Question: Good evening, Doctor. For some time now, I have been having swollen knee. It comes and goes.  The last time it happened, I visited the hospital, doctor said it arthritis. I was treated for malaria, I took injection that will make me urinate more, and he said I should stop salt.  The knee went down. Now since Friday, it came with full force, I can’t walk, have been using stool to walk. Yesterday I began to walk though with support. I’m treating it this time in a traditional way but it’s paining me. The knee is heavy, I cannot bend it. Please is there anything I can do and can I massage it like bending the knee? Please help me.

A: I believe that a doctor made the diagnosis of Rheumatoid Arthritis and that’s why you are sure that’s what you have. Over time, I have heard people use the term rheumatism (which is a lay term that is not really used in the medical world anymore) for osteoarthritis or rheumatoid arthritis. I will briefly describe both conditions.

Rheumatoid arthritis is an auto-immune condition. This means that in this situation, the body no longer recognizes components of itself and its immune system begins to fight itself. In other words, the body launches a war against itself!

In this instance, the body’s fight against itself leads to joint pain, swelling and stiffness, especially in mornings and can lead to permanent damage. It affects multiple joints, can involve multiple organs (eg lungs, heart, eyes etc) and there are usually nodules (small lumps known as rheumatoid nodules) found under the skin, especially the elbows. Some people are lucky and have long periods between flare-ups; others are not and have symptoms often. This disease is more common in people aged between 40 to 60 years, women and if a family member has it, it’s more likely one may also have it.

There is no cure as it is not clear why the body turns on itself. The focus is on management of the symptoms: Physiotherapy to keep the joints supple, medications to take care of the pain and inflammation and sometimes surgery for joint repair or replacement.

For anyone who has this condition, be sure to take your medications, eat healthy, exercise and learn to relax 😀

Now to osteoarthritis (OA), this is a more common type of arthritis. It would usually occur due to wear and tear (ageing) of the cartilage at the end of bones which allows free movement at the joints. The knees, hips, neck, lower back are usually affected and symptoms would include stiffness, pain and swelling. This disease is common in older people, women and the obese (clearly, being obese puts more stress on the weight bearing areas of the body like the knees etc), some types of occupation eg people who carry a lot of heavy loads are more likely to have osteoarthritis of the lower back. A family history of OA puts one at risk and having some diseases like Diabetes Mellitus makes one more at risk.

Where this disease affects the knee, it can lead to bow-leg and limping as the cartilage continues to wear away with even more wear and tear. Just like for RA, there’s no cure. Focus is on limiting pain and maintaining joint movement.

Treatment includes pain relief (using drugs in the class of ibuprofen or Paracetmaol), physiotherapy and sometimes, surgery. Injection of steroids into the joint space of affected joint has also been found useful but cannot be given too often.

Just like for RA, exercise, eat healthy, keep a healthy weight, use support (like walking stick) if need be etc

I hope this was helpful.

Have a good night, everyone 😀