Arthritis Specialist Singapore
MBBS (SINGAPORE) MMED (ORTHO) FRCS ED (ORTH)
Arthritis is a common disorder that affects your joints, causing joint damage resulting in pain, inflammation and loss of mobility. There are many types of arthritis, and each form causes different symptoms. While arthritis usually affects older adults, it can develop in people of any age. Understanding your symptoms and seeking medical treatment as soon as possible is vital, as early diagnosis and management can reduce arthritis complications.
What Is Arthritis?
Arthritis refers to a group of conditions that cause inflammation in the joints, leading to pain, swelling, and stiffness. It can affect people of all ages with severity varies from person to person. The condition can develop in any joint, though it commonly affects weight-bearing joints such as the knees, hips, and spine. Over time, if left untreated, the inflammation can cause further damage to the joint tissues, including cartilage, and lead to joint deformity. As arthritis progresses, it can result in reduced mobility and function. This may make it difficult for individuals to perform basic tasks like walking, standing, or even holding objects. While the exact cause of arthritis can vary depending on the type, it can often be linked to factors such as age, genetics, previous injuries, or underlying health conditions. Obtaining early diagnosis arthritis treatment in Singapore are essential to managing symptoms and preventing further damage to the joints.
Osteoarthritis, a specific type of arthritis, is the most common form. It primarily affects older individuals and occurs when the cartilage that cushions the joints begins to wear away. As the cartilage deteriorates, bones may begin to rub against each other, causing pain and swelling. Osteoarthritis commonly affects weight-bearing joints such as the knees, hips, and spine, but it can also affect the hands, shoulders and elbows. The exact cause of osteoarthritis is unclear, but factors such as age, genetics, joint injuries, and obesity can increase the risk. While it is a progressive condition, with early intervention, symptoms can be managed to improve quality of life. Treatment options include medications, physical therapy, and in some cases, surgery.
Types of arthritis
Osteoarthritis (OA): A degenerative joint disease caused by the breakdown of cartilage. It can lead to pain, stiffness, and swelling, typically in weight-bearing joints like the knees and hips.
Rheumatoid Arthritis (RA): An autoimmune disorder where the body’s immune system attacks healthy joints. It can cause inflammation, pain, and potential joint damage, often affecting smaller joints like the hands and feet.
Psoriatic Arthritis (PsA): An inflammatory type of arthritis associated with psoriasis, characterised by joint pain, swelling, and skin rashes. The fingers and spine are commonly affected by this condition.
Ankylosing Spondylitis (AS): A type of arthritis that primarily affects the spine, causing pain and stiffness. It may lead to the fusion of spinal bones over time.
Juvenile Arthritis (JA): A type of arthritis that affects children under the age of 16, causing joint pain, swelling, and stiffness, often with no clear cause.
Infectious Arthritis: Caused by an infection in the joint, this arthritis may lead to pain, swelling, and redness, often requiring antibiotics for treatment.
Reactive Arthritis: Triggered by an infection elsewhere in the body. It often causes pain and swelling in the joints, particularly in the knees, ankles, and feet.
What Causes Arthritis?
Common causes of arthritis include:
Genetic Predisposition
Some forms of arthritis, such as osteoarthritis and rheumatoid arthritis, have a hereditary component. If your family has a history of arthritis, you may be at an increased risk. Certain genetic markers can make an individual more susceptible to autoimmune diseases like rheumatoid arthritis. Some may predispose someone to cartilage breakdown, contributing to osteoarthritis.
Osteoarthritis (OA): Individuals with a family history of OA are more likely to develop the condition. The genetic factors involved may influence how cartilage in the joints breaks down over time.
Rheumatoid Arthritis (RA): Specific genes, such as HLA-DR4, increase the risk of developing RA. It occurs when the immune system mistakenly attacks the synovium (lining of the joints).
Age and Wear and Tear (Osteoarthritis)
As people age, the wear and tear on joints can lead to osteoarthritis (OA). This type of arthritis occurs when the cartilage gradually deteriorates over time, triggering pain and stiffness.
Joint Degeneration: Over time, joints naturally experience stress and strain from repetitive use. This leads to the breakdown of cartilage, especially in weight-bearing joints such as the knees, hips, and spine.
Ageing Factors: Age-related changes such as the loss of elasticity in connective tissues and reduced cellular repair processes can make cartilage more vulnerable to damage. As people grow older, the risk of osteoarthritis increases.
Rheumatoid Arthritis (RA) – Autoimmune Disease
Rheumatoid arthritis is an autoimmune disorder in which the body’s immune system mistakenly attacks the synovium (the lining of the joints). The condition may result in inflammation and damage. Inflammation can also cause joint deformities and loss of function.
Autoimmune Response: RA occurs when the body’s immune system becomes confused and targets the joints as foreign invaders. This immune response causes chronic inflammation, pain, and swelling in the joints, especially in smaller joints like the hands and feet.
Inflammation and Joint Damage: Persistent inflammation can lead to permanent joint damage, affecting mobility and quality of life
Previous Joint Trauma or Injury
Injuries to the joints, such as fractures, dislocations, or torn ligaments, increase the risk of developing arthritis later in life. These injuries can cause structural changes in the joint, increasing the likelihood of cartilage breakdown and the development of conditions like osteoarthritis.
Post-Traumatic Osteoarthritis (PTOA): Following joint injuries, individuals may experience arthritis years after the injury heals. The trauma disrupts the normal function of the joint, contributing to cartilage wear and tear, which can lead to osteoarthritis.
Joint Instability: Damage to the ligaments or tendons around a joint can lead to instability, causing abnormal stress on the joint and triggering the cartilage breakdown.
Risk Factors for Arthritis
1. Age
The risk of arthritis increases with age. Joint cartilage wears down over time, leading to osteoarthritis in older adults.
2. Genetics
A family history of arthritis, particularly osteoarthritis or rheumatoid arthritis, raises the likelihood of developing the condition due to inherited genes.
3. Gender
Women are more likely to develop rheumatoid arthritis, especially after menopause, due to hormonal changes. However, osteoarthritis is more common in men before the age of 45. The risk equalises after that.
4. Obesity
Being overweight puts extra stress on weight-bearing joints like knees and hips. This may increase the risk of osteoarthritis. Moreover, obesity is likely to promote inflammation and worsen conditions like rheumatoid arthritis.
5. Joint Injuries
Previous injuries, such as fractures or ligament damage, increase the risk of developing arthritis in the affected joint later in life.
6. Occupation
Jobs that involve repetitive joint movements or heavy lifting can increase the wear and tear on joints, raising the risk of osteoarthritis.
7. Physical Activity Level
Both lack of exercise and excessive strain on the joints can lead to arthritis. Moderate, regular physical activity helps maintain joint health, while high-impact sports may increase the risk of injury.
What Are the Symptoms of Arthritis?
Common symptoms of arthritis include:
How Is Arthritis Diagnosed?
1. Physical Examination
During a physical examination, your doctor will assess the affected joints for signs of inflammation, such as swelling, redness, and warmth. They will also evaluate the range of motion of the joints and check for any pain or tenderness when the joints are moved or touched. The physician may test the strength of muscles around the joint. The results will help the doctor understand the extent of joint damage, stiffness, and functional limitations.
2. X-rays
X-rays are the most commonly used imaging test for arthritis and provide detailed images of bones and joints. They can help detect bone damage or changes due to arthritis. In cases of osteoarthritis, an X-ray may reveal cartilage loss. Bone spurs (osteophytes), which form as the body tries to repair damaged joints, may also be visible.
3. MRI (Magnetic Resonance Imaging)
MRI scans are non-invasive and use magnetic fields to generate detailed images of the body’s internal structures. An MRI is particularly useful for identifying soft tissue damage around the joints. For arthritis, MRI can reveal changes in the cartilage, bone marrow, and joint lining, which may not be visible on X-rays.
4. Blood Tests
Blood tests can help determine if there is an underlying infection or inflammation contributing to arthritis symptoms. They measure the levels of specific markers that indicate inflammation or the presence of autoimmune responses.
5. Urine and Joint Fluid Tests
Joint fluid analysis involves the extraction of fluid from the affected joint to check for signs of infection or gout. It can identify the presence of crystals, which indicate gout. Additionally, examining joint fluid can help rule out infections, such as septic arthritis, or confirm other types of inflammatory arthritis.
How Is Arthritis Treated?
1. Physical Therapy and Stretching Exercises
A structured physical therapy regimen can help restore joint movement and strength through specific exercises.
How it helps: Targeted exercises help maintain or improve range of motion. They also reduce stiffness and strengthen muscles to support the joint.
2. Occupational Therapy
Occupational therapy helps patients adapt to their daily activities while reducing strain on affected joints. Therapists may recommend modifications to the home or workplace to make activities easier.
How it helps: This therapy aims to improve function in daily life and enhance the quality of life. It covers techniques to perform tasks in a way that avoids further joint damage.
3. Weight Management
Maintaining a healthy weight reduces the stress and pressure on weight-bearing joints.
1. Osteotomy
Osteotomy involves cutting and reshaping the bones around the affected joint to realign the joint and relieve pressure on damaged areas.
How it helps: This procedure is typically used for knee arthritis and can help delay the need for full joint replacement by redistributing weight and relieving pressure on the damaged cartilage.
2. Regenerative Medicine (Stem Cell Therapy)
Stem cell therapy involves using stem cells to repair or regenerate damaged tissue in the affected joint. The efficacy of stem cell therapy in the treatment of arthritis is currently still being evaluated and is thus not yet available for use in Singapore.
How it helps: Stem cells have the potential to regenerate cartilage and promote healing of damaged tissues.
Recovery and Prevention Strategy for Arthritis
Managing arthritis involves a combination of recovery techniques and preventive measures. Recovery strategies focus on physical therapy, medication, and lifestyle changes to relieve symptoms. Prevention emphasises physical fitness to protect joints from injury. Together, these approaches can enhance quality of life and delay the onset or worsening of arthritis.
1. Rest and Joint Protection
Rest affected joints to reduce strain and allow for recovery.
Use assistive devices like braces or splints to protect joints from further damage.
2. Regular Exercise
Engage in low-impact exercises such as swimming, walking, or cycling to maintain joint mobility and strength.
Stretching and strength-building exercises can help improve flexibility and reduce stiffness.
3. Joint Care and Mobility Aids
Consider joint supplements, like glucosamine and chondroitin, to support joint health.
Use mobility aids (e.g., walking aids, cushioned insoles) to reduce joint strain during daily activities.
4. Prevent Injury
Avoid high-impact activities that can stress joints, particularly in the early stages of arthritis.
Practice proper posture and ergonomics to reduce joint strain during physical activities.
5. Regular Monitoring and Medical Care
Keep regular follow-ups with your osteoarthritis doctors to monitor arthritis progression and adjust treatment plans as needed.
Early intervention can prevent long-term joint damage and improve overall outcomes.
6. Surgical Intervention (if necessary)
In advanced stages, surgery like joint replacement or arthroscopy may be necessary to restore joint function and alleviate severe pain.
Ensure rehabilitation after surgery to regain strength and mobility.
Frequently Asked Questions
Is arthritis serious? When should I visit a doctor?
Can arthritis be prevented?
When should I see an osteoarthritis doctor?
What can an osteoarthritis doctor do to help with joint pain?
Can an osteoarthritis doctor help prevent arthritis from worsening?
What should I ask my osteoarthritis doctor during my first visit?
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