Arthritis means inflammation of the bone joint. The most common forms of arthritis are called Osteoarthritis, Rheumatoid arthritis and gout, although many other types exist as well. Osteoarthritis' major symptoms are pain and stiffness particularly in joints that bear weight, although it can also occur in the finger joints. The most common joints affected are the knees, hips and spine as these joints bear most of the weight. As many as 40 million people in the United States have some form of arthritis. Although arthritis is mainly a disease of adults, children may also have it.

A joint is where the ends of two or more bones meet. For example, a bone of the lower leg, called the shin and the thighbone meet to form the knee joint. The hip is a ball and socket joint. It is formed by the upper end of the thighbone - the ball - fitting into the acetabulum (socket).

The bone ends of a joint are covered with a smooth material called cartilage. The cartilage cushions the bone and allows the joint to move easily without pain. The joint is enclosed by a fibrous envelope called the synovium which produces a fluid that helps to reduce friction and wear in a joint. Ligaments connect the bones and keep the joint stable. Muscles and tendons power the joint and enable it to move.

Inflammation is a consequence of injury or disease and this results in swelling, pain and stiffness. Inflammation is usually temporary, but in arthritic joints, it may cause long-lasting disability.

The most common type of arthritis is osteoarthritis (OA).  OA occurs when cartilage in the joint begins to deteriorate or wear away due to aging and other factors. In many cases, bone growths called "spurs" can develop in osteoarthritic joints.  It is seen in many people as they age, although it may begin when they are younger as a result of injury or overuse. It is often more painful in weight bearing joints such as the knee, hip, and spine than in the hand, elbow, and shoulder joints. All joints may be more affected if they are used extensively in work or sports, or if they have been damaged from fractures or other injuries.  Symptoms of OA can be controlled effectively using a variety of techniques.  These treatment methods have made it easier than ever for you and your doctor to care for OA.

Rheumatoid arthritis is a disease that affects younger people usually between the ages of 20 and 45 and is three times more common in women than men. The most common joints involved with rheumatoid arthritis are the small joints of the hands. Patient with rheumatoid arthritis often have thickening of the tissue around the joints and even destruction of bone with bone deformity and some significant disability. This commonly occurs in joints in the hands and feet. Larger joints such as hips, knees, and elbows also may be involved. The reason for rheumatoid arthritis is still poorly understood and many researchers feel that it may be some fault in the body's immune system or some form of viral infection which involves the joints. Many joints of the body may be involved at the same time.

Making a diagnosis of arthritis often includes evaluating symptoms, a physical examination, and X-rays, which are important to show the extent of damage to the joint. Blood tests and other laboratory tests may help to determine the type of arthritis.

The goals of treatment are to provide pain relief, increase motion, and improve strength. There are several kinds of treatment:

Aspirin compounds, the most widely prescribed medicine, historically have been the use of salicylates which includes aspirin and coated aspirin. Aspirin can be taken and has been used in varying dosages for years and years with excellent success. Unfortunately, the main problems with aspirin use are the development of stomach problems, particularly ulcers with or without bleeding. Aspirin is also a blood thinner by itself and bleeding tendencies do exist.

More recently, the use of nonsteroidal anti-inflammatory drugs have become the most popular first line of treatment for arthritis. These drugs are also known as NSAIDs (after the first initials of the drug type). NSAIDs are related in many ways to aspirin in that they block an inflammatory response that is seen in joints. The most common NSAIDs that are used today include ibuprofen, naproxen, carprofen, diclofenac, fenoprofen, flurbiprofen, indomethacin, ketoprofen, meclofenamate, piroxicam, phenylbutazone, tolectin and sulindac. Naproxen and ibuprofen can be purchased over the counter in small doses than most physicians use in patients for active treatment.

Corticosteroids are potent drugs similar to a naturally occurring hormone called cortisone which is made in the adrenal glands. Corticosteroids are able to quickly reduce inflammation, but have significant side effects and should be used in most instances only for a short time. Corticosteroids can be injected directly into the inflamed joint or be taken by pill or by systemic injection. The most common corticosteroids include hydrocortisone, prednisone, prednisolone, methylprednisolone and triamcinolone. Because of the serious side effects often seen with steroids, the entire spectrum of side effects should be discussed with your physician.

When medications are not successful in the treatment of arthritis other treatments may be indicated. These would include physical therapy and surgery.

Physical therapy includes heat and cold along with exercises and special range of motions. Special devices such as braces and crutches may give temporary relief by taking some of the pressure off of the joints. Canes, crutches, walkers, or splints may help relieve the stress and strain on arthritic joints. Learning methods of performing daily activities that are the less stressful to painful joints also may be helpful. Certain exercises and physical therapy (such as heat treatments) may be used to decrease stiffness and to strengthen the weakened muscles around the joint.

Surgery is indicated in many forms of arthritis by removing inflamed tissue and replacing inflamed joints. Surgery is usually the last resort, but is very successful in cases that are properly selected. In general, an orthopedist will perform surgery for arthritis when other methods of nonsurgical treatment have failed to give relief. The physician and patient will choose the type of surgery by taking into account the type of arthritis, its severity, and the patient's physical condition. Surgical procedures include:

• Removal of the diseased or damaged joint lining.
• Realignment of the joints.
• Total Joint Replacement.
• Fusion of the bone ends of a joint to prevent joint motion and relieve joint pain.

Most types of Arthritis can not be cured at present. Researchers continue to make progress in finding the underlying causes for the major types of arthritis. In the meantime, orthopaedists, working with other physicians and scientists, have developed many alternative treatments for arthritis which are effective.

In common cases, persons with arthritis can continue to perform normal activities of daily living. Exercise programs, anti-inflammatory drugs, and weight reduction for obese persons are common measures to reduce pain, stiffness, and improve function.

In persons with severe cases of arthritis, orthopaedic surgery can often provide dramatic pain relief and restore lost joint function. A total joint replacement, for example, can usually enable a person with severe arthritis in the hip or the knee to walk without pain or stiffness.

Some types of arthritis, such as rheumatoid arthritis, are often treated by a team of health care professionals. These professionals may include rheumatologists, physical and occupational therapists, social workers, rehabilitation specialists, and orthopedic surgeons.