For the vast majority of people, your doctor will be able to work out what’s wrong with you by:

  • listening to you describe your symptoms
  • examining you joints
  • examining your range of movement
  • looking at your medical history
  • looking at the medical history of your family
  • ordering certain tests (e.g. x-rays, blood test, MRI)

Putting your symptoms into words into words can be difficult. It may help you to think about how you would answer the following questions before you visit your doctor.

  • Which of your joints affected?
  • Have you noticed that your range of movement has changed?
  • Have you started to find it difficult to carry out certain tasks (e.g. buttoning up clothes) that never used to be a problem?
  • Have you experienced any swelling around your joints?
  • How often do you have pain or stiffness?
  • Do your symptoms get worse at certain times of days or after doing certain things?
  • What makes your symptoms better or worse?

Testing for Arthritis

Although there is no single diagnostic test that can confirm explicitly whether or not you have arthritis (be it osteo- or rheumatoid), there are a number of tests that can help your doctor piece together the evidence. The most common of these are blood tests and scans.

Blood Tests

There are a number of reasons why the doctor treating you may order a blood test:

  • to help them confirm that you have arthritis
  • to rule out other illnesses
  • to see how advanced your arthritis is
  • to see if your treatment is working.

Blood samples will usually have to be sent away to a laboratory for analysis and so it may take several days for the results to come in. In the laboratory, there are a number of things that can be measured, including:

Rheumatoid Factor (RF)

This is a type of antibody, a special type of blood cell that helps to fight infections. Rheumatoid factor can sometimes be used to show whether or not you have rheumatoid arthritis. The test should only be used to diagnose rheumatoid arthritis together with other pieces of evidence.

Full Blood Count (FBC)

This measures the levels of a whole host of cells and substances in your bloodstream. It can reveal anaemia or a high white cell count. Both of these are usually just part of the disease and inflammation of rheumatoid arthritis, but sometimes anaemia can be due to lack of iron and a high white count may indicate infection.

Erythrocyte Sedimentation (ESR)

This test measures how quickly your red blood cells (erythrocytes) settle down when they are spun around and then left to stand. The ESR is a means of measuring how much inflammation your arthritis is currently causing. Other tests which measure the amount of inflammation include plasma vicosity and the C-related protein (CRP) tests.

X-rays

As a disease like osteoarthritis progresses, the damage to the bone can become more pronounced, and it is at this stage that X-rays are most useful.

X-ray OA Knee

MRI scans

MRI (Magnetic Resonance Imaging) scans are relatively quick and easy ways of obtaining detailed images of the inside of the body, without having to perform surgery.

MRI scanners use radio waves (which are safer than X-rays) and high-powered magnetic field to create two- or three-dimensional images. MRI scanners in particular can distinguish between bone and soft tissue and therefore provide a more detailed picture of the state of a joint as a whole (and not just the bone).

How is Arthritis Treated?

The way in which your arthritis is treated depend on the type of arthritis that you have. However, the overall aims of any treatment programme are to:

  • reduce or relieve pain
  • reduce inflammation
  • improve your mobility
  • improve your quality of life.

Treating Arthritis with Medications

  • For osteoarthritis, drug treatment revolves around providing pain relief.
  • For rheumatoid arthritis, drugs can be used to relieve pain and reduce inflammation but may also be used to slow down the progression of the disease itself.

Treating Arthritis with Injection

  • For osteoarthritis, Synvisc injection can be explored.
  • For rheumatoid arthritis, anti-inflammatory injection is recommended.

Treating Arthritis with Surgery

Although most people with arthritis will never need surgery, it can be used as a last resort if all other treatment options failed to work or if the joint is very badly damaged.

Joint Replacement

This procedure involves the total replacement of the affected joint (usually the hips or knee). During the operation, the surgeon will remove the damaged joint and replace it with an artificial one (made from plastic, ceramics or metal). Joint replacements usually last between 10 and 20 years.

Hip Resurfacing

Resurfacing the damaged joint is a less drastic alternative to replacing the joint completely, and is most usually performed in younger people with arthritis. Typically, the surface of the joint (usually the hip joint) is replaced by a metal hemisphere and the joint socket is lined with a metal shell.

Call +65 6471 2674 (24 Hour) if you wish to see our doctor and seek treatment regarding arthritis.

 

Learning how your joints function and what happens when your arthritis symptoms flare up can help you to understand your condition and make it easier to live with.

We have already seen how arthritis is a disease that causes pain and inflammation in the joints. It doesn’t matter which type of arthritis you have been diagnosed with, if it is not managed properly you will usually end up in a certain amount of pain and may have problems getting around and doing certain things. That said, the two major types of arthritis, osteoarthritis and rheumatoid arthritis, are actually quite different in terms of:

  • their symptosm
  • the rate at which they develop
  • the people they affect
  • the way in which they are treated

These differences arise because what’s actually going on in the joints is very different. Although both conditions involve the breakdown of cartilage in the joint, osteoarthritis is due to age related changes in which the cartilage becomes thinner in some joints, and the joint becomes less cushioned, whereas rheumatoid arthritis is related to a problem with the body’s own immune system.

Osteoarthritis occurs when the cartilage starts to disappear and the lubricating (synovial) fluid loses its protective cushioning properties.

Osteoarthritis

Osteoarthritis is also known as degenerative arthritis, because the cartilage that protects the bone gradually gets worn away (or degenerates). If the cartilage wears away completely then the ends of the bones can end up rubbing together, which can be extremely painful.

At one stage, scientists believed that osteoarthritis was a natural (and inevitable) consequence of getting older, but we now know this to be untrue. The real story is probably much more complicated. Although it is true that the older you get, the more worn out your joints become, not everyone of a certain age automatically develops arthritis. It is more likely that osteoarthritis can be put down to changes taking place in the miscroscopic structure of the joints. These changes may start with the cells that make cartilage. The changes that go on in your joint(s) if you have osteoarthritis usually happen in a certain order.

  • The cartilage in the joint roughens and becomes worn down (and may disappear altogether).
  • Tiny cracks may start to appear in the cartilage.
  • Extra bone is laid down to replace the damaged or lost cartilage. The bone underneath the cartilage thickens and grows outwards.
  • The amount of bone laid down far exceeds the quantity that is actually needed to replace the damage cartilage.
  • Bony outgrowths (called osteophytes) start to form along the damaged joint.
  • Fragments of bone may break off into the joint, which cause the joint to become inflamed and swollen (and painful_.
  • The synovium starts to produce more synovial fluid than usual, which adds to the swelling in the joint.
  • The loss of cartilage, the wearing of bone and the bony outgrowths can all start to change the shape of the joint. This forces the bones out of their normal position and causes deformities.

Rheumatoid Arthritis

A case of mistaken identity

Rheumatoid arthritis can be traced back to a malfunction in the immune system. The body produces antibodies that attach the cells of the joint lining (the synovium) because it mistakes it for a foreign invader, making it painful, unstable and deformed.

At the moment, no-one knows exactly what causes them but the more we understand autoimmune diseases, the easier they will be to treat and even prevent. At the moment, however, there are some gaps in what we know.

The immune response

So what are antibodies and what do they do? Antibodies are made by white blood cells called B-lymphocytes. They can be thought as Y-shaped structures, with a special region at the tip that recognises and attaches to specific foreign substances, called antigens. Once it has bound to  the antibody, the antigen is neutralised so that it is no longer harmful. This process is known as immune response.

Of course, if the immune response is triggered inappropriately, perfectly healthy and harmless cells may become damaged. This is what happens in the joints when autoantibodies are made in people with rheumatoid arthritis.

Our blood is made up of three types of cell: white blood cells, red blood cells (which help to form blood clots). White blood cells are a key part of the body’s defence mechanism against infection.

How does autoimmunity cause inflammation and pain?

Rheumatoid arthritis usually progresses in three distinct stages:

  1. The synovium swells up and becomes inflamed as so-called inflammatory cells in the blood (specialised cells that are responsible for controlling inflammation) flock to the place where they are needed (i.e. the joint). This causes pain, warmth, redness and stiffness.
  2. The inflammatory cells in the synovium grow very rapidly, which causes the synovium to thicken and swell together.
  3. The inflamed cells then start to break down the bone and cartilage of the joint, often causing the joint to lose its shape and become unstable to move as it once did.

Call +65 6471 2674 (24 Hour) to make an appointment with our doctor to treat arthritis today.

If you have arthritis, or are caring for someone with the condition, you are certainly not alone. Arthritis is the single biggest cause of physical disability in Singapore.

How Common is Arthritis?

The answer is ‘very common indeed’. Of the two major types of arthritis (osteo- and rheumatoid arthritis), osteoarthritis is by far the most common.

  • Osteoarthritis is more common in people over the age of 60 and as the population of the UK gets older, the number of people who suffer from osteoarthritis will also increase.
  • In contrast, rheumatoid arthritis can affect people of any age, and is usually first picked between your 30s and 50s. About one in every hundred people is affected by rheumatoid arthritis, with women up to three times more likely to suffer than men.

Osteoarthritis is much more common than rheumatoid arthritis and tends to affect older people.

How did I end up with Osteoarthritis?

In the past, osteoarthritis was wrongly considered to be an unavoidable consequence of wear and tear on the joints. We no know that joints don’t just wear out with age, so if you do develop osteoarthritis, it can usually be traced back to at least one (and possibly a few) of the causes listed below.

Arthritis

Growing older

The chances of getting osteoarthritis seem to increase with age.

Being overweight

Carrying extra weight can put joints (especially the knees and hips) under unnecessary stress and can damage them, leading to osteoarthritis.

Injury

Sustaining an injury to a joint (like a fracture) can make you more likely to develop osteoarthritis in the future. Some professional athletes can injure the same joints over and over again.

Your occupation

Performing certain tasks on a regular basis can put your joints under strain. Farmers often develop osteoarthritis in their hips and people who operate machinery like pneumatic drills can develop arthritis in their hands or elbows.

Damage from another joint disease

Suffering from a joint-damaging disease like rheumatoid arthritis can make you more likely to develop osteoarthritis in later years.

Your family history

Some forms of osteoarthritis do run in families, especially those cases that affect the small joints of fingers. But in general, heredity is not a major reason for developing osteoarthritis.

Rheumatoid Arthritis Hand

Your gender

In most joints, especially the knees and hands, osteoarthritis is more common and severe in women.

Your anatomy

Being born with abnormal anatomy (like having one leg slightly longer than the other) can make you more susceptible to developing osteoarthritis. This is called a congenital abnormality, because you are born with it.

How did I end up with Rheumatoid Arthritis?

Unlike osteoarthritis, if you develop rheumatoid arthritis in all probability there would have been very little you could have done to prevent it. In many cases the actual cause of rheumatoid arthritis is unknown. Scientists simply do not know enough about the condition to point the finger at any one particular factor, but some of those listed below may contribute.

Genetic factor

We have seen that rheumatoid arthritis is an autoimmune disease that occurs when the body’s own immune system starts attacking the tissues of the body’s own joints. Our genetic make-up is determined before we are born, and with it, our susceptibility to developing rheumatoid arthritis.

Infection

Some scientists believe that it is possible that being exposed to or infected with a particular bacteria or a virus could trigger the autoimmune response and ultimately lead to rheumatoid arthritis (although nobody has been able to show exactly what this infecting agent is).

Hormones

Rheumatoid arthritis is more common in women that in men, and this may be linked to different levels of different hormones. Furthermore, the disease can go into remission during pregnancy, only to relapse afterwards. There is also some evidence that those women who take the contracetive pill are at less risk of developing rheumatoid arthritis.

Call +65 6471 2674 (24 Hour) to make an appointment to see our doctor regarding arthritis today.

Arthritis is the name given to diseases that bring about pain in our joints. Diseases that affect our joints also govern how mobile we are and therefore how independent we are. Managing arthritis effectively is all about controlling pain and stiffness and staying as active as possible.

What is Arthritis and Why is it a Problem?

Arthritis is a collection of distinct diseases that all cause pain in the joints. It is usually accompanied by swelling and sometimes changes in the structure of the joint.

People who have arthritis often have trouble moving and experience some loss of function (for example, trouble with fastening clothing or performing simple household chores or other everyday tasks). This has a number of knock-on effects, to the extent that (if it is not managed properly) arthritis can end up compromising your:

  • Moblity
  • Independence
  • Self-confidence
  • Sense of well-being
  • Family life

Osteoarthritis and Rheumatoid Arthritis

Osteoarthritis and rheumatoid arthritis are the two most common types of arthritis.

Osteoarthritis

Occurs when the cushioning of the joint (from the cartilage and synovial fluid) starts to wear down and disappear. The two bones of the joint start to rub together when the joint moves, which can be very painful.

Knee Osteoarthritis

Rheumatoid Arthritis

Occurs when the joint as a whole becomes inflamed and swollen as a result of underlying autoimmune disease.

People with rheumatoid arthritis can often end up developing osteoarthritis eventually, because once a joint has been damaged (e.g. by rheumatoid arthritis) it becomes more susceptible to developing what is known as ‘secondary osteoarthritis‘.

Rheumatoid Arthritis to the Fingers

Rheumatoid Arthritis is an Autoimmune Disease

Our immune system protects us from foreign invaders (such as bacteria and viruses) by destroying them with specially tailored substances called antibodies.

Under normal circumstances our immune system helps to protect us against infection and without it we would not survive. However, if you have an autoimmune disease, your body mistakes healthy cells, organs, or tissues in the body for foreign invaders and starts attacking them.

If you have rheumatoid arthritis, your immune system mistakes one or more of your joints for a foreign invader and attacks it. This causes inflammation, and it is the inflammation that damages the joint and brings about the symptoms of arthritis.

What’s the Difference Between Osteoarthritis and Rheumatoid Arthritis?

Although they share a name and have many symptoms in common, osteoarthritis and rheumatoid arthritis are in fact very different diseases.

  • They are caused by different things. Although both conditions involve the breakdoen of cartilage in the joint, osteoarthritis is largely due to age-related changes in which the cartilage becomes thinner in some joints, whereas rheumatoid arthritis is related to a problem with the body’s own immune system.
  • They affect people of different ages. Osteoarthritis tends to affect people as they get older and rarely occurs before the age of 40, but rheumatoid arthritis can occur at any age (and usually tends to affect people between the ages of 30 and 50 but can sometimes even start during childhood).
  • They can affect different joints. Osteoarthritis mostly affects the weight-bearing joints (like the knees and the hips) whilst rheumatoid arthritis tends to affect the smaller joints (such as those in the hands, wrist or elbows). Rheumatoid arthritis is a symmetrical disease. This means that if one wrist is affected then it is likely that the other one will be too, but this is not always the case in osteoarthritis.
  • They develop at different rates. Whilst osteoarthritis can take many years to develop, rheumatoid arthritis can come on over a period of months.
  • They look different in X-rays. Bones affected by osteoarthritis cans how bony lumps and other deformities, whereas bones affected by rheumatoid arthritis can look thin and the joints may show signs of damage (‘erosions’) due to the inflammation.

The Symptoms of Osteoarthritis

The major symptoms of osteoarthritis are:

  • Pain (that gets worse after exercising or towards the end of the day)
  • Stiffness (that is usually worse in the mornings and after long periods of sitting down).

They symptoms of osteoarthritis usually come on gradually and you may only end up noticing them at certain times of the day (e.g. in the morning when you first get up) or after doing certain activities (e.g. weight-bearing exercises like walking or jogging). You may start to notice that your joints aren’t as flexible as they used to be and that your range of movement is impaired (i.e. you can’t straighten your leg out in front of you as far as you used to be able to). Performing certain activities like bending down, kneeling, gardening or climbing stairs may also start to become more difficult.

As osteoarthritis becomes more advanced, you may start to notice other symptoms like:

  • muscle weakness
  • swelling around the joints
  • a crunching feeling in the joints
  • pain during the night that keeps you awake
  • changes in the the outward appearance of the joint, for example they may start to look knobbly.

Deformed Knees due to Osteoarthritis

Symptoms of Rheumatoid Arthritis

Rheumatoid arthritis tends to follow a different course in different people and symptoms can even vary from one day to the next. Given the right treatment, the symptoms of rheumatoid arthritis can disappear altogether, but this is not always the case and some people’s symptoms will continue to get steadily worse, even when they are receviing treatment.

Rheumatoid arthritis can affect any synovial joint (but tends to affect the smaller joints like the wrists, elbows and fingers) and interestingly enough, is usually symmetrical (if one wrist is affected, it is more likely that the other one will be too).

In contrast to osteoarthritis, the symptoms of rheumatoid arthritis can affect the whole body rather than just the joint in question. The main symptoms of rheumatoid arthritis are:

  • pain
  • stiffness
  • swelling around the joints
  • warmness and redness around the joints
  • lumps under the skin (called rheumatoid nodules)
  • tiredness
  • loss of appetite

Diagnosis Arthritis

Depending on the type of arthritis, your symptoms can develop over a matter of weeks or it may take many months before they start to bother you to the extent that you go and see your doctor for advice. If you suspect that you may have a form of arthritis, it is important that you seek medical advice as soon as you can.

Managing Arthritis

If your arthritis is causing you pain, your doctor may suggest some pain management strategies. These may include:

Call +65 6471 2674 (24 Hour) to fix an appointment to see our doctor regarding Arthritis treatment today. 

What is Autologous Platelet Rich Plasma (PRP)?

“Autologous Platelet Rich Plasma (PRP) is defined as the volume of plasma in autologous blood with a platelet concentration above baseline.”

Platelets are tiny plate-shaped, colourless bodies which when activated helps release growth factors that work with white blood cells for tissue regeneration. This is where PRP can help to reduce pain, promote and accelerate tissue healing, regenerate and increase collagen deposition.

Application of Platelet Rich Plasma has been evaluated in various medical disciplines including orthopaedics, sports medicine, and wound healing as well as cosmetic, plastic, maxillofacial and cardiothoracic surgery.

What can Platelet Rich Plasma (PRP) Do?

PRP is safe and effective treatment to accelerate wound healing for various injuries. The growth factors released by PRP will have beneficial effects to regenerate tissue, reduce pain and shorten healing time by 40 – 50%.

What Conditions are Platelet Rich Plasma (PRP) used for?

  • Cartilage degradation / worn out
  • Chondromalacia patellae
  • Osteoarthritis
  • Sports injury (e.g. tennis elbow, muscle/ligament tear, etc.)
  • Wound healing for surgeries

Suitability

PRP is suitable for almost everyone, however, patients with blood disorder or cancer are not recommended to undergo this treatment.

Benefits of Platelet Rich Plasma (PRP)

  • Accelerates wound healing, with shorter downtime, allows patient to return to activities of daily living sooner.
  • Significant reduction of pain through the acceleration of wound healing and activities of the growth factors.
  • With high concentration of leukocytes in PRP, it offers an antimicrobial effect, reducing the risk of infections
  • PRP is developed from Autologous blood, it is therefore inherently safe and free of transmissible diseases such as HIV and hepatitis.

Platelet Rich Plasma (PRP) Procedure

  1. A small amount of blood is drawn from the patient. This step will be similar to blood-taking for any other test.
  2. The blood drawn in this special tube will be centrifuge at high speed to isolate the PRP from red blood cells.
  3. When ready, the PRP will be reintroduced back to the same patient via injection.

When PRP is applied back into the same patient, there will be a release of growth factors which will help to accelerate healing and regeneration.

Ask our specialist today on how PRP can help you. Call (+65) 6471 2674 (24 Hour).