The Rise Of Arthritis In The Young Population

Arthritis is often thought of as a disease that is only characteristic of elderly people, but more and more are being diagnosed at younger ages, even for young people, like teenagers but not too much time after the teenage period. This uptick is alarming, underscoring the importance of education, early intervention and lifestyle changes to control and potentially avoid its deadly consequences.

Lifestyle Factors:

Lifestyle changes have been a major factor in the rise of arthritis among young people. Leading causes include sedentary behaviour, unhealthy diet, and obesity (console and at) Being overweight adds stress to joints, especially the knees and hips – weight-bearing joints — causing them to wear down faster than normal possibly bringing on osteoarthritis (OA) at an earlier age.

Sports and Physical Activity

Although exercise is good for the body and especially for the joints, high-impact activities or overtraining with a lack of sufficient recovery can result in injury to a joint. If neglected, injuries such as these can lead to the development of post-traumatic arthritis in young people later on. Hyper-competitiveness in youth sports is behind this growing number of injuries caused by overuse. When the joint is involved road traffic accidents also contribute to it.

Rheumatic aetiology may be genetic or environmental: Genetic predisposition is important for the occurrence of the autoimmune forms of arthritis (rheumatoid arthritis = RA, juvenile idiopathic arthritis = JIA). The gospels that have been diagnosed are the results of a combination of genetic and environmental factors, which, for example, can cause exposure to a certain virus or smoking in genetically susceptible individuals.

Juvenile Rheumatoid Arthritis (JRA), now more commonly referred to as Juvenile Idiopathic Arthritis (JIA), is the most prevalent type of arthritis affecting children and adolescents under the age of sixteen. It is a chronic inflammatory condition that can lead to joint damage, growth abnormalities, and significant impacts on a child's quality of life if not properly managed.

There are several subtypes based on symptoms, the number of joints affected, and the presence of certain antibodies.

Oligoarticular JIA: 

Affects four or fewer joints, often larger ones such as knees and ankles. It is the most common form and may lead to eye inflammation (uveitis).

Polyarticular JIA: 

Involves five or more joints and resembles adult rheumatoid arthritis. It can affect both small and large joints and may involve the neck and jaw.

Systemic JIA: 

Characterised by systemic symptoms such as fever, rash, and inflammation of internal organs, in addition to joint involvement.

The common symptoms are persistent joint pain, swelling, and stiffness, particularly in the morning or after periods of inactivity.

There can be associated fever, fatigue, and weight loss. Sometimes growth disturbances occur due to prolonged inflammation and corticosteroid use.

Eye inflammation can occur, which requires regular ophthalmologic evaluation.

It is an autoimmune disorder, where the immune system mistakenly attacks the body's own tissues, leading to inflammation in the joints.

Diagnosis involves a combination of clinical evaluation, laboratory tests, and imaging tests.

The goal of treatment is to control inflammation, relieve symptoms, prevent joint damage, and maintain function and quality of life.

There are Nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs) like methotrexate, and biologic agents such as TNF inhibitors which help.

Physical Therapy to maintain joint function and muscle strength is very crucial.

Occupational Therapy to assist with daily activities and recommend adaptive aids if necessary helps the quality of life.

Surgery is rarely needed but may be considered in severe cases to correct joint deformities or even replace damaged joints

With early diagnosis and appropriate treatment, many children with JIA can achieve remission and lead active, healthy lives. Regular follow-up and monitoring are essential to manage the condition effectively and address any complications as and when they arise

Awareness and Diagnosis: 

Better recognition and diagnostic capabilities are also making arthritis in younger people increasingly apparent. This insight could lead to earlier diagnosis and intervention, which may also help to prevent irreversible joint damage in the future.

Impact and Management:

Arthritis at a young age has significant repercussions on education, working life and quality of life. Diagnosis and treatment of the disease should be done as soon as possible.

Lifestyle modifications are used as management strategies by some, including maintaining a healthy weight and diet and doing regular exercise. Medical treatments can include physical therapy and medications to manage swelling and pain.

The increasing incidence of arthritis among youth can be countered by incorporating a comprehensive strategy which emphasises prevention through healthy lifestyles, early diagnosis and treatment provided through Orthopedic And Rheumatology inputs to improve outcomes in this category of patients.

Dr. Kiran Kharat

Guest Author Senior consultant Orthopedic surgeon Ruby Hall Clinic