Various Types of Arthritis

Arthritis is a disease that causes pain and loss of movement of the joints. Joint pain is referred to as arthralgia. Arthritis is the leading cause of disability in people over the age of 55. The causes of arthritis depend on the form of arthritis. Causes include injury (leading to osteoarthritis), abnormal metabolism (such as gout and pseudogout), inheritance, infections, and for unclear reasons (such as rheumatoid arthritis and systemic lupus erythematosus). There are many forms of arthritis .There are about 200 different kinds of arthritis. The most common type is osteoarthritis (or degenerative arthritis), where the cartilage that protects the bones gets worn away. This makes joints stiff, painful and creaky. About 5 million people in the UK have osteoarthritis. OA is a chronic degenerative arthropathy that frequently leads to chronic pain and disability. With the aging of our population, this condition is becoming increasing prevalent and its treatment increasingly financially burdensome. Using radiographic criteria, the distal and proximal interphalangeal joints of the hand have been identified as the joints most commonly affected by OA, but they are the least likely to be symptomatic. Age is the most consistently identified risk factor for OA, regardless of the joint being studied. Prevalence rates for both radiographic OA and, to a lesser extent, symptomatic OA rise steeply after age 50 in men and age 40 in women. Occupation-related repetitive injury and physical trauma contribute to the development of secondary (non-idiopathic) OA, sometimes occurring in joints that are not affected by primary (idiopathic) OA, such as the metacarpophalangeal joints, wrists and ankles.

Rheumatoid arthritis (RA) is traditionally considered a chronic, inflammatory autoimmune disorder. Rheumatoid arthritis occurs when the body's defence mechanisms go into action when there's no threat and start attacking the joints and sometimes other parts of the body. RA affects 2.1 million Americans, or about 1% of the adult population in the United States. This disease is 2 to 3 times more common in women than in men, and generally affects people between the ages of 20 and 50. However, young children can develop a form of RA called juvenile rheumatoid arthritis. Two of the 100 types of arthritis are rheumatoid arthritis and lupus. There are specific symptoms, distinguishing characteristics, as well as overlapping symptoms associated with rheumatoid arthritis and lupus. Rheumatoid arthritis is an additive polyarthritis, with the sequential addition of involved joints, in contrast to the migratory or evanescent arthritis of systemic lupus erythematosus or the episodic arthritis of gout. Occasionally, patients experience an explosive polyarticular onset occurring over 24 to 48 hours. Morning stiffness, persisting more than one hour but often lasting several hours, may be a feature of any inflammatory arthritis but is especially characteristic of rheumatoid arthritis. Its duration is a useful gauge of the inflammatory activity of the disease.

Psoriatic arthritis is related to the skin condition psoriasis. It occurs more commonly in patients with tissue type HLA-B27. There are five clinical patterns of psoriatic arthritis. First is Asymmetrical mono- and oligoarticular arthritis (30-50% of cases) is the most common presentation of psoriatic arthritis. Second is symmetrical polyarticular arthritis (30-50% of cases) is ultimately the most common form of psoriatic arthritis. Third is distal interphalangeal (DIP) joint involvement (25% of cases) is nearly always associated with nail manifestationsm. Fourth is Arthritis mutilans is affects less than 5% of patients and is a severe, deforming and destructive arthritis. This condition can progress over months or years causing severe joint damage. Fifth is Axial arthritis (30-35% of cases) may be different in character from ankylosing spondylitis, the prototypical HLA-B27-associated spondyloarthropathy. It may present as sacro-iliitis, which may be asymmetrical and asymptomatic, or spondylitis, which may occur without sacro-iliitis and may affect any level of the spine in "skip" fashion. Genetic factors appear to play an important role. There is a 70% concordance for psoriasis in monozygotic twins. There is a 50-fold increased risk of developing psoriatic arthritis in first-degree relatives of patients with the disease. Environmental factors have been implicated. Streptococcal infection can precipitate the development of guttate psoriasis. HIV infection can present with both psoriasis and psoriatic arthritis, as well as worsen existing disease.

Gout is one of the most painful types of arthritis. Gout was once incorrectly thought to be a disease of the rich and famous, caused by consuming too much rich food and fine wine. Gout is a disease due to a congenital disorder of uric acid metabolism. Uric acid is produced when purines are broken down by enzymes in the liver. Purines can be generated by the body itself (via the breakdown of cells in normal cellular turnover) or can be ingested in purine-rich foods (e.g. seafood, beer). Gout usually attacks the big toe (approximately 75% of first attacks), however it can also affect other joints such as the ankle, heel, instep, knee, wrist, elbow, fingers, and spine. In some cases the condition may appear in the joints of the small toes which have become immobile due to impact injury earlier in life, causing poor blood circulation that leads to gout. Chronic gout can lead to deposits of hard lumps of uric acid in and around the joints, decreased kidney function, and kidney stones. An acute attack of gout is a highly inflammatory arthritis often with intense swelling, redness and warmth surrounding the joint. The inflammatory component is so intense, an acute attack of gout is often mistaken for a bacterial cellulitis. Gout is mainly treated with anti-inflammatory drugs. Corticosteroids (also called steroids), may be prescribed for people who cannot take NSAIDs. Steroids also work by decreasing inflammation. Steroids can be injected into the affected joint or given as pills. Colchicine is often used to treat gout and usually begins working within a few hours of taking it.

Septic arthritis also known is Pyogenic arthritis. Septic arthritis is infection, usually bacterial, in the joint cavity. Septic arthritis usually affects just one joint, though occasionally it may occur in more than one joint at a time. It is the most dangerous form of acute arthritis. The joint cavity is usually a sterile space, with synovial fluid and cellular matter including a few white blood cells. Many different types of bacteria (germs) can cause septic arthritis. Infection with a bacterium called Staph. aureus is the most common cause. Septic arthritis is inflammation of a synovial membrane with purulent effusion into the joint capsule, usually due to bacterial infection. This disease entity also is referred to in the literature as bacterial, suppurative, purulent, or infectious arthritis. The most common bacterial isolates in native joints include gram-positive cocci, with S. aureus found in 40% to 50% of the cases. Septic arthritis is uncommon from age 3 to adolescence. Children with septic arthritis are more likely than adults to be infected with group B streptococcus and Haemophilus influenza. Young children and older adults are most likely to develop septic arthritis. As the population ages, doctors are finding that septic arthritis is becoming more common. Symptoms of septic arthritis occur suddenly and are characterized by severe pain, swelling in the affected joint along with acute pain. Chills and fever are also common symptoms. Chronic septic arthritis (which occurs less frequently) is caused by organisms such as Mycobacterium tuberculosis and Candida albicans. The knee and the hip are the most commonly infected joints.

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Acupuncture - Different Types of Acupuncture
Co-Editor-in-Chief, Tracy E. Austin, MD
Tuesday, February 2, 2010 - 07:01 AM

The Different Types of Acupuncture

Acupuncture is commonly thought of as an alternative medical treatment. Though in the United States acupuncture is considered an alternative medicine, it is widely practiced throughout the rest of the world and is an extremely common practice in Chinese medicine.

It has been used in China’s medical system since the 1930s. Most people imagine acupuncture as being stuck with needles in certain key areas to alleviate pain or cure other ailments. It is true that acupuncture involves needles being strategically placed on a person’s body, but there are many varieties of acupuncture.  

Traditional Chinese Medicine (TCM)

This type of acupuncture not only involves acupuncture with needles, but also the burning of Chinese medicinal herbs. TCM in considered to be a holistic approach to medicine since it treats the whole person; not only the body, but also the mind and the spirit.

It is based on the concept of Qi (or Chi), which is believed to be a force of energy within the body that keeps the functions of the body, including organs, working properly. The Qi travels along the body on pathways called “meridians” with each one representing a certain body system or organ function. It is along these pathways that the acupuncturist places the needles.

The herbs used along with the acupuncture treatment aid in strengthening the body. These herbs can be used to help stop bleeding, fight a cold, and aid in digestion, for just a few examples. Normally, the herbs are used in combinations of three or more and can be taken in pill form, burned and inhaled, or in tinctures placed on the body during treatment.

Classical Acupuncture

Classical Acupuncture is the most common thought of type according to westerners. It is also known as the five element acupuncture. This type uses needles alone. It is also referred to as Classical Five Element Acupuncture because it corresponds to the seasons according to the Chinese cycle. This cycle includes:
Summer; Harvest; Fall; Winter; Spring

Not only does Classical Acupuncture correspond to the seasons, but also to the five elements found in nature as they relate to a person’s body. These five elements are:
Fire; Earth; Metal; Water; Wood

Japanese Acupuncture

Japanese acupuncture is along the same lines as classical acupuncture, but this type uses smaller needles. It also focuses more on precision and efficient techniques that promote accomplishing bigger results using the smallest amount of stimulation possible.

Electro acupuncture

Like the name implies, electro acupuncture combines traditional acupuncture combined with a low electric current running through the needles and is becoming an ever-increasing popular form of acupuncture. Electro acupuncture uses the same meridians as classical acupuncture, but uses a small device that clips onto the needles. The device sends electric pulses that the acupuncturist can adjust depending on the intensity needed.

Unlike Japanese Acupuncture, electro acupuncture does not need to be so precise. The electric pulses stimulate a wider area making it easier to treat the area. Those who are squeamish about needles will prefer electro acupuncture because it can be done with electrodes instead of needles and attain the same results.

Medical Acupuncture

Medical acupuncture is very similar to classical acupuncture, but it is performed by a licensed medical doctor. It incorporates the medical science surrounding neuromuscular anatomy. Some also include historically Chinese acupuncture patterns; thereby, creating a hybrid of western and eastern medical knowledge.

Auricular Acupuncture

Auricular acupuncture is unique. This type treats the entire body, just like other types of acupuncture, but it does so through particular points located in the patient’s ears. The acupuncturist pinpoints certain nerves found in the ear that relate to other parts of the body to help heal or alleviate pain in that particular part.

Auricular acupuncturists have over 200 acupuncture points to know on the outer ear. This is also called the pinna, more commonly known as the cartilage. Western auricular acupuncturists utilize a tool called an electro acupunctoscope, which is an electric tool. This is along the same lines as the electro acupuncture methods. This method is known as Transcutaneous Electical Nerve Stimulation (TENS).

The type of acupuncture a person chooses may directly relate to the ailment that person has. Acupuncture treats a variety of maladies ranging from health conditions to pain and even helping to increase blood flow to particular areas of the body. For references and resourced information, go to http://www.smilemd.com/acupuncturist/the-different-types-of-acupuncture.aspx

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Getting a massage is a great way to relax. More and more people who exercise include massage as part of their fitness regimen. Gone are the days when massage was only indulged in by athletes training for a sports event. Nowadays, people from all walks of life spare a part of their time to enjoy a weekly massage. Everyone, with the exception of those who have certain conditions and diseases, can enjoy a massage and its health benefits.
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