Alex Stellmar, age 15, of Campbell, Ohio, for his question:
WHAT CAUSES ARTHRITIS?
One type of arthritis is called osteoarthritis, and it manifests itself in some persons with hard, bonelike enlargements of the finger joints closest to the nails. These are called Heberden's nodes. When the nodes occur on other finger joints, they are called Bouchard's nodes. Both types seem to run in families but may develop as a result of injuries.
Arthritis is a name given to a variety of conditions. The name means inflammation of a joint, and many different factors can cause such inflammation.
There are two common arthritis diseases: rheumatoid arthritis, which involves not only the joints but frequently other connective tissue, and osteoarthritis, a less serious condition which four out of five persons will have in some form during their lifetimes.
Rheumatoid arthritis begins with an inflammation of the synovial membrane, a thin part of the joint that encloses the synovial fluid, a lubricating material. The fluid then begins to thicken and accumulate, contributing to the swelling. From a temporary inflammation often comes the growth of permanent granular tissue called pannus.
The disease can advance with the cartilage (the soft, flexible extensions of bone at the joints) deteriorating and being replaced with a growth of fibrous tissue that can eventually become hard and bonelike, fusing the joint together so it cannot bend.
Most cases of rheumatoid arthritis, however, do not advance to the crippling stage.
Research continues in an effort to determine what causes rheumatoid arthritis. One theory says that the infection starts in one part of the body and then moves to connective tissue. Another theory says it is related to autoimmune reaction. Sometimes, when the body develops antibodies to fight certain abnormal substances, the antibodies may start a cycle of events that could lead to arthritis. Antibodies have been known to create many other abnormal problems.
Osteoarthritis involves deterioration of the flexible ends of bones at the joints. The cartilage loses its elasticity and gradually wears away, stiffening the joints, limiting movement and causing pain.
A primary type of osteoarthritis occurs for no apparent reason, usually in persons between the ages of 30 and 40, and involves the smaller joints. A secondary type appears in larger joints that have been injured or subjected to hard use. It is associated with aging.
Aspirin is the most common and effective drug used to relieve pain and reduce inflammation in arthritis. Cortisone and other corticosteriods have had dramatic success in reducing pain, but their use is limited because of side effects.
Bed rest, warm baths, hot packs, heat lamps and application of hot paraffin are helpful in reducing arthritis pain. Doctors also often prescribe special exercise programs which give relief.