pain and stiffness.  How much do we really know about it?

There are several different types of arthritis.  Osteoarthritis and rheumatoid arthritis are two of the most common forms. Although the symptoms of these two types of arthritis can be similar, it’s very important to distinguish between them in order to determine the proper treatment.

Signs and symptoms

Osteoarthritis (OA) occurs when the smooth cartilage joint surface wears out.        OA usually begins asymmetrically or in an isolated joint.  A common OA symptom is morning stiffness in joints within minutes of waking up.  Other signs and symptoms include a gradual onset, pain that is aggravated by weight bearing and tender and restricted joints.

Rheumatoid arthritis (RA) is an autoimmune disease, which means that the immune system malfunctions and attacks the body instead of intruders. In this case, it attacks the synovial membrane that encases and protects the joints. RA often targets several joints at one time. The symptoms of RA include sudden onset, morning stiffness >60mins, painful, swollen and stiff joints, fever, anaemia, fatigue and loss of appetite.  RA usually presents with symmetrical joint swelling that has been persistent for a long time, although that isn’t always the case, especially when the condition is in early stages. Deformities of the hand can occur in severe cases of RA, causing fingers to point in different directions. RA not only affects joints but can also cause lung inflammation that leads to shortness of breath.

Joints affected                                                                                                                                                                         

The joints most commonly affected by osteoarthritis include the:

• knees;
• hips;
• neck;
• lower back; and
• hands.

Rheumatoid arthritis is usually symmetrical – affecting joints on both sides of the body at the same time. The joints most commonly affected are the:

• wrists;
• hands;
• fingers;
• ankles;
• toes;
• shoulders; and
• knees.

The elbows, hips and the spinal joints in the neck are less commonly affected.

Treatment

OA is typically not treated with long term medication.  For short term pain relief paracetamol is often advised, but an opioid based medicine may be prescribed for those not responding to paracetamol. Muscle relaxants may also be indicated in the treatment of OA. The main goal in treatment of OA is to maintain joint function, reduce muscle tension and minimise pain via education, rehabilitation and supportive measures. This may involve physical therapy such as osteopathy which aims to improve and maintain joint flexibility, optimise joint function, address any biomechanical strain patterns and implement appropriate exercise and self-management strategies.  It is important to consider exercise as part of the regimen, as studies have shown that a simple walk around the neighbourhood can help relieve pain and reduce joint stiffness. Weight loss can also play a critical role in reducing OA symptoms because it can ease pressure on joints, which reduces frictional rubbing of bones.

RA is typically treated with disease modifying anti rheumatic drugs (DMARDs) and also corticosteroids. The corticosteroids aim to reduce inflammation while the DMARDs aim to suppress the immune response apparent in RA patients. Osteopathic treatment can aid those diagnosed with RA by decreasing muscular tightness surrounding affected joints, utilising techniques that improve joint range of motion as well as assisting with appropriate at home self-management strategies.