Arthritis literally means joint inflammation in Singapore, which refers to the areas where two bones meet, such as the elbows and knees. Typical symptoms include pain, swelling, increased warmth and redness in one or more joints. In Singapore, osteoarthritis and rheumatoid arthritis are the most commonly encountered types of arthritis. However, there are many other forms, each with distinct causes, symptoms, and treatment approaches.
Osteoarthritis (OA): the most common form of arthritis and is more common in older people. It results in wear and tear on the joints, causing the breakdown of cartilage that cushions the ends of bones in a joint, leading to pain, stiffness, and decreased range of motion. The most common joints affected are the knees, hips, hands and spine.
Rheumatoid arthritis (RA): an autoimmune form of arthritis where the immune system attacks healthy joint tissues, typically affecting the hand, wrist and ankle joints. This leads to inflammation characterised by joint stiffness, pain, and swelling in affected joints. In cases where treatment is delayed, joint damage can ensue, resulting in irreversible joint deformities. Unlike osteoarthritis, which primarily affects older individuals, rheumatoid arthritis can affect people of any age.
Gout: a form of arthritis characterised by sudden, severe attacks of pain, along with redness and swelling, often affecting joints like the toes, ankles, and knees.
Psoriatic arthritis (PsA): an autoimmune condition that affects the joints and is associated with a skin condition known as psoriasis (scaly red and silvery skin patches).
Ankylosing spondylitis: also known as axial spondyloarthritis, is a type of arthritis that causes inflammation in the joints and ligaments of the spine and sacroiliac joints.
Reactive arthritis: a form of inflammatory arthritis that commonly affects the knees, feet, toes, hips and ankles. It occurs as a reaction to an infection, particularly after food poisoning or a sexually transmitted infection.
Juvenile idiopathic arthritis: refers to a group of chronic arthritis that affects children and adolescents, causing persistent joint inflammation.
Each type of arthritis has unique characteristics and may affect different joints or organ systems.
Arthritis-related joint pain can occur on any joint in the body.
What are the symptoms of Arthritis?
The symptoms of arthritis vary depending on the type of arthritis and the joints affected. However, common symptoms of arthritis include
Joint pain, swelling, and stiffness: inflammation of the joints can cause joint pain, swelling and stiffness. Pain may be persistent or intermittent, affecting one or more joints, which may be aching, throbbing, or sharp in nature. Swelling may be accompanied by warmth and redness in the affected joint, which can also be tender to the touch. Stiffness is often worse in the morning or after periods of inactivity.
Joint deformities: the affected joints may become deformed after a period of time in some forms of arthritis.
Muscle weakness: prolonged joint pain and limited mobility can cause muscle disuse around the affected joint. Over time, loss of muscle mass and weakness can occur.
Fatigue: many people with arthritis experience fatigue, resulting from the body's efforts to cope with inflammation and pain.
Fever (in some cases): arthritis, like rheumatoid arthritis and systemic lupus erythematosus (SLE), can be associated with fever and other systemic symptoms.
Skin changes (in some types): certain types of arthritis, like psoriatic arthritis, may have psoriasis (red, silvery skin patches).
Psoriatic arthritis is a common occurrence in individuals with psoriasis
Who is at risk of Arthritis in Singapore?
The risk of developing arthritis varies depending on the type of arthritis, but several common risk factors are associated with various forms of the condition. These risk factors include:
Age: osteoarthritis, the most common type of arthritis among Singapore's ageing population, is more likely to occur as people grow older. However, arthritis can affect individuals of all ages, including children (juvenile idiopathic arthritis) and adults (e.g., psoriatic arthritis/ RA).
Other health conditions: conditions like psoriasis and inflammatory bowel disease (IBD) (e.g., Crohn's disease) are associated with specific types of arthritis, such as psoriatic arthritis and IBD-related spondylarthritis.
How is Arthritis diagnosed?
The diagnosis of arthritis typically involves a combination of the following:
Medical history: a detailed medical history will be obtained. Your rheumatologist will ask about your symptoms, including the location and duration of joint pain, stiffness, and other relevant information. They will also inquire about your family history, previous injuries, and other medical conditions.
Physical examination: a physical exam assesses joint tenderness, swelling, warmth, and range of motion. Your joints may also be checked for signs of inflammation or deformities.
Laboratory tests: blood tests can help in diagnosing certain types of arthritis and ruling out other conditions. Common blood tests include:
Rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies: used to diagnose rheumatoid arthritis.
C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR): elevated levels of these markers in the blood can indicate inflammation, which may be associated with various types of arthritis.
Uric acid levels: elevated uric acid levels are a marker for gout.
Imaging studies: X-rays, magnetic resonance imaging (MRI), or computed tomography scans (CT scans) scans may be ordered to visualise the affected joints. These imaging tests can help assess joint damage, inflammation, and the extent of the condition.
Synovial fluid analysis: In some cases, a sample of synovial fluid (the fluid that lubricates the joints) may be extracted from the affected joint and analysed to diagnose conditions like gout or infectious arthritis.
What are the treatment options for Arthritis in Singapore?
The treatment options for arthritis in Singapore may include a combination of the following:
Medications: the type of medication prescribed depends on the form of arthritis that the individual has.
Physical and occupational therapy: physical and occupational therapy can help improve joint mobility, strengthen muscles, reduce pain, and help individuals with arthritis learn strategies to manage daily tasks and reduce joint strain.
Lifestyle modifications: lifestyle changes can complement medical treatment. Maintaining a healthy weight, regular exercise, and managing stress can help alleviate symptoms.Regular low-impact exercises like swimming, walking, or cycling can improve joint flexibility and strength.
However, the aforementioned treatment options are general guidelines. The specific treatment plan for arthritis will depend on the type of arthritis, its severity, and individual factors.
While arthritis cannot always be prevented, maintaining a healthy weight, staying physically active, protecting joints from injury, and managing underlying health conditions can help reduce the risk.
When should I see a doctor for joint pain?
If you experience persistent joint pain, stiffness, swelling, or reduced range of motion, it is advisable to consult a rheumatologist for evaluation. Early diagnosis and treatment are important in managing various forms of arthritis and related conditions to prevent further joint damage and improve quality of life.
Is exercise safe for people with arthritis?
Yes, exercise is generally safe and beneficial for people with arthritis when they opt for low-impact activities. It helps improve joint flexibility and strength while reducing pain. Consult a healthcare provider or physical therapist to develop a safe exercise plan.
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Dr Annie Law
Senior Consultant Rheumatologist
MB BCh BAO, MRCP (UK), MMed, FAMS (Rheumatology)
Dr Annie Law is an experienced Senior Consultant Rheumatologist and Medical Director at Asia Arthritis & Rheumatology Centre.
She leads subspecialty SLE clinics, showcasing her dedication to lupus care. Dr Annie Law has been duly recognised for patient-oriented care, earning multiple awards. Her extensive education includes FAMS (Rheumatology) and MRCP (General Medicine). Actively involved in lupus research, she established a lupus database and contributed to paramount protein therapy discoveries. Dr Law is a committed medical educator, holding faculty positions and receiving accolades for her teaching. Her impactful contributions extend to the professional organisation for rheumatology in Singapore exemplifying deep commitment to advancing rheumatology knowledge.
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