A joint is where the ends of two or more bones meet. For example, a bone of the lower leg, called the shin or tibia and the thighbone, called the femur, 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 socket-part of the pelvis called the acetabulum.

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 one of the body's normal reactions to injury or disease. In an injured or diseased joint, this results in swelling, pain, and stiffness. Inflammation is usually temporary, but in arthritic joints, it may cause long-lasting or permanent disability.

Arthritis is the number one cause of chronic disability in the world. It refers to more than 100 diseases that cause pain, stiffness and swelling from the inflammation of a joint or the area around joints.

»  What is osteoarthritis?

Osteoarthritis is the most common type of arthritis affecting most joints and is essentially wear and tear of the joint. It usually affects the middle-aged and older people. This is a noninflammatory degenerative joint disease characterized by the breakdown of the joint's cartilage. Cartilage that cushions the bones of the hip starts to erode, eventually allowing the bones to grind or rub together and causing hip pain and stiffness. The exact cause of osteoarthritis is unknown. 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 wrist, 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.

»  What is rheumatoid arthritis?

»  What is inflammatory arthritis?

Fibromyalgia is the second most common type of arthritis affecting 3.7 million Americans, mostly women; 70 to 90 percent of people who develop this disease are women aged 20 to 50. Fibromyalgia is a disease involving pain in muscles or joints with no clinical signs of infection. It is often misdiagnosed as chronic fatigue syndrome, and usually does not require surgery.

The cause of Ankylosing Spondylitis is unknown although there appears to be some genetic component. Ankylosing Spondylitis is associated with the HLA B27 gene but it is unclear why. The gene is seen in about 8 percent of normal Caucasians, about 10 percent of Ankylosing Spondylitis patients don't have the gene and only about 10 percent of people with the gene will get Ankylosing Spondylitis.

Early on, there is pain and stiffness in the buttocks and low back due to sacroiliac joint involvement. Over time, the symptoms can progress up the spine to involve the chest and neck. Ultimately, the bones may fuse together causing limited range of motion of the spine and limiting one's mobility. Shoulders, hips and sometimes other joints may be involved. Ankylosing Spondylitis may affect tendons and ligaments. The heel may be involved with Achilles tendonitis and plantar fasciitis. Since it is a systemic disease, patients can get fever and fatigue, eye or bowel inflammation, and rarely, there can be heart or lung involvement. Ankylosing Spondylitis is typically non life-threatening. Usually, it is a slowly progressive disease. Most people are able to work and function normally.

The diagnosis is typically suspected by the doctor based on the signs and symptoms. The doctor will take a thorough history and do a physical examination.

X-rays, especially those of the sacroiliac joints can be confirmatory. The HLA B27 gene may be checked by a blood test, but its presence or absence does not ultimately confirm or reject the diagnosis.

At this time, there is no known curative treatment. Goals of treatment are to reduce pain and stiffness, slow progression of disease, prevent deformity, maintain posture and preserve function.

Exercise programs are an essential part of the treatment. Patients may be referred for a formal physical therapy program. Patients with Ankylosing Spondylitis are given daily exercises for stretching and strengthening, deep breathing exercises and posture exercises to avoid stooping and slumping. A hard mattress is recommended.

Medications are also used to treat Ankylosing Spondylitis. Non-steroidal anti-inflammatory drugs (NSAIDs) are traditionally used to control symptoms. Steroids, such as prednisone, are rarely used. Sometimes, medications that are normally used for rheumatoid arthritis, such as sulfasalazine or methotrexate, may be used. These medications have more toxicities and it is unclear if they actually slow the progression of the disease. More recently, the biologic agents etanercept (Enbrel), adalimumab (Humira), and infliximab (Remicade) have been approved for use in AS. These drugs may not only help symptoms but also slow the progression of the disease. They are only given as IV's in the doctor's office or by self-administered shots at home.

Surgical options are limited. There are no specific surgical interventions for the spine. Sometimes, in severe cases, replacement of the shoulder or hip joint is beneficial.

Enteropathic arthritis is peripheral joint or spine disease associated with inflammatory bowel disease (IBD), such as Crohn's disease or ulcerative colitis.

The arthritis typically occurs after the bowel disease is well established. Rarely, the arthritis can start before IBD is diagnosed. There is pain and swelling in one or more joints. Typically, the arthritis occurs in the lower extremity joints. The arthritis may mirror the activity of the bowel disease. There may also be spine involvement (ankylosing spondylitis-like). The HLA B27 gene is seen in up to 50 percent with spine involvement. The spondylitis is less likely to correlate with the bowel disease activity. Patients may have other systemic symptoms such as fever, skin or eye inflammation, and oral ulcers. Enteropathic arthritis rarely causes joint destruction, deformity or significant disability.

Like the other spondyloarthropathies, the patient needs physical therapy and exercise. Treatment of the bowel disease may help the peripheral joints but not the spine. Removing the colon (colectomy) in ulcerative colitis may “cure” the arthritis. One can use non-steroidal anti-inflammatory drugs (NSAIDs), but there is a need to be aware of the bowel effects. Local injection of steroids into joint(s) can be very helpful. Oral steroids can be used in more severe cases. In resistant cases, medications normally used to treat rheumatoid arthritis, such as methotrexate, azathioprine (Imuran) or sulfasalazine can be tried for the joints. Anti-TNF drugs, like adalimumab (Humira) and infliximab (Remicade) have been helpful with the joint and bowel disease of Crohn's.

The causes of the 100 types of arthritis are unknown. Because there are so many different forms of arthritis, the causes are likely to vary. Scientists are currently examining how the roles of major factors including genetics and lifestyles affect the development of arthritis. The causes of most types of arthritis are unknown. Scientists currently are studying what roles three major factors play in certain types of arthritis. The three areas being studied are:

• Genetic factors
• What happened during a person’s lifetime
• The person’s current lifestyle

Although the exact cause of arthritis might not be known, there are several risk factors for arthritis. A risk factor is a trait or behavior that increases a person's chance of developing a disease or predisposes a person to a certain condition. Risk factors for arthritis include:

• Age — the risk of developing arthritis, especially osteoarthritis, increases with age.
• Gender — In general, arthritis occurs more frequently in women than in men.
• Weight — Being overweight puts extra stress on weight-bearing joints, increasing wear and tear, and the risk of arthritis.
• Work factors — Some jobs that require repetitive movements or heavy lifting can cause stress in the joints and/or cause an injury, which can lead to arthritis.

In a healthy hip, cartilage cushions the area surrounding the hip ball and socket to allow easy movement without pain. In an unhealthy hip, the cartilage is damaged or worn away causing pain from bones rubbing and grinding together.

Different types of arthritis have different symptoms, which can range in severity from person to person. Osteoarthritis generally does not cause any symptoms outside the joint. Symptoms of other types of arthritis might include fatigue, fever, a rash, and the signs of joint inflammation, including:

• Pain
• Swelling
• Stiffness
• Tenderness
• Redness
• Warmth

The type of pain caused by arthritis depends on the type you have. Pain from arthritis can be continuous or intermittent. Pain may occur after activity or exercise but it may also happen even if you've been resting and still for a period of time. Pain may be concentrated in one spot or you may feel it all over your body. Joints may feel stiff and difficult to move. Daily chores such as climbing stairs and opening cans may become a challenge. You may notice that pain is more severe during certain times of the day or after performing certain tasks.

Some kinds of arthritis cause swelling or inflammation. The skin over the joint may appear swollen and red, and feel hot when touched. Arthritis may also cause fatigue or weariness.

Early diagnosis and treatment tailored to an individual's needs are crucial in slowing or preventing damage to joints. Only a physician can determine if you have arthritis and what type it is. Arthritis is diagnosed based on the overall pattern of symptoms, medical history, physical exam, x-rays and lab tests.

Your doctor will start by taking your history and doing a complete physical exam. Your doctor may observe you while standing, sitting, lying down, etc. and watch how well you walk around the room. He or she will also examine your hip and knee carefully, looking and feeling for details that offer clues about your condition. He or she will ask you where it hurts and how long you’ve had the pain. He or she will want to know if you fell or suffered any other trauma to the hip.

The location of the pain is often a tip-off of the condition you have. The source is not always what you'd think. Pain that truly comes from a hip problem is often located in the thigh or groin area. In other cases, hip pain may be a signal of a problem elsewhere in the body. If the pain is more in the buttocks than the hip, for example, it may actually be the result of a problem in the back. And, while hip pain that travels down the leg may be the result of infammation in the hip joint, it can also be a sign of sciatica (a condition usually caused by a pinched nerve in the back). If the pain travels below the knee, it could be a sign of disease in the nerves or blood vessels. In women, pain in the hip or upper leg may stem from several other causes, including tumors of the uterus or ovaries, endometriosis (the presence of uterine tissue elsewhere in the body), or pelvic inflammatory disease (infection in the reproductive organs).

Your doctor will also observe your posture while standing, sitting, and lying down, and watch how well you walk around the room. He’ll check for bruises, discoloration, areas of muscle wasting, and any curvature of the back. These observations all offer clues about your condition.

He may order x-rays to rule out a fracture or detect osteoarthritis. A magnetic resonance imaging (MRI) scan can confirm the presence of avascular necrosis or soft tissue damage. If he thinks you have an inflammatory condition or infection, he may order blood tests.

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.

In diagnosing arthritis pain, a doctor usually will take a medical history and ask questions about the patient’s pain. The doctor will do a physical examination to determine causes of pain and how this pain is affecting the patient’s ability to function. The patient might undergo X-rays or other imaging procedures such as a CT scan (computerized tomography) or MRI (magnetic resonance imaging) to see how much joint damage has been done.

Because there are so many types of arthritis, each type of arthritis has different symptoms and treatments. The good news is there are many ways to help control arthritis. Care for arthritis often involves more than one type of treatment. Treatment may vary over time and may be different depending on the kind of arthritis. Consult your doctor to discuss the best treatment options for you.

There are three basic categories of treatments, and your plan may involve one, two, or all three. Brief details are provided here and you can also go to individual sections for each option. Click the links to these sections for detailed information that may help. The goals of treatment are to provide pain relief, increase motion, and improve strength. There are several kinds of treatment.

Treatment of arthritis will depend on the type of arthritis, its severity, and the arthritis patient’s overall health. A number of different specialists might be involved in the care of a patient with arthritis. The goal is to treat all aspects of arthritis pain, increase joint mobility and strength, and help patients learn to manage pain. Treatment options include medicine, exercise, heat/cold, use of joint protection, and surgery. Individual treatment plans might involve more than one of these options.

Lifestyle Changes

It's hard to make changes in your life, but altering some small daily habits can make a big difference to the way your feel every day. Think about:

Medication: Many drugs, both prescriptions and over-the-counter medications, are used to treat arthritis. Common medications are aspirin-free pain relievers, anti-inflammatory drugs, corticosteroids, disease modifiers, and sleep medications. Many over-the-counter medications, including aspirin, ibuprofen, and naproxen (common anti-inflammatory drugs) may be used to effectively control pain and inflammation in arthritis. Acetaminophen (Crocin,Panadol,Tylenol) may be used to effectively control pain.

Prescription medications also are available if over-the-counter medications are not effective. The physician chooses a medication by taking into account the type of arthritis, its severity, and the patient's general physical health. Patients with ulcers, asthma, kidney, or liver disease may not be able to safely take anti-inflammatory medications. Injections of liquid cortisone directly into the joint may temporarily help to relieve pain and swelling. It is important to know, however, that repeated frequent injections into the same joint can damage the joint and have undesirable side effects.

Arthritis literally means "joint inflammation," but generally refers to the more than 100 rheumatic diseases and related conditions that can cause pain, stiffness and swelling in the joints and connective tissues. Affecting one in every seven Americans of all ages, arthritis also can deteriorate the joints' support systems, including muscles, tendons, ligaments and other parts of the body.

While medication may be part of a recommended treatment plan for people with arthritis, a tailored exercise program can be beneficial to management of pain and fatigue and to preserve joint structure and function. Once you know what type of arthritis you have and understand what symptoms you can expect, you and your physician or physical therapist can develop a balanced program of physical activity to reduce the damaging affects of arthritis and promote overall good health.

Exercise: Regular exercise is important to keep the body moving and flexible. It may lessen pain, increase movement, reduce fatigue, and helps you look and feel better.

Heat or Cold: Use of heat or cold over joints may provide short- term relief from pain and stiffness.

Pacing Activities: Pacing helps protect your joints by alternating periods of activity with periods of rest so that your joints don't tire from the stress of repeated tasks.

Joint Protection: Joints can be protected by learning to use them in ways that avoid excess stress. One way of doing this is to avoid using sore and weak joints. Unless larger joints are sore, for example, it is best to use them when carrying heavy items. The second method is walking with assistive devices like a cane. Lastly, weight control helps ease pain by reducing stress on your joints.

Self-Help Skills: You can learn ways to better manage how arthritis affects you emotionally by talking about your feelings with family members and friends, doing mental exercises, and by joining your local arthritis support group.

Stiffness, pain and swelling associated with arthritis can severely reduce the range of motion in joints (the normal distance joints can move in certain directions). Avoiding physical activity because of pain or discomfort also can lead to significant muscle loss and excessive weight gain. Exercise, as part of a comprehensive arthritis treatment plan, can improve joint mobility, muscle strength, overall physical conditioning and help to maintain a healthy weight.
A tailored program that includes a balance of three types of exercises - range-of-motion, strengthening and endurance exercises - can relieve the symptoms of arthritis and protect joints from further damage. Exercise also may:

• Help maintain normal joint movement
• Increase muscle flexibility and strength
• Help maintain weight to reduce pressure on joints
• Help keep bone and cartilage tissue strong and healthy
• Improve endurance and cardiovascular fitness

To help relieve pain, people with arthritis often keep affected joints bent - especially in the knees, hands and fingers - because it's more comfortable during the early stages of arthritis. While this may temporarily relieve discomfort, holding a joint in the same position for too long can cause permanent loss of mobility and hinder daily activities.

Range-of-motion exercises (also called stretching or flexibility exercises) help maintain normal joint function by increasing and preserving joint mobility and flexibility. In this group of exercises, affected joints are conditioned by gently straightening and bending the joints in a controlled manner as far as they comfortably will go. During the course of a range-of-motion exercise program, the joints are stretched progressively farther (maintaining comfort levels) until normal or near-normal range is achieved and maintained.

In addition to preserving joint function, range-of-motion exercises are an important form of warm-up and stretching, and should be done prior to performing strengthening or endurance exercises or engaging in any other physical activity. A physician or physical therapist can provide you with instructions on how to perform range-of-motion exercises for the fingers, shoulders and back, chin and neck, hips, knees and ankles.

Strong muscles help keep weak joints stable and more comfortable and protected against further damage. A program of strength-conditioning exercises that target specific muscle groups can be beneficial as part of your arthritis treatment program. There are several types of strengthening exercises that, when performed properly, can maintain or increase supportive muscle tissue without aggravating affected joints.

Some people with arthritis avoid exercise because of joint pain. However, a group of exercises called isometrics are designed to strengthen targeted muscle groups without bending painful joints. Isometrics involve no joint movement, but rather strengthen muscle groups by using an alternating series of isolated muscle flexes and periods of relaxation.

Another group of exercises called isotonics are similar to range-of-motion exercises because they involve joint mobility. However, this group of exercises is more intensive, achieving strength development through increased repetitions or speed of repetitions, or by introducing light-weight resistance with small dumbbells or stretch bands.

A physical therapist or fitness instructor (preferably one with experience working with arthritis patients) can provide you with instruction on how to correctly and effectively perform isometric and isotonic exercises.

Hydrotherapy or aquatherapy (water therapy), is a program of exercises performed in a large pool. Aquatherapy may be easier on painful joints because the water takes some of the weight off of the affected areas while providing resistance training.

The foundation of endurance training is aerobic exercise, which includes any activity that uses large muscle groups, can be maintained continuously for a long period of time and is rhythmic in nature. Aerobic activity conditions the heart, lungs and cardiovascular system to:

• Use oxygen more efficiently
• Supply the entire body with larger amounts of oxygen-rich blood
• Build stronger muscle tissue

When paired with a healthy diet, aerobic activity also is fundamental for weight control (which reduces excess pressure on affected joints) and improving overall general health.

People with arthritis should perform about 15 minutes of aerobic activity (called the duration of the exercise) at least three times a week (called the frequency of the exercise) at first, then gradually build up to 30 minutes daily. The activity also should include at least 5 to 10 minutes of warm up plus 5 to 10 minutes of cool down. While peak benefits are achieved when an aerobic activity is performed continuously for at least 30 minutes, aerobic exercise can be spread out in smaller segments of time throughout the day to suit your comfort level, without overexerting yourself. Aerobic exercise should be performed at a comfortable, steady pace that allows you to talk normally and easily during the activity. Ask your therapist what intensity of exercise is appropriate for your fitness level.

Intensity is how hard you are exercising. During exercise, your heart's "training range" or training heart rate should be closely monitored. To improve your body's aerobic condition, you need to exercise at an intensity between 60 and 80 percent of your maximum heart rate.

Examples of aerobic activities include walking, swimming, low-impact aerobic dance, skiing and biking, and may even include such daily activities as mowing the lawn, raking leaves or playing golf. Walking is one of the easiest aerobic exercise programs to begin because it requires no special skills or equipment other than a good pair of supportive walking shoes, and it's less stressful on joints than running or jogging. Biking also may be more beneficial to people with arthritis than other aerobic activities because it places less stress on knee, foot and ankle joints.

Appropriate recreational exercise, including sports, can be helpful to most people with arthritis, but only if it is preceded by a program of range-of-motion, strength and aerobic exercise to reduce the chance of injury.

Regardless of your condition, discuss exercise options with a physician before beginning any new exercise program. Also, begin new exercise programs under the supervision of a physical or occupational therapist, preferably one with experience working with arthritis patients.

People with arthritis who are beginning a new exercise program should spend some time conditioning using a program that consists only of range-of-motion and strengthening exercises, depending on their physical and athletic condition. Endurance exercises should be added gradually, and only after you feel comfortable with your current fitness level.

As with any change in lifestyle, your body will have to take time to adapt to your new program. During the first few weeks, you may notice changes in the way your muscles feel, changes in your sleep patterns or different energy levels. These changes are to be expected with increased activity levels. However, improper exercise levels or programs may be harmful, making symptoms of arthritis worse. Consult your physician or therapist and adjust your program if you experience any of the following:

• Unusual or persistent fatigue
• Sharp or increased pain
• Increased weakness
• Decreased range of motion
• Increased joint swelling
• Continuing pain (lasting two or more hours after exercising)

Effective treatment of arthritis should include a comfortable balance of range-of motion, strengthening and endurance exercises. But regardless of the exercise program you select, it's important to begin slowly and choose a program you enjoy so that you maintain it. Make exercise part of your weekly routine so that it becomes a lifetime commitment.

"Arthritis" means inflammation of the joints, and it might cause pain, swelling, and limited motion of one or many joints in the body. More than 100 different illnesses can cause arthritis.

Treatment begins after diagnosis by a doctor, who might prescribe medicine to reduce inflammation, pain, swelling, and loss of motion. As part of a comprehensive plan for arthritis treatment, your doctor might also prescribe occupational and physical therapy, which can provide additional help in your recovery.

Occupational therapists can teach you how to reduce strain on your joints during daily activities. They can show you how you can modify your home and workplace environments to reduce motions that might aggravate arthritis. Occupational therapists might also provide splints for your hands or wrists, and recommend assistive devices to aid in tasks such as driving, bathing, dressing, housekeeping, and certain work activities.

Physical therapists teach you exercises designed to preserve the strength and use of your joints. They can show you the best way to move from one position to another. They can also teach you how to use walking aids such as crutches, a walker, or a cane when needed.

The therapists on your health care team will work closely with your doctor to tailor a program to your specific needs, whether your arthritic problems are widespread or confined to one joint or body area.

The goals of treatment are to:

• Prevent loss of use of the joints
• Restore abilities that may have been lost
• Help you adapt to new activity levels
• Maintain your fitness
• Maintain your ability to take part in the activities you choose with minimal help from others

Therapy should be started early in order to reduce painful symptoms of inflammation, prevent deformity and permanent joint stiffness, and maintain strength in the surrounding muscles. When pain and swelling are better controlled, treatment plans may include exercises to increase range of motion, and improve muscle strength and endurance.

Rest — Bed rest helps reduce both joint inflammation and pain, and is especially useful when multiple joints are affected and fatigue is a major problem. Individual joint rest is most helpful when arthritis involves one or only a few joints. Custom splints can be made to rest and support inflamed joints, and a soft collar can support the neck while you are sitting or standing.

Thermal modalities — Applying ice packs or heating pads, as well as deep heat provided by ultrasound and hot packs, helps relieve pain locally. Heat also relaxes muscle spasms around inflamed joints. Heating joints and muscles with a warm bath or shower before exercising might help you exercise more easily.

Exercise — This is an important part of arthritis treatment that is most effective when done properly every day. Your doctor and therapist will prescribe a program for you that may vary as your needs change.

• Range of motion exercise. Gentle movement of each joint through its normal range of motion will help relieve stiffness, improve and maintain joint movement, and increase flexibility.
   
• Strengthening exercise. Strengthening exercise helps preserve or increase muscle strength. Isometric exercises tighten and strengthen the muscle without moving the joint and are most useful when joints are painful. Isotonic exercises strengthen the muscle by using it to move a weight.
   
• Water exercise. Warm water helps relieve pain and relax muscles. Swimming is not necessary, as water exercises may be done while sitting in a shallow pool or standing in shoulder-high water. Support by the water decreases body weight applied to the joints of the spine, legs, and feet. Water support of the arms and legs also helps you move your joints through range of motion exercises more easily.
   
• Recreational exercise. Recreational exercise does not replace your therapeutic exercise program, but might enhance it with a variety of enjoyable activities. Some examples are games, sports, exercise classes, running, and swimming, all of which can benefit muscle strength and joint range of motion. Running and swimming are excellent aerobic activities and will help improve your endurance and lessen fatigue. Any exercise needs to be tailored to the patient's disease and limitations.

Therapy for joint surgery patients — Preoperative programs of education and exercise, started before surgery in the outpatient therapy department, are continued at home. They might be changed in the hospital after surgery to fit new needs in the rehabilitation period. These exercises might be added to your usual exercise regimen, and you might find your ability to exercise has improved after surgery.

Joint protection techniques — There are ways to reduce the stress on joints affected by arthritis while participating in daily activities. Some of these include:

• Control your weight to avoid putting extra stress on weight-bearing joints such as your back, hips, knees, and feet.
• Be aware of body position, using good posture to protect your back and the joints of your legs and feet. Sit down to do a job when you can instead of standing. Change position often since staying in one position for a long time tends to increase stiffness and pain.
• Conserve energy by allowing for rest periods, both during the day and during an activity.
• Respect pain. It is a body signal that is telling you something is wrong. Don't try an activity that puts strain on joints that are already painful or stiff.

A therapist can show you ways to do everyday tasks without worsening pain or producing joint damage. Some joint protection techniques include:

• Use proper body mechanics to get in and out of a car, chair or tub, as well as for lifting objects.
• Use your strongest joints and muscles to reduce the stress on smaller joints. For example, carry a purse or briefcase with a shoulder strap rather than in your hand.
• Distribute pressure to minimize stress on any one joint. Lift dishes with both palms rather than with your fingers, and carry heavy loads in your arms instead of with your hands.
• If your hands are affected by arthritis, avoid tight gripping, pinching, squeezing, and twisting. Ways to accomplish the same tasks with alternate methods or tools can usually be found.

Assistive devices — many assistive devices have been developed to make activities easier and less stressful for the joints and muscles. Your therapist will suggest devices that will be helpful for tasks you might have found difficult at home or work.

A few examples of helpful devices include a bath stool in the shower or tub, grab bars around the toilet or tub, and long-handled shoehorns and sock grippers. Your therapist can show you catalogs that have a wide variety of assistive devices you may order.

At present, most types of arthritis cannot be cured. 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 effective treatments for arthritis.

In most 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 orthopaedic surgeons.

Your orthopaedist is a medical doctor with extensive training in the diagnosis and no surgical and surgical treatment of the musculoskeletal system, including bones, joints, ligaments, tendons, muscles and nerves.