The Many Faces of Arthritis

Ankylosing spondylitis psoriatic and rheumatoid arthritis differences

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Joint pain. Inflammation. Muscle fatigue. Your body just feels tired, and you're aching every day. When you're diagnosed with arthritis, you have one of 100 different types of the disease.

The most common type of arthritis is osteoarthritis. That's the type of arthritis you develop as you get older. But other widespread forms of the condition are ankylosing spondylitis, psoriatic arthritis, and rheumatoid arthritis.

Sufferers of all types of arthritis share the painful experience of joint pain, to different degrees. Inflammation around joints – where two bones meet - may range from mild to severe, and affect just one joint or many.

The joints in our body endure constant, and repetitive use. Think about how many times you bend your knees or how much of the day you spend typing on your computer keyboard. For a person with arthritis in their knees or fingers, these mundane movements cause constant pain.

Arthritis causes swelling and stiffening in the area around the joint. The skin nearby may turn red and warm. It can get difficult, or even impossible to move the joint, resulting in degrees of disability.

Most people think of arthritis as a disease that emerges late in life, but ankylosing spondylitis, psoriatic arthritis, and rheumatoid arthritis can occur much earlier. While sufferers of these diseases have similar symptoms, causes and treatment vary.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic disease, and has no cure. The cause is still a mystery, but researchers suspect it involves a combination of genetic and environmental factors.

According to Arthritis Foundation, nearly 1 percent of adult Americans have RA, and it's more common among women.

RA can strike between the ages of 30 and 60, or later for men. But it doesn't discriminate based on age – even teens and twenty-somethings can find themselves with a diagnosis.

RA is closely related to juvenile arthritis, a disease diagnosed in children around the world.

This form of arthritis is classified as an autoimmune disease. That means that the body's immune system, which guards against disease, is attacking rather than protecting the body.

RA attacks healthy tissues in the body, taking aim specifically at the thin membrane that lines the joints. It causes fluid to build up in the joints, creating the inflammation characteristic of arthritis.

For RA sufferers, joint pain and inflammation isn't limited to specific areas – it occurs throughout the body. But for some, the disease can go through periods of flares and remissions. That means that there may be times of intense pain and other times where they have no symptoms.

But for others, the disease is constantly present and gets worse over time.

RA affects the body symmetrically. That means if you have joint pain in your right knee, you'll likely have it in your left as well.

The long-term effects of RA include cartilage, tendon, and ligament damage, joint deformity and disability, and lumpy nodules forming under the skin over bony areas. The inflammation can eventually affect organs and other internal systems.

The strongest recommendation that the Arthritis Foundation gives for dealing with RA is early diagnosis and aggressive treatment.

Your doctor will diagnose RA based on your medical history and a series of tests.

RA requires constant treatment, and when it's treated early, it can preserve your joints for a longer life.

There are two types of medication for RA. One class of drugs is designed to delay the progression of the disease, and they are typically tried first. They're called disease-modifying antirheumatic drugs (DMARDs) and they're prescribed by your doctor. Examples include Remicade, Rituxan, Simponi, Enbrel, and Humira in the TNF inhibitor class, and  cyclosporin, methotrexate, sulfasalazine, and corticosteroids in the immunosuppresor class.

DMARDs can have side effects and the doctor should monitor your response closely. Some drugs require regular blood testing. They can lower your white blood cell count, cause rash, hair loss, and more. Each drug has its own side effects.

The other type of drug, called nonsteroidal anti-inflammatory drugs (NSAIDs), aim to reduce inflammation and relieve the symptoms of the disease. NSAIDs include over-the-counter medications like Tylenol and Aleve, and stronger drugs can be prescribed.

Lifestyle changes may have a positive impact on the disease. Eating a healthy diet, and moderate exercise while you're not in pain can help strengthen your body.

Ankylosing Spondylitis

Like rheumatoid arthritis, ankylosing spondylitis (AS) is a disease that lasts throughout the patient's life. But the disease is partially defined against RA – a person with AS tests negative for the rheumatoid antibody in their blood test.

AS is one of a number of joint diseases that affect the spine. It touches the joints where the spine attaches to the pelvis, the spine, and hip joints.

In AS, inflammation occurs where muscles and ligaments attach to bones. AS patients feel pain and stiffness in these areas.

Eventually, AS causes the spinal bones to fuse together. The ligaments are transformed into bone, and the joint grows permanently together.

The cause of AS is unknown. It commonly begins between ages 20 and 40, but can affect children as young as 10. Males are at a higher risk than females.

The first symptoms are typically lower back pain. The pain is worse at night, when the body is inactive. Physical activity reduces the pain.

The best course of treatment available are anti-inflammatory drugs, to reduce the inflammation and pain. Some immune-suppressing drugs have been shown to relieve AS symptoms, similar to RA treatment. In some cases where there's serious deformity, surgery can be done for joint replacement or correcting the spine itself.

Like rheumatoid arthritis, AS can flare up and go through remission periods. But some patients have constant pain, and the disease can lead to permanent disability.

Psoriatic Arthritis

Psoriatic arthritis is a disease that is common among people who have psoriasis, a chronic skin condition. Up to 30 percent of people with psoriasis will develop arthritis, a much higher percentage than the general population.

Psoriasis itself is an autoimmune disease that often manifests as bumpy, red patches of skin covered with a white buildup of dead skin cells.

It's not known why some people with psoriasis develop psoriatic arthritis and others do not, but researchers believe the reason may be connected with a certain gene.

There are five different types of psoriatic arthritis. They range from mild to severe, and affect different joints in the body in different ways.

The form of arthritis thought of as “classic” for people with psoriasis is distal interphalangeal predominant (DIP). It affects the joints of the fingers and toes like osteoporosis, but it also changes the patient's nails.

If you're diagnosed with psoriatic arthritis, your doctor will most likely prescribe anti-inflammatory drugs for you. Ibuprofen and naproxen may help reduce the swelling and pain, or you may need stronger varieties of the medication.

In some cases, disease-modifying drugs aimed at the condition itself may be prescribed, and surgery is an option.

Exercise and physical rehabilitation are also used to preserve function in affected joints.

According to the National Psoriasis Foundation, early diagnosis and treatment are essential, and managing the primary skin condition may help manage the joint disease.