What Is Inflammation?
When you think of arthritis, you think of inflammation. Inflammation is a process in which the body's white blood cells and chemicals help protect us from infection and foreign substances such as bacteria and viruses.
In some diseases, however, the body's defense system (immune system) triggers an inflammatory response when there are no foreign substances to fight off. In these diseases, called autoimmune diseases, the body's normally protective immune system causes damage to its own tissues. The body responds as if normal tissues are infected or somehow abnormal.
What Diseases Are Associated With Inflammation?
Some, but not all types of arthritis, are the result of misdirected inflammation. Arthritis is a general term that describes inflammation in joints. Some types of arthritis associated with inflammation include:
- Rheumatoid arthritis
- Psoriatic arthritis
- Gouty arthritis
- Systemic lupus erythematosus
The most common form of arthritis called osteoarthritis (also known as degenerative arthritis) is a bit of a misnomer. It is not believed that inflammation plays a major role in osteoarthritis. Other painful conditions of the joints and musculoskeletal system that are not associated with inflammation include fibromyalgia, muscular low back pain, and muscular neck pain.
What Are the Symptoms of Inflammation?
The symptoms of inflammation include:
- Swollen joint that's tender and warm to the touch
- Joint pain
- Joint stiffness
- Loss of joint function
- Often, only a few of these symptoms are present.
Inflammation may also be associated with general "flu"-like symptoms including:
- Fatigue/loss of energy
- Loss of appetite
- Muscle stiffness
What Causes the Symptoms of Inflammation?
When inflammation occurs, chemicals from the body are released into the blood or affected tissues. This release of chemicals increases the blood flow to the area of injury or infection and may result in redness and warmth. Some of the chemicals cause a leak of fluid into the tissues, resulting in swelling. This process may stimulate nerves and cause pain.
What Are the Results of Joint Inflammation?
Increased blood flow and release of these chemicals attract white blood cells to the sites of inflammation. The increased number of cells and inflammatory substances within the joint can cause irritation, wearing down of cartilage (cushions at the end of bones), and swelling of the joint lining (synovium).
How Are Inflammatory Diseases Diagnosed?
Diagnosis of inflammatory diseases consists of all or some of the following:
- Complete medical history and physical exam.
- The location of painful joints.
- Presence of joint stiffness in the morning.
- Evaluation of other symptoms.
- Results of X-rays, blood tests, and other studies.
Can Inflammation Affect Internal Organs?
Yes. Inflammation can affect organs as part of an autoimmune disorder. The type of symptoms depends on which organs are affected. For example:
- Inflammation of the heart (myocarditis) may cause vague chest pain or fluid retention.
- Inflammation of the small tubes that transport air to the lungs (bronchiolitis) may cause shortness of breath.
- Inflammation of the kidneys (nephritis) may cause high blood pressure or kidney failure.
- Inflammation of the eye (iritis or uveitis) may cause pain or decreased vision.
- Inflammation of the muscles (polymyositis) may cause achiness or weakness.
- Inflammation of the blood vessels (vasculitis) may cause rash, headaches, or internal organ damage.
Pain may not be a main symptom since many organs do not have pain-sensitive nerves. Treatment of organ inflammation is directed at the cause of inflammation whenever possible.
How Are Inflammatory Joint Diseases Treated?
There are a number of treatment options for inflammatory joint diseases including medications, rest, exercise, and surgery to correct joint damage. The type of treatment prescribed will depend on several factors including the type of disease, the person's age, type of medications he or she is taking, overall health, medical history, and severity of symptoms.
The goals of treatment are to:
- Avoid or modify activities that aggravate pain
- Relieve pain through pain medications and anti-inflammatory drugs
- Maintain joint movement and muscle strength through physical therapy and exercise
- Decrease stress on the joints by using braces, splints, or canes as needed
What Drugs Are Used to Treat Inflammatory Diseases?
There are many drugs available to decrease joint pain, swelling, and/or inflammation and hopefully prevent or minimize the progression of the inflammatory disease. These medications include:
- Anti-inflammatory pain reliever drugs (NSAIDs -- such as aspirin, ibuprofen, or Celebrex).
- Corticosteroids (such as prednisone).
- Other medications* include chemotherapy drugs, disease modifying treatments, biologic therapy, or narcotic pain relievers.
*Some of these medications are traditionally used to treat other conditions such as cancer and inflammatory bowel disease or to prevent organ rejection after transplants. However, when "chemotherapy" types of medications are used to treat inflammatory diseases, the doses are significantly lower and the risks of side effects tend to be considerably less than when prescribed in higher doses for cancer.
When you are prescribed any drug, it is important to meet with your doctor regularly so he or she can check its effectiveness and detect the development of any side effects.