Enthesitis refers to inflammation at the entheses. The entheses are point of insertion sites where tendons and ligaments attach to bone.
Psoriatic arthritis can cause inflammation in the entheses, where the tendons or ligaments insert into a bone. Learn how enthesitis is diagnosed & treated.
Juvenile enthesitis-related arthritis includes swelling and pain where tendons and ligaments attach to bone. It affects more boys than girls.
Ankylosing spondylitis can cause heel pain and pain in the foot, which may be associated with enthesitis, also called hot spots.
Learn more about what causes enthesitis, enthesitis symptoms, how to treat enthesitis, and more.
Ankylosing spondylitis (AS) is a type of arthritis that primarily affects the back (spine) and produces pain and stiffness.
Foot pain is a common component of Ankylosing Spondylitis (AS) & other seronegative spondyloarthropathies (SpA- psoriatic arthritis, reactive arthritis). In AS/ SpA, the inflammation is predominantly at two locations- within the joints- synovitis & at the attachment of ligaments/ tendons to a bone (enthesitis) Let us have a look at the various causes of foot…
So whether you eat or drink, or whatever you do, do everything for the glory of God. (1 Coritnhians 10:31) Anyone who uses food or drink in such a way as to harm her/his health or damage the mental equipment needed for the fulfillment of her/his duties, is guilty of the sin of gluttony. It is incontestable that to eat or drink for the mere pleasure of the experience, which is also absolutely committing the sin of gluttony. Thus, unbalanced diet occurs as a result herein. In the United States, arthritis is a common health problem affecting more than 46 million people and resulting in disability for 19 million people. Among chronic diseases in the US, arthritis causes more disability than any other condition, including heart disease, diabetes, and back or spine problems. Rheumatoid Arthritis (RA) is the third most common type of arthritis behind osteoarthritis (prevalence 26.9 million) and gout (prevalence 6.1million). RA affects approximately 1.3 million in the US.[1] Conversely, in the United Kingdom, around 10 million people have arthritis. It affects people of all ages, including children.[2] While in the Philippines, Rheumatoid arthritis (RA) is one of the leading causes of significant burden among Filipinos, aside from asthma and cancer and about four times as many women as men have this disease, based on National Nutrition & Health Survey.[3] Arthritis is a common condition that causes pain and inflammation in a joint caused by bad diet, excess body weight, previous injury, to name a few. The important thing to remember is that, old or young, one must manage a safe and healthy life to elude arthritis or be attentive at the leading signs and symptoms of the disease so that the condition can be controlled in its most minimal stage and quality of life is well-kept-up.[4] Identifying the cause of arthritis can be tough, because often numerous factors[5] contribute to an individual developing this common problem, which include: Hereditary It is not well recognized by studies as to how much heredity or genetics contributes to the cause of arthritis. Nevertheless, there are probable genetic variations that can contribute to the cause of this common problem. Age Factor Cartilage becomes more brittle with age and has less of a capacity to repair itself. As people grow older they are more likely to develop arthritis. Nonetheless, it can occur at any age as a result of an injury and this is true to me wherein my arthritis started when I had an ankle sprain, or be associated with other joint-related conditions, such as gout or rheumatoid arthritis. Excess Body Weight As joint damage is partly dependent on the load the joint has to support, excess body weight can lead to arthritis. This is specifically true of the hips and knees that can be worn quickly in heavier patients. Past Injury Joint damage can bring about abnormalities in the normal smooth joint surface. Past major injuries can be part of its cause. An example of an injury leading to arthritis is a tibial plateau fracture, where the broken area of bone enters the cartilage of the knee joint. Job-related Vulnerabilities Workers in some particular professions seem to have a higher risk of developing arthritis than other jobs, primarily the high demand jobs like assembly line workers and heavy construction. Certain Prominent Sports It is hard to identify how much sports participation contributes to development of arthritis but undoubtedly sports participation can lead to joint injury and subsequent arthritis. Nevertheless, the benefits of activity likely prevail over any risk of arthritis. Ailment or Infection Individual who experience a joint infection (septic joint, which occurs when a bacterial infection occurs inside a joint space), multiple episodes of gout, or other medical conditions, can develop arthritis of the joint. Forms of Arthritis[6] 1). Gout It is a type of arthritis caused by too much uric acid in the body. This can be left in joints (usually affecting the big toe) but can develop in any joint. It causes intense pain, redness and swelling. 2). Osteoarthritis It most often develops in adults who are in their late 40s or older. It's also more common in women and people with a family history of the condition. However, it can occur at any age as a result of an injury or be associated with other joint-related conditions, such as gout or rheumatoid arthritis. It initially affects the smooth cartilage lining of the joint. This makes movement more difficult than usual, leading to pain and stiffness. Once the cartilage lining starts to roughen and thin out, the tendons and ligaments have to work harder. This can cause swelling and the formation of bony spurs, called osteophytes. Severe loss of cartilage can lead to bone rubbing on bone, altering the shape of the joint and forcing the bones out of their normal position. The most commonly affected joints are those in the: hands spine knees hips 3). Rheumatoid Arthritis Rheumatoid arthritis affects more than 400,000 people in the United Kingdom. It often starts when a person is between 40 and 50 years old. Women are three times more likely to be affected than men. Rheumatoid and osteoarthritis are two dissimilar conditions. The former occurs when the body's immune system targets affected joints, leading to pain and swelling. The outer covering (synovium) of the joint is the first place affected. This can later spread across the joint, which leads to further swelling and a change in the joint's shape. It may bring about the bone and cartilage to break down. Individuals with rheumatoid arthritis can also develop problems with other tissues and organs in their body. 4). Ankylosing spondylitis (AS) It is a long-term inflammatory condition that mainly affects the bones, muscles and ligaments of the spine, leading to stiffness and joints fusing together. Other problems can include the swelling of tendons, eyes and large joints. 5). Cervical spondylosis 5). Fibromyalgia It causes pain in the body's muscles, ligaments and tendons. 6). Lupus 7). Juvenile Rheumatoid Arthritis (JRA) 8). Psoriatic Arthritis 9). Enteropathic Arthritis 10). Reactive Arthritis Secondary arthritis – is a type of arthritis develops after a joint injury and sometimes occurs many years afterwards. 11). Polymyalgia Rheumatica Symptoms of arthritis The symptoms of arthritis that one experiences will vary depending on the type she/he has. Hence, it's important to have an accurate diagnosis if an individual has: Symptoms Joint aching, tenderness, swelling, soreness, or warmth Early morning stiffness Lowered ability on movement of the joints Mysterious weight loss, fever, or weakness related with joint pains. Inflammation in and around the joints Warm, red skin over the affected joint weakness and muscle wasting Arthritis and children Arthritis is often linked with older people, but can also affect children. Most types of childhood arthritis are known as Juvenile Idiopathic Arthritis (JIA). It causes pain and inflammation in one or more joints for at least six (6) weeks. Although the exact cause of JIA is unknown, the symptoms often improve as a child gets older, which means that they can lead a normal life. Different types of Juvenile Idiopathic Arthritis (JIA) Oligo-articular JIA - is the most common type of JIA, which affects fewer than five joints in the body, most commonly in the knees, ankles and wrists. It has good recovery rates and long-term effects are uncommon. Nevertheless, there's a danger that children with the condition may develop eye problems, so regular eye tests with an ophthalmologist (eye care specialist) are recommended. Polyarticular JIA (polyarthritis) - It affects five or more joints, which can develop at any age during childhood. Its symptoms are similar to adult rheumatoid arthritis. The condition is often associated by a rash and a high temperature of 38C (100.4F) or beyond. Systemic onset JIA - it begins with symptoms such as a fever, rash, lethargy (a lack of energy) and enlarged glands. Subsequently, joints can become swollen and inflamed. Like polyarticular JIA, it can affect children of any age. Enthesitis-related arthritis - is a type of juvenile arthritis that affects older boys or teenagers. It can cause pain in the soles of the feet and around the knee and hip joints, where the ligaments attach to the bone. Treating arthritis There's no cure for this condition, but there are many treatments that can help slow down the condition. For osteoarthritis, medications are often prescribed, including: painkillers non-steroidal anti-inflammatory drugs (NSAIDs) corticosteroids In severe cases, the following surgical procedures may be recommended: arthroplasty (joint replacement) arthodesis (joint fusion) osteotomy (where a bone is cut and re-aligned) Treatment for rheumatoid arthritis seeks to hold up the condition's progress and minimize joint inflammation or swelling. This is an attempt and prevention of damage to the joints. Recommended treatments include: analgesics (painkillers) disease modifying anti-rheumatic drugs (DMARDs) – a combination of treatments is often recommended physiotherapy regular exercise Excellent Foods For Arthritis While there is no diet treatment for arthritis, particular foods have been shown to fight inflammation, strengthen bones and boost the immune system. Adding the following foods to a balanced diet may help ease the symptoms of arthritis. Fish As particular types of fish are packed with inflammation-fighting omega-3 fatty acids, like salmon, tuna, mackerel and herring, it is recommended at least 3 to 4 ounces of fish, twice a week. Soy Soybeans (tofu or edamame)is heart-healthy, which are also low in fat, high in protein and fiber and an all-around good food. Oils Extra virgin olive oil is loaded with heart-healthy fats and oleocanthal, which has properties similar to non-steroidal, anti-inflammatory drugs. Avocado and safflower oils have cholesterol-lowering properties, whereas walnut oil has 10 times the omega-3s that olive oil has. Cherries Cherries help reduce the frequency of gout attacks. The anthocyanins found in cherries have an anti-inflammatory effect. Anthocyanins can also be found in other red and purple fruits like strawberries, raspberries, blueberries and blackberries. Dairy Low-fat dairy products, like milk, yogurt and cheese are packed with calcium and vitamin D, both found to increase bone strength. Vitamin D is essential for calcium absorption, which improves the immune system. Go for other calcium and vitamin D-rich foods like leafy green vegetables if dairy is not a choice. Broccoli Not only rich in vitamins K and C, but also contains a compound called sulforaphane, which prevents or slows the development of osteoarthritis (OA). It is also rich in calcium, which is known for its bone-building benefits. Green (Tea) It is loaded with polyphenols, antioxidants which are believed to reduce inflammation and slow cartilage damage. Another antioxidant in green tea called epigallocatechin-3-gallate (EGCG) prevents the production of molecules that cause joint damage for individuals with rheumatoid arthritis (RA). Citrus Citrus fruits (like oranges, grapefruits and limes) are rich in vitamin C which prevents inflammatory arthritis and maintaining healthy joints with osteoarthritis (OA), when getting the right amount of its vitamins. Grain Whole grains reduce levels of C-reactive protein (CRP) in the blood. CRP is a indicator of inflammation related with heart disease, diabetes and rheumatoid arthritis. Oatmeal, brown rice and whole-grain cereals are outstanding sources of whole grains. Beans Beans are packed with fiber, a nutrient that reduces CRP. It is also an excellent and easy on the pocket source of protein, significant for muscle health. Some beans like red beans, kidney beans and pinto beans are rich in folic acid, magnesium, iron, zinc and potassium, all known for their heart and immune system benefits. Garlic Individuals who regularly ate foods from the allium family like garlic, onions and leeks have fewer signs of early osteoarthritis (OA). The compound diallyl disulphine found in garlic may control cartilage-damaging enzymes in human cells. Nuts Nuts are rich in protein, calcium, magnesium, zinc, vitamin E and immune-boosting alpha linolenic acid (ALA), as well as filling protein and fiber. They are heart-healthy and beneficial for weight loss. Try walnuts, pine nuts, pistachios and almonds. Respect for Health (Catechism of the Catholic Church) Life and physical health are precious gifts entrusted to us by God. We must take reasonable care of them, taking into account the needs of others and the common good. (CCC 2288) Concern for the health of its citizens requires that society help in the attainment of living-conditions that allow them to grow and reach maturity: food and clothing, housing, health care, basic education, employment, and social assistance. If morality requires respect for the life of the body, it does not make it an absolute value. It rejects a neo-pagan notion that tends to promote the cult of the body, to sacrifice everything for its sake, to idolize physical perfection and success at sports. By its selective preference of the strong over the weak, such a conception can lead to the perversion of human relationships. (CCC 2289) The virtue of temperance disposes us to avoid every kind of excess: the abuse of food, alcohol, tobacco, or medicine. Those incur grave guilt who, by drunkenness or a love of speed, endanger their own and others' safety on the road, at sea, or in the air. (CCC 2290) The use of drugs inflicts very grave damage on human health and life. Their use, except on strictly therapeutic grounds, is a grave offense. Clandestine production of and trafficking in drugs are scandalous practices. They constitute direct co-operation in evil, since they encourage people to practices gravely contrary to the moral law. (CCC 2291) References: [1] RA Statistics, https://rheumatoidarthritis.net/what-is-ra/ra-statistics/ [2] Arthritis, National Health Service, England, http://www.nhs.uk/Conditions/Arthritis/Pages/introduction.aspx [3] Frost & Sullivan, Rheumatoid Arthritis Therapeutics in Philippines, https://www.frost.com/prod/servlet/press-release.pag?docid=165360079 [4] Phil Rheuma, IS ARTHRITIS JUST AN OLD MAN’S SCOURGE? Posted on August 31, 2014, https://rheumatology.org.ph/2014/08/31/theres-more-to-arthritis-than-being-an-old-mans-scourge/#more-65 [5] Jonathan Cluett, MD - Reviewed by a board-certified physician. Updated July 20, 2016, What Are The Causes of Arthritis?, https://www.verywell.com/does-sports-participation-cause-arthritis-2549246 [6] Arthritis, http://www.thefilipinodoctor.com/condition-details.php?name=Arthritis&id=156
