MAY 1, 2016
Arthritis, a disease affecting the joints, is one of the most common chronic conditions in the United States. More than one out of five American adults has been diagnosed with arthritis by a physician. While arthritis is commonly viewed as a condition affecting older adults – increased age is certainly a primary risk factor for the disease – arthritis can affect people of all ages, including children.
Arthritis causes pain, stiffness, and swelling in the joints, most commonly the hands, knees and spine. Some forms of arthritis can even affect the organs. May is Arthritis Awareness Month, a good time to discuss a disease which impacts more than 52 million adults in the United States.
Osteoarthritis
The most common type of arthritis is osteoarthritis. Especially prevalent in older people, osteoarthritis occurs when the cartilage in between joints wears down. Cartilage is a hard and slippery tissue that enables our bones to glide over one another when we bend our joints, such as the fingers, knees, elbows, toes and hips. Over time, the cartilage can deteriorate, causing bone to rub against bone and leading to pain, swelling and stiffness. The most commonly affected joints are the ones in the fingers closest to the nails, thumbs, lower back, knees, neck and hips.
While age and normal wear and tear are major contributing factors to cartilage loss and the onset of arthritis, there are other risk factors, as well. An injury to a joint can cause damage to the cartilage. Obesity is also a significant risk factor for arthritis in the knees, spine and hips. The extra weight causes added stress to these joints and can hasten cartilage loss. Finally, some types of arthritis can be hereditary, so family history plays a role, as well.
Osteoarthritis is characterized by pain and stiffness in the joints. Sometimes, redness and swelling may occur. As symptoms worsen, the arthritis can lead to a restricted range of motion. This can impact everything from a golf swing to a mundane household task, such as opening a jar.
It’s important to understand that osteoarthritis is more than just an inconvenience. According to the U.S. Centers for Disease Control and Prevention (CDC), arthritis is a leading cause of disability in the United States. CDC studies also suggest that arthritis may be an “unrecognized barrier” to properly managing other chronic conditions, including obesity, heart disease and diabetes. Since arthritis restricts motion and can make movement uncomfortable and painful, arthritic patients are less likely to engage in sufficient physical activity. The CDC found that obese adults with arthritis are 44 percent more likely to be physically inactive, compared with obese adults who do not have arthritis. In addition, 29 percent of patients who had both heart disease and arthritis were physically inactive, compared with 21 percent who had heart disease but not arthritis.
“Many people view arthritic symptoms as an inevitable side effect of getting older,” says Dr. Joe Todd, an Orthopedic Surgeon. “And while that may be true in some cases, it does not mean that those symptoms can’t be managed in a way that helps you maintain as much of your normal activity as possible.”
There is not a singular test used to diagnose osteoarthritis. Your physician will ask you about your symptoms in detail, conduct a physical examination of the affected joint and may order an x-ray or MRI. A blood test may also be done in order to rule out other possible causes of symptoms.
While there is no cure for arthritis, there are treatments that can ease the severity and frequency of symptoms. One of the best treatments for arthritis is exercise. Strength exercise – using weights or resistance bands – helps to strengthen the muscles that support the joints. Aerobic exercise improves your blood flow and helps to control weight.
“Controlling weight through a combination of a healthy diet and regular exercise is one of the best things someone can do to manage arthritis,” says Dr. Torrance Walker, M.D., an orthopedic surgeon. “Factoring in the benefits to your cardiovascular health and overall well-being, keeping the weight off will make a tremendous difference in your life.”
Physical activity must be properly balanced with rest, one of the most important factors in relieving arthritis symptoms. If your knees are flaring up and causing a lot of pain, you need to rest them and stay off your feet. Your physician may also suggest a warm bath or a hot towel to promote blood flow, which can help ease symptoms. Additionally, using an ice pack can help to reduce inflammation.
There are also medications that can help to alleviate symptoms. Over the counter drugs such as acetaminophen can provide pain relief, while ibuprofen and naproxen can help with pain, as well as reduce inflammation. However, there can be side effects to taking these medications on a regular basis, so be sure to consult with your doctor before taking any over the counter drugs on a regular basis. There are also some prescription drugs your physician may recommend.
In some cases, surgery is an option for patients with osteoarthritis. A surgeon can smooth out the bones in the joint or reposition them, if necessary. For severely damaged joints, a total or partial replacement may be an option – knee replacement is a fairly common surgery in which the surgeon removes the damaged portion of the joint and replaces it with a prosthetic.
Rheumatoid Arthritis
Rheumatoid arthritis is an autoimmune disease, meaning the body’s immune system attacks healthy cells in the body. In the case of rheumatoid arthritis, the membrane that surrounds and lubricates the joint is attacked and eventually the cartilage and bone in the joint is damaged or destroyed.
Rheumatoid arthritis most commonly occurs in the finger joints closest to the hand and the wrist but it can affect joints throughout the body. Unlike osteoarthritis, rheumatoid arthritis frequently affects joints in a symmetrical pattern – in other words, if the right index finger is affected, the left is likely to be, as well. The disease also causes fever and fatigue and in some cases can lead to anemia, which is caused when red blood cell production decreases. In rare cases, the disease can harm the eyes, lungs and heart.
It is estimated that 1.5 million Americans have rheumatoid arthritis, which can be chronic or a lifelong condition. The disease generally develops in middle-aged people and is more prevalent in women.
“Early diagnosis and treatment is essential to treating rheumatoid arthritis as effectively as possible,” says Dr. Rajni Kalagate, a Rheumatologist. “With early, aggressive treatment, we have a better chance of fighting the disease, improving symptoms and in several cases, achieving remission.”
As with osteoarthritis, there is no one test or exam that can produce a diagnosis. However, lab tests can be helpful in identifying certain antibodies in the blood associated with the disease.
The right mix of exercise and rest is especially important for people with rheumatoid arthritis. As with osteoarthritis, exercise produces benefits that can help reduce pain and improve range of motion, but rest is essential to managing the disease. Rheumatoid arthritis tends to flare up periodically, necessitating more frequent rest at these times. In general, short periods of rest are preferable; long intervals between motion can worsen stiffness and pain.
There are a number of medications used to treat rheumatoid arthritis, including the over the counter drugs also used for osteoarthritis. In addition, there are some prescription medications that can help reduce inflammation and others which have been shown to slow the progression of the disease.
Surgery is also an option in some cases and could include joint replacement, as well as tendon reconstruction.
Other Types of Arthritis
Lupus
Lupus is another autoimmune disease, in which the body attacks healthy tissue. It too is a disease that is much more likely to impact women than men, especially Hispanic, African American and Native American women. Lupus can adversely affect joints, the skin, blood vessels and organs. It can cause a red rash on the face, pain and swelling in the joints, muscle pain, fever and fatigue.
It can be difficult and take a long time to accurately diagnose Lupus. A rheumatologist is best able to diagnose the disease. As with other forms of arthritis, there is no cure, but Lupus can be managed through a series of lifestyle adjustments and medications.
Gout
Unlike rheumatoid arthritis and lupus, gout primarily affects men. Gout occurs when the body overproduces and/or under-excretes uric acid, causing uric acid crystals to be deposited in the body’s tissue. Gout usually begins in the big toe and can also attack multiple other joints throughout the body.
Gout causes redness, warmth, stiffness, swelling and extreme pain in the affected joint. A flare-up can last for days or weeks. Over time, flare-ups can become more frequent and last longer. Gout is also associated with a greater risk of kidney stones.
The buildup of uric acid can be brought on by alcohol consumption, as well as eating too many foods containing purines – these include liver, anchovies, dried beans, and peas.
A gout flare-up can often be treated effectively with anti-inflammatory medications, while the frequency and severity of flare-ups can be mitigated through dietary changes, avoiding alcohol and losing weight.
Conclusion
Arthritis is one of the most common health conditions, particularly in older people. For some people, a mild case of osteoarthritis may simply cause periodic, minor discomfort that does not interfere with their daily activity or lifestyle. For others, it can be severely limiting and painful. And for patients affected by rheumatoid arthritis, lupus or gout, these are serious conditions that will dramatically affect overall health and daily activity if not treated by a physician.
While there is no cure for arthritis, your physician can give you the best advice and treatment available to make the disease easier to live with.
In conjunction with Arthritis Awareness Month, the Arthritis Foundation will hold a Walk to Cure Arthritis to raise money and awareness at Globe Life Park in Arlington on May 21, 2016. For more details, visit their website.
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