Coming to Grips with Arthritis

June 18, 2008

"Oh my aching bones ..." is a common statement heard from nearly all individuals at some point in life; yet joint pain is really the issue that causes this complaint.

Inflammation of joints - or arthritis - affects about 20 percent of people 25 years and older. This number approaches 50 percent when only looking at the group of people 65 years and older. The Centers for Disease Control in Atlanta, Ga., have gone so far as to predict that arthritis will be an epidemic within the United States by 2020.

While there are many forms of arthritis including gout, rheumatoid arthritis, systemic lupus and others, osteoarthritis is by far the most common form. A chronic, progressive disease which usually affects the spine, knees, hips, and hands, osteoarthritis is caused by the loss of cartilage -- the hard, slippery tissue that helps your bones move over one another at a joint. Oftentimes, patients also will have bony overgrowths or spurs in these same regions. This degenerative illness causes pain, swelling and stiffness at joints and can lead to a decrease in overall function and in a reduction in the quality of life.

What can you do to prevent arthritis? Common risks include age, gender and genes. These factors can't be changed. But weight, joint injuries, infection, and occupation can be. Shedding excess weight can help delay the onset and slow the progression of arthritis. Joint injuries and infections can be identified early and treated appropriately to help modify long-term arthritis consequences. Individuals with occupations which involve excessive bending or squatting may need to learn and utilize back-safe methods and exercises, and individuals participating in repetitive movements of the hands or wrists may need to modify activities or wear protective devices when necessary.

What can you do to find out if you have arthritis? Pain, swelling and stiffness around one or more joints are common symptoms. Consult your physician or primary healthcare provider for a definitive diagnosis as there are several different types of arthritis and treatments vary depending on the type. Referral to a rheumatologist or orthopedist may be warranted for difficult to diagnose cases or for individuals with irreparable damage and associated loss of function.

What can you do if you have been diagnosed with arthritis? For those people diagnosed with rheumatoid arthritis, great advances in drug therapy have been made in recent years. Several new rheumatoid arthritis-specific therapies are available, as can be seen by the variety of television commercials and magazine advertisements.

Unfortunately, no disease modifying treatments exist for most other forms of arthritis. However, disease self-management tools, when combined with physician care, can reduce the pain associated with arthritis and help minimize further loss of function within the affected joints. Common treatments prescribed by physicians for osteoarthritis include medications to ease pain, such as acetaminophen, topical creams, and non-steroidal anti-inflammatory drugs or NSAIDs. Severe cases may require stronger pain medication, injections or surgery.

Maintaining a healthy weight is another helpful disease self-management tool. For individuals at a healthy weight, that means balancing caloric intake with activity level. For individuals that are overweight or obese, losing weight can help reduce the stress placed on arthritic joints, increase mobility and slow the progression of the disease.

If you are not already exercising, adding an exercise program to this therapy has been reported to help minimize pain. "Motion is lotion" is the mantra of Bart Conner, Olympic gold medalist. Through his work with the Arthritis Foundation, he used this phrase to help motivate patients with arthritis to keep active, maintain function and reduce pain. Although exercise may initially be somewhat difficult for the patients, joint-safe exercises will help to improve overall strength and flexibility and keep joints moving. However, not all forms of exercise are good for people with arthritis. For example, stair climbers or deep knee bends are not recommended, especially for patients with arthritis in the knees. Also, exercise is not recommended while experiencing arthritic flares when joints are red, hot and swollen.

The Arthritis Foundation has developed two exercise programs: an aquatic program and a Tai Chi program. Both are joint-safe and may be offered at a local YMCA. Another program developed by the Arthritis Foundation, called PACE, or People with Arthritis Can Exercise, is a community-based, non-clinical exercise program designed to promote exercise through socialization and peer support.

The Arthritis Foundation also has a self-help program which teaches patients a variety of coping mechanisms and adaptive techniques to get the individuals back to active, engaged lifestyles. Many Arthritis Foundation chapters can be found throughout Oklahoma and the United States. Contacting your nearest chapter or visiting the Arthritis Foundation online (www.arthritis.org) may provide useful resources for learning to cope with this chronic disease.

Finally, regular rest is just as important as regular exercise in managing arthritis. Knowing when to stop or slow down will help prevent pain caused by overexertion. Getting enough sleep also will help manage the pain associated with arthritis.

Is there hope on the horizon for patients with arthritis? Biomedical research from my group and many other groups study basic features of systemic lupus and other forms of arthritis. We work with the goal of understanding the cellular mechanisms of disease to then identify potential targets for new drug therapies.

Most of the new medications used to treat patients with rheumatoid arthritis will not help the majority of patients with other forms of arthritis, and no new therapies for osteoarthritis are available. Yet, there are several active clinical trials of new drugs to help delay the progression of osteoarthritis so hope is on the horizon for these patients.

With self-management tools and physician care, individuals with arthritis can decrease arthritis-related pain, and they should be able to maintain active, productive lives.