Ask the Pharmacist

Q: I’m dealing with lots of pain and stiffness in my joints. I assume it’s just the run-of-the-mill arthritis, but how do I know for sure?

A: If you were to ask your neighbour to name as many types of arthritis as he or she could, you would be lucky to hear more than the two most common types, rheumatoid and osteoarthritis.

However, there are, in fact, more than 100 different types of arthritis (many of them extremely rare) and it is critically important to identify the type you are suffering from as treatment options vary greatly and many of these can cause permanent damage if disease progression is not halted promptly.

Perhaps the best way to identify whether you need to be immediately concerned with that pain in your joint, is to identify the most-common symptoms with which the main types of arthritis present.

As we mentioned a few articles ago, osteoarthritis (OA) is by far the most common from this group of diseases, and fortunately, given its prevalence, the least concerning. It is essentially a byproduct of the wear-and-tear on our joints that starts usually in middle age as a result of a life spent working and living.

It starts slowly and usually worsens over years as opposed to other types of arthritis which can become severe very quickly. Its hallmark symptoms are stiffness, particularly first thing in the morning or after prolonged sitting, along with pain and swelling in the joints after extended activity. The most common sites include the knees, hips, fingers and lower back.

Rheumatoid arthritis (RA), on the other hand, is a condition where the joints (and possibly some of your organs as well) are aggressively attacked by your immune system. In its earliest stage, it can resemble OA in that the joints tend to be tender and painful.

There are some clues that should help you identify when RA is the likely culprit. Typically, its the small joints (in the wrists, hands and feet) that are more likely involved and it tends to be bilateral (i.e. both the left and right one). As well, the symptoms may come and go, far more so than in OA. Hence a joint can get dramatically worse in a very short time frame and then appear to be fine days to weeks later.

Morning stiffness tends to persist longer in RA, often extending beyond 30 minutes, and as the disease progresses, the joints may feel warm to the touch and be swollen. As well, RA may come with symptoms in areas other than your joints, such as fatigue, a loss of appetite, a low-grade fever, a dry mouth and eyes, along with a wide range of other possible signs.

Psoriatic arthritis (PA) is probably the next most frequent form of arthritis seen. This type of arthritis tends to start between the ages of 30 and 50, and usually initially presents not with joint pain but rather the raised red scaly patches of inflamed skin that psoriasis victims know all too well.

These patches are usually located in areas such as the elbows, knees, scalp, navel and the skin around the genitals. At some point thereafter, up to 30 per cent of psoriasis patients will start to develop significant pain and swelling in the fingers and toes and many will experience discomfort in their spine as well.

Another hallmark sign can be found on the fingernails which may be pitted or discoloured. It may or may not be bilateral and affects both males and females equally.

Gout is an inflammatory form of arthritis that develops in some people who have high levels of uric acid in their blood. The levels can become so elevated that eventually, the uric acid becomes a solid crystal (i.e. it is no longer dissolved within your blood) and can cause sudden severe pain and swelling in the joint in which it crystallizes.

Hence, for many people, the first sign of gout is excruciating pain and swelling, often in the big toe. The first attack frequently seems to occur after your body has been through an ordeal such as an injury or illness.

While the big toe is frequently the location, it may appear in other joints of the lower body, such as an ankle or foot. It usually affects only one joint at a time, but if left untreated, can progress to affect many joints.

Usually, it will go away in a week to 10 days but, once again, if allowed to reoccur continually untreated, it can lead to a constant mild pain in between those brutal flareups, and disfiguring lumps of crystals may also develop under the skin around the joints.

As we mentioned before, these are but a few of the many types of arthritis that have been identified. The key with many, is to get professional advice as to which type you may be dealing with and how best to limit its progression before the unchecked disease disfigures your joints for good.

For more information about this or any other health-related questions, contact the pharmacists at Gordon Pharmasave, Your Health and Wellness Destination. Also check the website at www.gordon-pharmasave.com/ and the Facebook page at www.facebook.com/GordonPharmasave/?fref=ts