Uncovertebral joint hypertrophy: Symptoms and causes
Early Signs And Symptoms Of Arthritis
When people hear the term "arthritis," they typically think of osteoarthritis (OA)—likely because it's the most common form of arthritis, affecting 80% of U.S. Adults over the age of 65 . According to Dr. Graham, OA is considered a degenerative disorder caused by trauma or age-related wear and tear on joints over time. "OA is most likely to affect weight-bearing joints, such as the knee, hip, lower spine or big toe, but it can also cause pain and stiffness in the thumb or finger joints."
Osteoarthritis can affect anyone at any age, but it most commonly appears in older adults. This particular type of arthritis affects the cartilaginous portion of the bone (the smooth surface at the end of a bone where it articulates with another bone and forms a joint). The degree of degeneration that occurs at a joint depends on many factors, including lifestyle, weight, medical history and activity level. OA affects people's bodies asymmetrically and usually at specific joints based on a person's lifestyle, profession, sports activities, hobbies and injuries.
Most notably marked by joint pain, inflammation and swelling, OA can have varying presentations and may even be asymptomatic for some people. People often discover they have arthritis incidentally after their health care provider requests medical imaging for another issue. Unfortunately, the effects of this disease can lead to moderate to severe disability, significantly affecting a person's life and often incurring high medical costs.
Early Signs And Symptoms of OsteoarthritisEarly signs and symptoms of OA can vary, but according to Dr. Graham, the earliest signs usually include joint pain or ache, as well as joint tenderness, swelling or stiffness that feels worse in the morning. Untreated pain or stiffness can lead to a limitation in mobility and overall function. While it's estimated that 80% of U.S. Adults ages 65 and older have radiographic evidence of OA somewhere in their bodies, only 60% of those with OA present with symptoms, according to Creighton University researchers Rouhin Sen and John Hurley .
Everything You Need To Know About Psoriatic Arthritis
Psoriatic arthritis is a painful joint condition linked with psoriasis. If your psoriasis evolves into psoriatic arthritis various medications and lifestyle changes can help manage the condition.
Psoriatic arthritis (PsA) is a condition that combines the swollen, sore joints of arthritis with psoriasis. Psoriasis typically causes itchy, scaly, discolored patches to appear on the skin and scalp.
About 8 million Americans have psoriasis, and up to 30 percent of these people develop PsA. PsA can be mild or severe and involve one or many joints.
If you or a loved one has received a diagnosis of PsA, you may have questions about what life is like with this condition.
Symptoms of PsA are different for each person. They can range from mild to severe. Sometimes your condition will go into remission and you'll feel better for a while. Other times your symptoms may get worse. Your symptoms also depend on the type of PsA you have.
General symptoms of PsA include:
Spondylitis PsA, in particular, can also cause the following symptoms:
Symmetric PsA affects five or more joints on both sides of your body. Asymmetric PsA affects less than five joints, but they can be on opposite sides.
Psoriatic arthritis mutilans is a rare form of arthritis that deforms your joints. It can shorten affected fingers and toes. Distal PsA causes pain and swelling in the end joints of your fingers and toes.
Photos of some psoriatic arthritis symptomsIn PsA, your immune system attacks your joints and skin. Doctors don't know for sure what causes these attacks. They think it stems from a combination of genes and environmental factors.
PsA runs in families. About 40 percent of people with the condition have one or more relatives with PsA. Something in the environment usually triggers the disease for those with a tendency to develop PsA. That could be a virus, extreme stress, or an injury.
The goal of PsA treatment is to improve symptoms, like skin rash and joint inflammation.
Guidelines released in 2018 recommend the "treat to target" approach, which is based on a person's individual preferences. A specific treatment goal and how to measure progress are determined, then a doctor works with you to select treatments.
You have many different treatment options. A typical treatment plan will include one or more of the following:
Nonsteroidal anti-inflammatory drugs (NSAIDs)These medications help control joint pain and swelling. Over-the-counter (OTC) options include ibuprofen (Advil) and naproxen (Aleve). If OTC options aren't effective, your doctor may prescribe NSAIDs in higher doses.
If used incorrectly, NSAIDs can cause:
These medications decrease inflammation to prevent joint damage and slow the progression of PsA. They may be administered by various routes, including oral, injection, or infusion.
The most commonly prescribed DMARDs include:
Apremilast (Otezla) is a newer DMARD that's taken orally. It works by blocking phosphodiesterase 4, an enzyme involved in inflammation.
DMARD side effects include:
There are currently five types of biologic drugs for treating psoriatic disease. They're categorized according to what they target and inhibit (block or lessen) in the body:
According to the treatment guidelines released in November 2018, these medications are recommended as first-line treatments.
You receive biologics through an injection under your skin or as an infusion. Because these medications dampen your immune response, they can increase your risk for serious infections. Other side effects include nausea and diarrhea.
SteroidsThese medications can bring down inflammation. For PsA, they're usually injected into affected joints. Side effects include pain and a slight risk of joint infection.
ImmunosuppressantsMedications like azathioprine (Imuran) and cyclosporine (Gengraf) calm the overactive immune response in PsA, particularly for psorasis symptoms. They're not used as often now that TNF-alpha inhibitors are available. Because they weaken the immune response, immunosuppressants can increase your risk for infections.
Topical treatmentsCreams, gels, lotions, and ointments can relieve the itchy PsA rash. These treatments are available over the counter and with a prescription.
Options include:
Light therapy uses medication, followed by exposure to bright light, to treat psoriasis skin rashes.
A few other medications also treat PsA symptoms. These include secukinumab (Cosentyx) and ustekinumab (Stelara). These drugs are injected under your skin. Stelara comes with a warning that it can increase your risk for infections and cancer.
There are things you can do at home to help improve your symptoms:
Add exercise to your daily routine, if you canKeeping your joints moving can ease stiffness. Being active for at least 30 minutes per day will also help you lose excess weight and give you more energy. Ask your doctor what type of exercise is safest for your joints.
Biking, walking, swimming, and other water exercises are gentler on the joints than high-impact exercises like running or playing tennis.
Limit alcohol and quit smokingSmoking is bad for your joints as well as the rest of your body. Ask your doctor about counseling, medication, or nicotine replacement to help you quit.
Also limit your alcohol intake. It can interact with some PsA medications.
Relieve stressTension and stress can make arthritis flares even worse. Meditate, practice yoga, or try other stress-relief techniques to calm your mind and body.
Use hot and cold packsWarm compresses and hot packs can ease muscle soreness. Cold packs can also reduce pain in your joints.
Move to protect your jointsOpen doors with your body instead of your fingers. Lift heavy objects with both hands. Use jar openers to open lids.
Consider natural supplements and spicesOmega-3 fatty acids have anti-inflammatory properties. These healthy fats, found in many supplements, reduce inflammation and stiffness in joints.
While research suggests there are health benefits, the Food and Drug Administration (FDA) doesn't monitor the purity or quality of supplements. It's important to talk with your doctor before you begin taking supplements.
Turmeric, a potent spice, also serves up a dose of anti-inflammatory properties and may help reduce inflammation and PsA flare-ups. Turmeric can be added to any dish. Some people even stir it into tea or lattes, like golden milk.
While no single food or diet will cure PsA, a nutrient-dense and balanced diet can help reduce inflammation and ease symptoms. Helpful changes to your diet can pay off tremendously for your joints and body in the long run.
In short, eat more fresh fruits and vegetables. They help lower inflammation and manage your weight. Excess weight puts more pressure on joints that are already sore. Limit sugar and fat, which are inflammatory. Put an emphasis on sources of healthy fats, like fish, seeds, and nuts.
There are five types of PsA.
Symmetric PsAThis type affects the same joints on both sides of your body, so both your left and right knees, for example. Symptoms can be like those of rheumatoid arthritis (RA).
Symmetric PsA tends to be milder and cause less joint deformity than RA. But symmetric PsA can be disabling. About half of people with PsA have this type.
Asymmetric PsAThis affects a joint or joints on one side of your body. Your joints may feel sore and turn red. Asymmetric PsA is generally mild. It affects about 35 percent of people with PsA.
Distal interphalangeal predominant PsAThis type involves the joints closest to your nails. These are known as the distal joints.
Spondylitis PsAThis type of PsA involves your spine. Your entire spine from your neck to your lower back may be affected. This can make movement very painful. Your hands, feet, legs, arms, and hips may also be affected.
Psoriatic arthritis mutilansThis is a severe, deforming type of PsA. About 5 percent of people with PsA have this type. Psoriatic arthritis mutilans usually affects your hands and feet. It can also cause pain in your neck and lower back.
PsA doesn't follow the same path for each person diagnosed with this condition. Some people may only ever have mild symptoms and limited impact on their joints. For others, joint deformity and bone enlargement may ultimately occur.
It's unclear why some people experience a faster progression of the disease and others don't. But early diagnosis and treatment can help ease pain and slow the damage to joints. It's important you talk with your doctor as soon as you begin experiencing signs or symptoms that hint at PsA.
Early stage PsAIn the initial phases of this arthritis, you may experience mild symptoms like joint swelling and reduced range of motion. These symptoms may happen at the same time you develop psoriasis skin lesions, or they may occur years later.
NSAIDs are the typical treatment. These medications ease pain and symptoms, but they don't slow PsA.
Moderate PsADepending on the type of PsA you have, the moderate or middle stage will likely see worsening symptoms that require more progressive treatments, like DMARDs and biologics. These medications can help ease symptoms. They may help slow the progression of damage as well.
Late-stage PsAAt this point, bone tissue is heavily affected. Joint deformity and bone enlargement are likely. Treatments aim to ease symptoms and prevent worsening complications.
To diagnose PsA, your doctor has to rule out other causes of arthritis, like RA and gout, with imaging and blood tests.
These imaging tests look for damage to joints and other tissues:
Blood tests for these substances help assess any inflammation present in your body:
No single blood or imaging test can determine if you have PsA. Your doctor uses a combination of tests to rule out other possible causes.
You're more likely to get PsA if you:
PsA puts you at risk for complications that include:
PsA flare-ups make the condition worse for a period of time. Certain things can set off PsA flares. Everyone's triggers are different.
To learn your triggers, keep a symptom diary. Each day, write down your symptoms and what you were doing when they started. Also note whether you changed anything in your routine, like if you started taking a new medication.
Common PsA triggers include:
Although you can't avoid all of these triggers, you can try to manage stress, stop smoking, and cut down your alcohol intake.
Ask your doctor if you take any medications known to set off PsA symptoms. If so, you might want to switch to a new drug.
PsA and RA are two of several types of arthritis. While they may share a common name and many similar symptoms, different underlying factors cause them.
PsA primarily occurs in people with skin psoriasis, although it can occur in people without skin psoriasis. Psoriasis is a skin condition that causes lesions and scaly spots on the skin's surface.
RA is an autoimmune disorder. It occurs when the body mistakenly attacks the tissues lining the joints. This causes swelling and eventually pain and joint destruction.
PsA occurs almost equally in men and women, but women are more likely to develop RA. PsA often first shows up between the ages of 30 and 50 for most individuals. RA usually first develops a bit later in middle age.
In their early stages, both PsA and RA share many similar symptoms. These include pain, swelling, and joint stiffness. As the conditions progress, it may become clearer which condition you have.
Fortunately, a doctor won't have to wait for the arthritis to progress in order to make a diagnosis. Blood and imaging tests can help your doctor decide which condition is affecting your joints.
Everyone's outlook is different. Some people have very mild symptoms that only cause problems from time to time. Others have more severe and debilitating symptoms.
The more severe your symptoms are, the more PsA will affect your ability to get around. People with a lot of joint damage may find it hard to walk, climb stairs, and do other daily activities.
Your outlook will be affected if:
To improve your outlook, follow the treatment regimen your doctor prescribes. You might have to try more than one drug to find what works best for you.
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5 Best Vitamins And Supplements For Joint Pain
Researchers have studied the effects of the following supplements in people living with osteoarthritis. However, it's important to note that while some supplements may help ease symptoms, they shouldn't be seen as a substitute for physician-prescribed treatment. It's important to always speak with your doctor before adding a new supplement to your routine.
TurmericTurmeric is a relative of ginger and is often used in traditional Chinese and Indian medicine. When used as a spice, it gives foods like curries their golden hue. Also known as Curcuma longa, turmeric contains curcumin—an anti-inflammatory compound that may help reduce inflammation caused by arthritis, says Dr. Scott, citing a 2022 Frontiers In Immunology systematic review and meta-analysis.
The review examines the administration of curcumin and Curcuma longa extract in over 2,000 participants with different types of arthritis, including osteoarthritis. Curcumin and Curcuma longa extract both showed potential in improving arthritis symptoms and reducing inflammation. Specific to osteoarthritis, curcumin and Curcuma longa extracts had comparable effects to nonsteroidal anti-inflammatory drugs (NSAIDs) in reducing joint pain and stiffness and improving function. Additionally, when combined with NSAIDs, curcumin's effects were more notable than with NSAIDs alone. However, researchers note more studies are warranted to draw conclusions .
Fish OilFish oil contains omega-3 fatty acids, essential nutrients that combat inflammation. "There have been limited studies that have consistently shown fish oil benefits on joint and cartilage health," says Dr. Scott. The Arthritis Foundation echoes this, but also notes that research yields mixed results.
On the positive end, a 2016 randomized control trial illustrates that both low and high-dose fish oil may improve symptomatic knee osteoarthritis. Interestingly, the group administered low-dose fish oil in the study had greater improvement in function and pain scores compared to the high-dose fish oil group at two years .
Another 2020 randomized controlled trial shows that fish oil supplementation significantly reduced osteoarthritic pain in participants living with excess weight and obesity compared with no fish oil supplementation .
While these studies are promising, optimal treatment protocols around fish oil supplementation have yet to be determined, so more research needs to be done.
Chondroitin and GlucosamineChondroitin and glucosamine are structural components of cartilage, the cushioning tissue around your joints. Chondroitin supplements are typically sourced from animal cartilage, while glucosamine supplements are made from shellfish or vegetable origins. It's been suggested that chondroitin and glucosamine can potentially alleviate joint pain and impede the progression of joint deterioration and cartilage loss, says Dr. Johansen. Chondroitin and glucosamine can be taken individually or in combination.
A 2018 meta-analysis found that chondroitin was superior to placebo in alleviating pain and enhancing physical function in participants with osteoarthritis. Additionally, glucosamine exhibited a significant effect on reducing stiffness compared to placebo .
However, another 2018 meta-analysis examining various supplements for osteoarthritis concluded that chondroitin and glucosamine, as individual supplements, were either ineffective or showed small benefits .
Recent research on chondroitin and glucosamine for osteoarthritis focuses more on the combination of these two supplements rather than on them individually. A 2022 systematic review and meta-analysis indicates that combining chondroitin and glucosamine is more effective than using them individually for treating knee osteoarthritis .
CollagenCollagen is a protein found in bones, cartilage, muscles, skin and tendons. It helps keep these tissues strong to withstand stretching. Most collagen products on the market are derived from animal sources like skins, tendons, bone and hides. Different types of collagen products have been studied in joint health, with type II collagen and hydrolyzed collagen being the most studied in osteoarthritis.
Collagen can help reduce activity-related bone pain and strengthen tendons and ligaments, notes Dr. Johansen, who cites, a 2019 meta-analysis in International Orthopaedics that shows collagen is effective in improving osteoarthritis symptoms .
However, a 2023 Nutrients review of collagen supplementation for joint health explains that while most collagen ingredients that have been studied seem to be effective, there is a lot of variation in how they've been studied, how much to take and the treatment period .
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