Arthritis:
Osteo-arthritis, infective, metabolic, auto-immune

Arthritis is inflammation of synovial joints. The commonest form of arthritis is osteo-arthritis (OA), which is associated with degenerative changes to the joint. There is an underlying predisposition in some people to developing this disease. In these people, OA commonly presents in the small joints of the hand, often associated with presence of small lumps or nodes at the end joints of fingers. These joints are not necessarily subject to greater stress; excess “wear and tear” appear not be a dominant factor in the development of the condition.

Osteoarthritis may also be a consequence of excessive use. This is not uncommon in people playing competitive sport, where hip and knee joints are subjected to constant and excessive stress. It also occurs in weight-bearing joints in older people. Osteoarthritis may be the end-result of other joint diseases e.g septic (infective) arthritis, gout, rheumatoid arthritis, and gonorrhoea. It may also occur as a result of damage to nerves supplying sensation to the joint e.g syphilis and nerve-related disorders.

Less common causes of arthritis include gout and biochemically-induced joint inflammation, immune-related arthritis, and viral-related joint pain.

Septic arthritis, especially in children, requires urgent surgery coupled with aggressive antibiotic therapy. Other forms of arthritis may need urgent and aggressive use of drugs.

Acupuncture is a useful adjunctive therapy in the management of arthritis. Most arthritic pain will respond to acupuncture as it helps resolve inflammation in joints. Apart from a reduction in pain intensity, a decrease in warmth and swelling also occurs. The early effects of treatment are usually rapid and commonly associated with an increase in mobility and range of movement.

Long-term outcomes vary, depending on the underlying causes. While degenerative changes cannot be reversed, the decrease in inflammation with acupuncture will often result in improvement of function and a decrease in pain.

Arthritic inflammation with underlying metabolic, auto-immune or infective causes will need medical treatment directed at the specific cause even though acupuncture will help alleviate symptoms.