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The symptoms of juvenile rheumatoid arthritis (JRA) may take several weeks or months before they are noticeable. Children may experience joint pain or swelling but might not complain about it. Some may have stiffness, especially early in the morning or after a nap. A child with an affected knee may limp in the morning but get better later in the day.

The signs and symptoms may vary from day to day, or even within one day. Certain eye problems associated with JRA may have no symptoms.

The most common symptoms associated with JRA include:

* Joint pain, swelling or stiffness. A joint must be swollen for at least six weeks to be considered for a diagnosis of JRA.
* Muscle aches. Usually affect muscles throughout the body, and not just one part.
* Recurrent fevers. High fevers that come and go occur with systemic JRA. Low-grade fevers are common with polyarticular JRA.
* Skin rash. A pink rash occurs with systemic JRA.
* Rheumatoid nodules. Painless lumps under the skin at the elbows and feet may be found in some children with polyarticular JRA.
* Eye problems. Redness, eye pain and sensitivity to light may occur in children with some forms of polyarticular JRA.
* Swollen lymph nodes. These may occur in children with systemic JRA.
* Weight loss. Weight loss may be unexplained or may occur because the child does not feel like eating.

Some children do not complain of pain, but parents or others may notice other signs of illness. Some JRA signs that parents may notice include:

* Limping or other gait disturbances, especially in the morning. This can be an early sign due to involvement of a knee joint.
* Reluctance to use an arm or leg.
* Reduced activity level.
* Changed dental or eating habits as a result of jaw pain, dental pain or orofacial pain.

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Juvenile rheumatoid arthritis (JRA) is divided into three categories, which are characterized by the number of joints and other body systems affected. These categories are:

* Pauciarticular JRA. This form involves four or fewer joints. It is the most common form of JRA and affects half of the children with the disease, according to the National Institutes of Health (NIH). Pauciarticular JRA usually involves the larger joints, such as the knee, ankle, wrist or shoulder. It usually occurs asymmetrically, affecting a joint on only one side of the body (e.g., one knee). Children with pauciarticular JRA frequently have eye inflammations.

* Polyarticular JRA. This form affects five or more joints and is more common in girls than boys. It involves the small joints in the fingers and hands, and usually occurs symmetrically, in the same joints on both sides of the body. The knees and hips are also commonly affected. Some children may have jaw pain, which can cause discomfort when chewing and may affect eating habits. Polyarticular JRA is more severe and may also include eye inflammations. It affects about 30 percent of children with JRA, according to the NIH. Some children with polyarticular JRA actually have adult rheumatoid arthritis that develops at an early age.

* Systemic JRA (Still’s disease). Systemic JRA affects about 20 percent of the children with JRA, according to the NIH. It can affect many body systems and have other symptoms, such as fever and rash, that may appear several months before any joint pain. Systemic JRA can cause inflammation of the heart (pericarditis) and lungs (pleuritis) and can enlarge the liver, spleen or lymph nodes. Flare-ups may occur after a child has a viral infection, such as chicken pox. Systemic symptoms may disappear in adulthood, but the arthritis may persist. The development of systemic JRA later in life is known as adult-onset Still’s disease.

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Juvenile rheumatoid arthritis (JRA) is a form of arthritis that affects children, usually before the age of 16. JRA involves inflammation and stiffness in a joint that lasts for more than six weeks. The joint may be red, swollen and sore, although the child may not complain of joint pain.

JRA is the most common form of juvenile arthritis. It may affect one joint or many joints. Like the rheumatoid arthritis that affects adults, JRA is a systemic disease and may also affect other systems in the body. Other than the joints, the eyes are the most common area affected. Some forms of JRA may also affect the skin and other organs such as the heart, lungs, liver and spleen.

An estimated 11,700 to 69,000 American children have JRA, according to the Centers for Disease Control and Prevention (CDC). JRA usually does not develop in infancy but can develop any other time in childhood. Certain types more commonly develop among 6- to 8-year-olds, whereas others occur in teenagers.

Juvenile rheumatoid arthritis affects the joints, where two or more bones meet. There are several types of joints. Arthritis occurs mostly in synovial joints, which can move, such as those in the hands, wrists, ankles, knees and feet. For each synovial joint, a space enclosed by the ligaments and adjoining bones forms a cavity called the joint capsule. The outer layer of the capsule is formed by a fibrous membrane.

The inside of the capsule is lined with a membrane called the synovium. This membrane secretes synovial fluid, which fills the joint capsule and provides lubrication. The ends of the bones encased in the capsule are cushioned in soft cartilage. The cartilage and synovial fluid permit the bones to move without rubbing against each other.

JRA is an autoimmune condition, which means patients have an abnormal immune response. Normally, the immune system protects the body from outside invaders, such as germs. Immune cells, such as white blood cells, attack these invaders and flush them out or make them inactive. Part of this process normally produces some inflammation in tissue.

For someone with autoimmune response, the immune system misidentifies normal body tissue as an outside invader. It attacks the tissue and tries to destroy it. In JRA, certain types of white blood cells attack parts of the synovium, causing the inflammation that characterizes JRA. The synovium then thickens, which causes the joint to swell. The synovium can form a body called a pannus, which has granular tissue that covers the bone and cartilage. The pannus tissue reacts with proteins called enzymes and erodes the bone surface.

The specific cause of JRA is not well understood. Although the immune system attacks the tissue in the joints, no one knows what triggers such an attack. Some researchers think that a genetic component is involved that makes a child more susceptible to developing JRA, but that some outside factor (e.g., viral infection) or a combination of factors trigger the initial inflammation.

JRA develops in several forms, which may affect a few joints in the body or many joints. Joints commonly affected by JRA include:

* Hips, knees and ankles
* Shoulders, elbows, wrists and hands
* Anatomy of the spine includes the cervical spine, thoracic spine, lumbar spine and sacral region.Neck
* Lower spine
* Jaw

All forms of arthritis may cause joint pain and swelling. Such joint changes in JRA may affect the growth and proper development of bones in children.

Many children with JRA also experience inflammations in the eye. Some of the inflammations involve the uveal tract, the middle layer of the eye that includes the iris, ciliary body and choroid. Some of these inflammations may not have symptoms but can cause vision problems if left untreated. Some children also develop recurrent rashes. The most severe cases of JRA can affect the heart, lungs, spleen, liver and lymph nodes.

The course of JRA may vary. Some children may have mild joint pain for a few months or a year. For others, the symptoms are recurrent over years and may affect their activity levels and result in frequent absences from school. Children may be reluctant to exercise or participate in activities because of pain.

Most children eventually outgrow JRA and are not affected by it as adults. Some patients may experience joint problems as adults, especially if their bones were affected during a growth period. If the inflammation of joints is not stopped, it can destroy the inflamed joints. About 75 percent of children with JRA enter remission eventually with a minimal loss of function and deformity, according to the National Institutes of Health. Other cases of JRA may actually be the adult form of rheumatoid arthritis starting at an early age.

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Juvenile rheumatoid arthritis (JRA) is a condition in children that involves joint pain and inflammation for more than six weeks. It is the most common chronic arthritis in children. Girls are affected twice as often as boys.

The cause of JRA is not well understood. It is an autoimmune disease, which means the immune system attacks normal body cells in the joints. This causes inflammation and pain in the joints. Although the immune response may trigger the inflammation, it is not known what causes the immune system to do so.

JRA may affect only a few joints, frequently the knees or hips. Other types of JRA affect many joints and other systems in the body as well. Many children with JRA may have inflammation in the eyes, which requires regular monitoring because it might not produce symptoms.

Physicians may use multiple blood tests and a physical examination to diagnose JRA. JRA cannot be cured although most children outgrow the symptoms when they reach adulthood. Treatment concentrates on pain relief and protecting growing joints. Drug treatment may include pain relievers and anti-inflammatory drugs. Other drugs modify the disease progress or work on parts of the immune system that malfunction to trigger JRA.

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In about half of all sarcoidosis cases, the disease is detected by a routine chest x-ray before any symptoms develop. A general physician may refer patients to a specialist dealing in whichever organs are affected by the disease, such as a lung specialist (pulmonologist) for lung involvement.

The physical will review the medical history and perform a physical examination, which sometimes reveals swelling of salivary glands or lymph nodes in the neck. A series of laboratory tests and imaging tests may be ordered. Sarcoidosis is diagnosed only after other diseases with similar symptoms (e.g., rheumatoid arthritis, fungal infection, tuberculosis) have been ruled out.

The American Thoracic Society recommends a comprehensive initial evaluation, including:

* History, including occupational and environmental exposure
* Physical examination
* Chest x-ray
* Pulmonary function tests (breathing tests)
* Blood tests, including complete blood count and calcium and liver enzyme tests
* Urine tests
* Electrocardiogram (EKG)
* Eye examination
* Tuberculin skin test

Most physicians recognize the following criteria for a diagnosis of sarcoidosis:

* Spotting characteristic signs and symptoms of the disease and/or abnormalities in a chest x-ray.
* Ruling out infection, particularly tuberculosis and histoplasmosis (fungal infection usually seen in the lungs).
* Biopsy of granulomas (collections of inflammatory cells) that are not encasing foreign particles. A biopsy may not be performed if other findings are highly suggestive of sarcoidosis.

During a physical examination, a physician looks for symptoms of sarcoidosis and checks for other possible causes of the symptoms found. Laboratory and imaging tests typically follow. These tests include:

* Chest x-ray. Radiation is used to produce images of tissues inside the chest. According to the National Institutes of Health, about 90 percent of people with sarcoidosis will have an abnormal chest x-ray. Granulomas, which appear as distinctive shadowing in the lungs, and enlarged lymph nodes at the place where the lungs meet the heart or to the right of the trachea (windpipe) may be observed. When other characteristics of sarcoidosis, such as erythema nodosum (tender or painful discolored bumps on the shins), also appear, the chest x-ray may be all that is needed for diagnosis.  A staging system is used depending upon the extensiveness of the disease on chest x-ray.

* Biopsy. Tissue is removed for laboratory examination. A biopsy of affected tissue reveals granulomas without encased germs or particles, which is very accurate. The sample used for biopsy can come from any affected organ and only one sample is necessary. The most convenient sources for tissue samples are skin lesions, enlarged lymph nodes close to the skin and granulomas on the conjunctiva (membrane over the eye and below the eyelid). Samples may also be taken from the lungs, liver or muscles.

* Pulmonary function tests. A device called a spirometer is used to evaluate lung function. The patient inhales and exhales into a tube, which records certain lung capacities. These tests are safe and easy, and their results are typically compared over time to monitor the disease. Various factors are measured in these tests, including:
- Lung strength. How much and how fast a person can blow air out of the lungs after taking a deep breath. Will be below normal if there is inflammation or scarring in the lung.
- Lung volume. How much air the lungs can hold. In some patients with sarcoidosis, the lungs may shrink and lung volume will be smaller than normal.
- Diffusing capacity. How well a gas moves into the bloodstream from the lungs. Sarcoidosis makes diffusion of oxygen from the lungs into the bloodstream more difficult.

In addition, a painless sensor called a pulse oximeter can be placed on the finger to estimate the level of oxygen in the blood.

* Blood tests. Numerous blood tests may detect different factors involved in sarcoidosis. For example, one test can reveal an elevated level of the gamma globulin antibody, which is common in black Americans with sarcoidosis. Other blood tests performed include:
- Complete blood count. Measures the numbers of red blood cells, white blood cells and platelets. Sarcoidosis often involves an insufficiency of white blood cells (leukopenia) and platelets (thrombocytopenia).
- Sedimentation rate. Detects inflammation in the body, which may be elevated for sarcoidosis.
- Enzyme tests. May test for several elevated enzymes, including angiotensin converting enzyme (ACE), which is produced in the granulomas. This test is positive in 60 percent of patients with sarcoidosis.  Enzyme tests may be repeated after treatment to monitor relapse. Some tests indicate the levels of certain enzymes in the liver.
- Calcium test. Hypercalcemia (too much calcium in the blood) plays a larger role in deciding if treatment is needed because concentrations of calcium can build up and cause complications, particularly in the liver and kidneys. Prolonged hypercalcemia can also weaken bones and lead to osteoporosis. Calcium and other minerals can be measured in an electrolyte panel.
- Rheumatoid factor test. May be positive for sarcoidosis patients.
- Blood gases. Blood from an artery may measure levels of oxygen in the blood and help determine the level of lung function. Blood levels of carbon dioxide may also be tested.

* Urine tests. A urine analysis can detect hypercalciuria (too much calcium in the urine).

* Electrocardiogram (EKG). Measures electrical activity of the heart. An EKG may be used to detect arrhythmias (irregularities in heartbeat) that may occur if sarcoidosis affects the heart.

* Eye examinations. General physicians typically refer patients to an ophthalmologist (eye specialist) for eye tests even if there are no symptoms in the eyes. Ophthalmologists look into the eyes for abnormalities and test for color blindness and other vision troubles. Results can help in monitoring sarcoidosis and are likely to be repeated, particularly if certain drugs are being used.

* Tuberculin skin test. A skin test used to determine if tuberculosis is present. If it is, sarcoidosis can be ruled out.

* Bronchoscopy. A long, narrow, flexible tube (bronchoscope) is inserted into an airway of the lung. This allows physicians to examine the lung tissues and makes certain tests possible, including:
- Bronchoscopy biopsy. A sample of lung tissue is removed for laboratory analysis during bronchoscopy. This may assist in diagnosis when pulmonary function tests and chest x-rays are abnormal and characteristic of sarcoidosis, but no more easily accessed organs seem to be affected. It is usually very safe and performed as an outpatient procedure, with the patient mildly sedated.
- Bronchoalveolar lavage (lung wash). During bronchoscopy, saline (salt water) is injected into a region of lung and suction is used to remove it. The fluid contains washed-out cells and other materials from inside the lungs that are examined for signs of inflammation, such as a large number of white blood cells. However, these findings are not unique to sarcoidosis.

* Mediastinoscopy. A physician removes a sample of lymph nodes for biopsy from the mediastinum (space between the lungs) using one or more small incisions. Risks of this include bleeding, temporary hoarseness and an adverse reaction to the anesthetic.

* Other imaging tests. May be performed when a diagnosis is uncertain or an affected organ is difficult to reach with a biopsy. These tests include MRI, CAT scan and radionuclide imaging. An MRI can also detect early stages of cardiac damage caused by sarcoidosis, researchers have found.

* Kveim-Siltzbach test. A standardized preparation of sarcoidosis-affected tissue is injected into the skin. The test is positive if a lump forms and biopsy of the lump reveals granulomas. However, it is not always positive, even when sarcoidosis is present. This test is not readily available in the United States and is rarely performed.

Physicians will also check for certain other conditions that may cause symptoms similar to sarcoidosis. These conditions include:

* Tuberculosis
* Histoplasmosis
* Lymphoma (lymph cancer)
* Rheumatoid arthritis
* Rheumatic fever
* Exposure to toxic substances, such as the metallic element beryllium

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Also called: Arthritic Rheumatoid Disease, PMR, Anarthritic Syndrome

Polymyalgia rheumatica (PMR) is an essentially benign (not life-threatening) inflammatory disease characterized by pain and stiffness in the muscles in and around the neck, shoulders and hips. It may develop rapidly but usually goes away over several years, even without treatment. With treatment, symptoms typically disappear in less than a week.

PMR may occur along with temporal arteritis, a condition that causes arteries, particularly those in the head, to swell. It is not known how or why PMR and temporal arteritis are connected, but temporal arteritis can potentially be life-threatening and is typically tested for along with PMR.

The cause of PMR has not been identified, but white women over the age of 50 are most commonly affected. Theories on the possible causes of PMR include links to genetics, aging, climate and viral infections.

Muscle pain and morning stiffness are the characteristic symptoms of PMR. Other symptoms include arthritis, joint swelling, edema (swollen tissue) and flu-like symptoms (e.g., general weakness, feeling of being unwell, loss of appetite).

PMR is a clinical diagnosis, mainly a diagnosis of exclusion, meaning other conditions should be ruled out. The only blood test found positive is the sedimentation rate (sed rate). Most physicians agree that the following criteria must be met for diagnosis of PMR:

* Patient over age 50.
* Aching and stiffness on both sides of the body that lasts at least 30 minutes and persists for at least one month.
* Sed rate over 40 millimeters per hour. This blood test detects inflammation by measuring the rate at which red blood cells fall in blood plasma.

Some physicians add another requirement – that symptoms respond quickly to corticosteroids. Also, other conditions that may cause the necessary criteria (e.g., rheumatoid arthritis, fibromyalgia, polymyositis) must be ruled out.

PMR is typically treated with low-dose corticosteroids, which eliminate symptoms quickly. Once symptoms disappear, the dose is reduced to the lowest effective dose and treatment with this drug is eventually ended. However, if the dosage is reduced too quickly or treatment is ended too soon, a relapse may occur.

PMR affects less than 1 percent of the U.S. population over the age of 50, according to the National Institutes of Health.

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Because of limited clinical research, the causes of myofascial pain syndrome (MPS) are not thoroughly understood. However, physicians have identified several factors that can lead to the development of one or more trigger points (TrPs) resulting in chronic musculoskeletal pain. These include:

* Trauma to the musculoskeletal tissues (e.g., muscles, ligaments, tendons, bursae)
* Repetitive motion injuries, such as bursitis or tennis elbow
* Poor posture and ergonomics
* Skeletal asymmetry (e.g., gait disturbances such as leg-length discrepancies, short upper arms)
* Sedentary lifestyle
* Nervous tension or stress
* Clenching or grinding the teeth (bruxism)
* Sleep deprivation
* Nutritional deficiencies (e.g., low levels of calcium, potassium, iron and vitamins C, B1, B6 and B12)
* Hormonal changes, such as occurs during menstruation and menopause
* Chilling areas of the body (e.g., sitting under an air conditioning vent for long periods of time)
* Alcohol
* Smoking cigarettes
* Overexertion

Additionally, many chronic illnesses may activate TrPs, such as:

* Viral or bacterial infections
* Inflammatory diseases including:

- Rheumatoid arthritis. Inflammation of the joints that can lead to damage, pain and reduced movement.
- Fibromyalgia. A rheumatic condition characterized by widespread pain in the joints, muscles, tendons and other soft tissues, among other symptoms. MPS can also co-exist with fibromyalgia.
- Appendicitis, gallbladder or stomach inflammation.
- Lupus. An autoimmune disorder that can affect many systems, including the skin, joints and internal organs.

* Other conditions, such as abnormal levels of blood sugar (e.g., diabetes, hypoglycemia), heart attack, hyperuricemia (buildup of uric acid in the blood, associated with gout and kidney stones), and hypothyroidism (underactive thyroid gland).

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Certain conditions are commonly associated with fibromyalgia, though their exact links to the condition are not well understood.

The following conditions often appear along with fibromyalgia:

* Irritable bowel syndrome (IBS). Characterized by frequent abdominal pain, bloating and episodes of alternating constipation and diarrhea. More than half of all fibromyalgia patients suffer from this condition.

* Migraines. Many people with fibromyalgia also suffer migraines and other headaches. Researchers have found that a common link may be problems with a brain chemical called serotonin and adrenal hormones such as cortisol or adrenergic nerve fibers.

* Restless legs syndrome and periodic limb movement disorder. Characterized by uncontrollable contractions of the calf muscles and leg muscles that twitch, ache or feel like pins and needles. Many fibromyalgia patients experience this source of leg pain.

* Raynaud syndrome. Characterized by episodes of whitish and bluish discoloration of the fingers and toes, associated with tingling sensations, numbness or pain and the subsequent redness of the affected areas. It is usually triggered by cold temperatures and strong emotions. Researchers have reported that nearly half of all fibromyalgia patients suffer from this disorder.

* Urethral syndrome. Characterized by the often severe urge to urinate without an identifiable cause, such as infection. Often associated with urinary frequency and pelvic pain.

* TMJ disorder. Commonly associated with fibromyalgia. It is characterized by:

- Jaw and facial pain or tenderness
- Limited jaw movement
- Clicking, snapping, or popping sounds while opening and closing the mouth
- Pain within the facial or jaw muscles, as well as in or around the ear
- Headaches

* Rheumatoid arthritis. A chronic disease primarily characterized by persistent inflammation of the joints, resulting in discomfort, pain, swelling and potential deformity of the affected joints. Fibromyalgia does not involve inflammation or deformity but may exist with rheumatoid arthritis. In fact, rheumatoid arthritis patients are more likely to develop fibromyalgia.

* Immune dysfunction. Fibromyalgia may cause a dysfunction with the immune system, making patients more susceptible to infections.

A great deal of controversy remains as to the relationship between fibromyalgia and certain similar disorders. Two disorders seem particularly linked to fibromyalgia, although physicians and researchers disagree on whether these links are substantiated:

* Chronic fatigue syndrome (CFS). A condition characterized by excessive fatigue that seriously impairs the patient’s ability to function. Many physicians believe that fibromyalgia and CFS may be different manifestations of the same underlying disorder. Both conditions share a large number of symptoms (e.g., headache, fatigue, pain) and similar physical abnormalities (e.g., reduced blood flow to key areas of the brain). Also, brain scans of fibromyalgia and CFS patients display very little difference. The most prominent difference lies in whether pain or fatigue is the most dominant symptom. Although fibromyalgia is the more common of the two, more than half of those diagnosed with fibromyalgia also fulfill the criteria for CFS.

* Myofascial pain syndrome (MPS). A chronic disorder characterized by pain and tenderness confined to a specific body region, such as the neck and shoulders. Many researchers have suggested that this may be a localized or regional form of fibromyalgia.

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What Is Rheumatoid Arthritis?

Rheumatoid arthritis, or RA, is a systemic inflammatory disease that causes pain, stiffness, swelling and loss of motion in the joints. It is an autoimmune disease – one of many in which, for unknown reasons, a person’s immune system attacks his or her own body tissues. In RA, the immune system attacks the synovium, which is the tissue that lines the joints, causing inflammation in and overgrowth of this tissue.

How Do I Know If I Have RA?

The symptoms of RA vary from person to person and can mimic those of other inflammatory joint conditions, sometimes making the diagnosis difficult. Common RA symptoms include:

* Tender, warm, swollen and stiff joints, often first noticed in the hands and feet and usually symmetrical, e.g., both wrists are affected at the same time.
* Stiffness and pain that are usually worse after waking in the morning and last at least an hour before improving, which occurs with use and motion.
* Symptoms like tiredness, low-grade fever, weight loss and a general feeling of malaise that may develop even before the onset of joint symptoms.
* Systemic effects on other parts of the body such as the tear and salivary glands, lungs, heart and blood vessels.
* Soft lumps called rheumatoid nodules that range in size from a pea to a walnut, which occur in 20 to 30 percent of people with RA.

How Is RA Treated?

RA patients use a combination of treatments to relieve pain, improve mobility and slow down or perhaps even stop damage to the joints. A treatment plan may include:

* Lifestyle modifications: exercise, stress reduction, healthful eating
* Medications including non-steroidal anti-inflammatory drugs (NSAIDs), steroids, disease-modifying anti-rheumatic drugs (DMARDs), and biologic therapies
* Physical therapy
* Surgery to repair damaged joints
* Alternative and complementary therapies such as acupuncture, massage or biofeedback for pain control

Sports-related activities as well as falls and other trauma can injure the cartilage within a joint and, if it is not provided sufficient time to heal, chronic pain and persistent disability can follow. These activities and incidents may increase the risk of osteoarthritis, especially if there’s impact involved or there’s the risk of injury to ligaments. Additionally, damage to the bone surface can start a biological process that results in joint degeneration. This in turn, often leads to rheumatoid arthritis or osteoarthritis.

Arthritis is often a chronic disease meaning it can affect the person afflicted over a long period of time. It cannot be cured, but it can be treated through a variety of methods and products. Learning how to manage your joint pain over the long term is an important factor in controlling the disease and maintaining a good quality of life. This is a brief overview of some of the methods that arthritis sufferers can use to alleviate many of the symptoms associated with arthritis, especially joint pain. Products, both prescription and over-the-counter, for relieving arthritic joint pain are described in Joint Pain Products.

Heat and cold

Heat and/or cold therapy is not recommended to alleviate symptoms associated with all types of arthritis and as such, the decision whether to use it or not should be discussed with your doctor or physical therapist. If your care provider determines that the use of heat and/or cold is appropriate for use on your arthritis pain, it must be determined which kind of temperature treatment should be used. Moist heat, such as a warm bath or shower, or dry heat, such as a heating pad, placed on affected joint for about 15 minutes may relieve the pain. An ice pack or bag of frozen vegetables wrapped in a towel and placed on the sore area for about 15 minutes may help to reduce swelling and stop the pain. If you have poor circulation, do not use cold packs.

Joint protection

In order to relieve the stress of everyday activity on an afflicted joint, which can exacerbate the condition and may lead to additional injury, a splint or brace can be used to allow joints to rest and keep them from being used. As with many other treatments, a medical care provider such as a physician or physical therapist can make recommendations and possibly provide you with the brace.

Massage

Massage is associated with temporarily relieving joint pain, one of the major symptoms associated with arthritis, rather than treating the underlying cause of a loss of cartilage. A massage therapist will typically lightly stroke and/or knead the muscles around the joint, which increases blood flow to the stressed area. It is important to realize that arthritic joints are very sensitive, so the massage therapist must be familiar with the disease and problems associated with the affected joints.

Exercise

Low-impact exercises such as stretching exercises, swimming, walking, low-impact aerobics, and range-of-motion exercises may reduce joint pain and stiffness while increasing joint mobility. A physical therapist or gym trainer can help plan an exercise program that will give you the most benefit with the least stress on the arthritis-stressed joints.

Weight Reduction

In addition to alleviating some symptoms, the weight loss associated with an exercise program is beneficial in relieving the extra stress that extra pounds put on weight-bearing joints such as the hips and knees. Studies have shown that overweight women who lost approximately 10 pounds substantially reduced the development of osteoarthritis in their knees. In addition, these studies suggested that if osteoarthritis has already affected one joint such as the knee or hip, weight reduction would reduce the chance of it occurring in the other knee or hip. A physical therapist or gym trainer can help plan an exercise program that will give you the most benefit with the least stress on the arthritis-stressed joints.

Transcutaneous electrical nerve stimulation (TENS)

Transcutaneous electrical nerve stimulation uses a small devi ce that is placed near the joint afflicted with arthritis and directs mild electric pulses to nerve endings in and around the arthritic joint. It is theorized that TENS blocks the pain messages sent to the brain from the nerves and modifies the body’s perception of pain. Although TENS relieves some joint pain associated with arthritis, it doesn’t offset the joint inflammation that is associated with arthritis.

Surgery

In some extreme cases of persons with arthritis, surgery may be necessary. The surgeon may perform an operation to remove the synovium, realign the joint, or in extreme cases, replace the damaged joint with an artificial one. Total joint replacement provides not only dramatic pain relief but also significant improvement in joint motion and mobility for many people with arthritis.

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