SPECIAL REPORT ON ARTHRITIS
By: Janet Forsythe
Arthritis means inflammation of a joint, whether the result of a disease, an infection, a genetic defect, or some other cause. The inflammation causes pain, stiffness, and swelling in the joints and surrounding tissue. Some forms of arthritis can be accompanied by problems of the muscles, tendons, and ligaments surrounding a joint or, more rarely, the skin or internal organs. Arthritis is the number one cause of chronic disability in the United States. It is a general term that refers to more than 100 different diseases. The aches and pains may come from one single joint or from multiple joints throughout the body. It can affect anyone at any age, but if you are over 60, chances are that you have felt the pain of arthritis. In 2003 it affected over 46 million Americans with medical costs topping $80 billion. From 1997 to 2003, the prescription drug costs nearly doubled. As the age of Americans increases, the number of people affected and the associated costs are expected to grow. The cause of arthritis is unknown and at present there is no cure.
Each of the forms of arthritis has various signs, causes, and symptoms. The most common type of arthritis is Osteoarthritis, also called degenerative joint disease or wear-and-tear arthritis. It usually appears after age 40 or 50 and develops slowly. A trauma to a joint may cause earlier or more rapid development. Osteoarthritis is associated with the breakdown of cartilage in the joints. It is thought to be caused by the wearing out of a joint through use or overuse. It occurs most commonly in weight bearing joints such as the hips, knees, and spine. It also occurs in the fingers, thumb, neck, and large toe. Cartilage is a firm, rubbery material that in normal joints covers the ends of bones and reduces friction in the joint and serves as a “shock absorber”. Osteoarthritis causes the cartilage to become stiff and lose its elasticity. Over time the cartilage roughens and begins to wear away until the bone ends touch and rub. In some cases, bony spurs develop on the edges of joints, causing damage to muscles and nerves, pain, deformity and difficulty in movement. The actual mechanism behind osteoarthritis is unknown. Risk factors, in addition to simply getting older, include lack of exercise, excessive weight, misuse of anabolic steroids, intense athletic activity, injury to joint or broken bone near a joint, and a genetic predisposition.
The second most common type of arthritis is Rheumatoid arthritis. It usually begins between the ages of 25 and 50, with 75% of those affected being women. It often develops in weeks of months. Rheumatoid arthritis is considered an autoimmune disease. Your immune system attacks joint linings called synovial membranes, which are supposed to protect and lubricate your joints. When your immune system attacks your synovial membrane, they become inflamed, causing your joint to feel warm, painful, stiff, and swollen. If it continues, chemicals and enzymes can be released that begin to eat away at cartilage and bone and cause damage to tendons and ligaments around the joint. Over time it may cause the hands and feet to become misshapen as muscles weaken, tendons shrink, the ends of the bones become abnormally enlarged, and the joint may even be destroyed. Rheumatoid arthritis usually affects corresponding joints on both sides of the body, often starting with the hands wrists, and feet. A general feeling of muscle aching and fatigue are common. Rheumatoid arthritis can also cause damage to other parts of the body, including your lungs, eyes, nerves, muscles, heart, and blood vessels. Most of the damage to the joints occurs during the first few years of the disease, so it is important to seek early treatment. With early treatment, the likelihood of permanent disability is reduced in all but 5-10% of sufferers.
Juvenile rheumatoid arthritis, or Still’s disease, is characterized by intermittent fever and anemia. It can also have secondary effects to the heart, lungs, eyes, and nervous system. This is believed to be an autoimmune disorder. One theory suggests that it is an immune reaction to a viral or bacterial infection somewhere in the body. However, it is not contagious and can not be spread to another person. Most affected children recover fully from the disease with no permanent damage or disabilities. Treatment includes heavy emphasis on physical therapy and exercise.
Infectious arthritis is caused by a bacterial or viral invasion of the joints. Signs and symptoms include a sudden, intense pain in a single joint usually in the arm and leg joints, the back, or the fingers and toes. The affected joint may become warm and swollen. It typically comes on the heels of another disease, such as a staph infection, tuberculosis, gonorrhea, Lyme disease, or parvovirus.
Some people now classify fibromyalgia as a type of arthritis, which would make it (not rheumatoid arthritis) the second most common type of arthritis. It affects mostly women who develop the disease between 20 and 50. This disease mostly involves pain in the muscles and soft tissue around the joints. The pain is frequently close to a joint, but not in the joint. The main characteristics of this disease are chronic pain and chronic fatigue (it is frequently misdiagnosed as chronic fatigue syndrome).
Other types of arthritis include, but are not limited to: psoriatic arthritis (arthritis associated with psoriasis), ankylosing spondylitis (arthritis of the spine), bone spurs (bony growths on the vertebrae or other areas), gout or pseudogout (crystal arthritis), and systemic lupus (inflammatory connective-tissue disease
Just as there are many different types of arthritis, there are many different types of pain associated with the different diseases. The pain may be continuous or intermittent. .Pain may occur after activity or exercise or it may happen when you are resting or still. It may be concentrated in one spot or all over your body. Joints may be stiff and difficult to move. Daily chores such as climbing stairs or opening cans may be difficult. The pain may be more severe at certain times of the day, after performing certain tasks, or in certain types of weather. Joints may become swollen, red, and feel hot to the touch. It may cause fatigue and weariness.
Because there are so many types of arthritis, each with their own symptoms, there are many different types of treatment. Care of arthritis often involves more than one type of treatment and may vary over time. The type of treatment depends on several factors including your age, activity level, occupation, overall health, medical history, type of arthritis, severity, and location of the pain. All medications have side effects, some more severe than others. The goal of any treatment plan is to give relief with the least amount of medication and side effects as possible.
There are many classes of drugs used to treat the various forms of arthritis. The choices used depend in part of which form of arthritis you have. For rheumatoid arthritis, a group of medications called disease-modifying antirheumatic drugs (DMARD) are typically used to slow or stop the disease process and save the joints and other tissue from permanent damage. The goal is to suppress the parts of your immune system that are driving joint inflammation, thus reducing or eliminating joint swelling and tenderness. This treatment should start as soon as possible after the diagnosis. Most DMARDs require careful monitoring, including frequent blood tests, to guard against uncommon, but potentially severe side effects.
For osteoarthritis and many other types of arthritis, there are many over-the-counter and prescription medications that can be used. Common medications used for pain relief are aspirin-free medications such as acetaminophen (Tylenol, others) and narcotic-related medicines (Tramadol, others). Anti-inflammatories include aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs such as ibuprofen, naproxen, and others), COX-2 inhibitors (Celebrex), and oral or injected Corticosteroid (methylprednisolone, others). Depression frequently accompanies arthritis. Antidepressants (nortriptyline, other Tricyclics) are frequently prescribed for pain management. Before taking any medications, discussed the benefits and possible side effects with your doctor.
Although pain-relieving medications are usually the mainstay of arthritis pain relief, there are techniques without medicines that may help. Applying cold may dull the sensation of pain and reduce swelling. Heat may ease pain in sore (but not inflamed) joints, relax tense muscles, and increase blood flow to the affected area. Topical creams, gels, and sprays which produce a warm or cool sensation (BenGay, Aspercreme, Capzasin-P, others) may reduce inflammation and ease pain. Transcutaneous electrical nerve stimulation (TENS) delivers a small, painless electrical current to the joint area. This reduces the pain for some people. Physical and occupational therapies can help you maximize your physical abilities with less pain. Psychological therapy may help you improve your ability to cope and teach you relaxation techniques.
In some cases, when conservative treatments aren’t enough, there are several surgical procedures that may help. In arthroscopic debridement a small tube is inserted into the joint to suction away loose fragments of bone, cartilage, or synovial tissue. Synovectomy, often used in rheumatoid arthritis, removes inflamed synovial tissue from the joint. Joint replacement is often done for hip, knee, elbow, and shoulder joints. In cases where joint replacement is not an option, permanently fusing a joint in the spine, wrist, ankle, or foot can reduce pain and improve stability.
Learning to cope with a chronic illness is an ongoing process. With most illnesses, you know it will go away in a few days or weeks. But a chronic illness like arthritis may never go away. Millions of American suffer from arthritis. People with the same symptoms and pain cope differently. Some people see themselves as fairly helpless and limited. Others see themselves in control of their disease and focus on what they can do and don’t dwell on what they can’t do. People with a positive, proactive attitude will usually experience less pain and limitations.
Lifestyle changes are often necessary. Stress causes muscle tension which can worsen arthritis pain. You will need to learn to control stress by avoiding situations which cause stress or changing your reaction to the situation. You will need to understand your pain and your body’s needs. Learn when it is time to relax and know when to rest before you become too tired. Learn to ask for help with a task when necessary. Learn to tell the difference between pain associated with your illness and that caused by overuse. Use assistive devices, such as jar openers, devices to extend your reach, or anything that make daily tasks easier and less harmful. Don’t view these devices as a sign of weakness. Our lives are full of assistive devices such as cars, washing machines, and microwaves. Assistive devices for arthritis are just one more tool you can use to help preserve function of your joints for as long as possible. Exercise is important to keep your body moving and flexible. It will help use lose weight, which will help your joints, as well as lessen pain, reduce fatigue, increase movement.
A good night’s sleep is important in pain management. If you never reach Stage 3 sleep (the deep sleep you need for your body and muscles to get true rest), your fatigue and pain will worsen. Tricyclics antidepressants can improve your sleep.
There are now a numbers of alternative therapies used for arthritis. Discuss them with your doctor if you are considering using any of them. Many of these therapies have not been proven to be effective although they seem to work for some people. Glucosamine, chrondroitin, and SAMe supplements may reduce pain, swelling and stiffness for some people. In some studies, fish oil has been shown to reduce inflammation, pain and stiffness. At least a dozen different herbs have been used to ease the symptoms of arthritis. The National Institutes of Health considers acupuncture an acceptable alternative treatment for osteoarthritis. Studies have shown that it helps reduce pain, may significantly lessen the need for painkillers, and can help increase range of motion in affected areas. Copper bracelets have long been used to ease the pain of arthritis for many people.
Bio-Magnetic Therapy is being used by many people to help control the symptoms and pain of arthritis. Bio-Magnetic Therapy increases the blood flow to the affected area, which allows the body the heal itself. It has been proven to reduce pain, lessen stress, improve sleep, increase energy, and improve circulation. All of these benefits of Bio-Magnetic Therapy are things that will help you cope with your illness. Unlike most medications for arthritis, there are no known side effects of using bio-magnetic therapy and it can be used in conjunction with other treatment options.
www.bio-magnetictherapy.com is a popular Bio-Magnetic product guide where you can find valuable information, articles, and knowledge about arthritis treatments, procedures, and products to help relieve your symptoms.
For many, although by no means everyone, arthritis seems to be an inevitable part of the aging process. There are no signs of real cure on the immediate horizon. However advances in conventional medical treatment and alternative therapies make living with arthritis more bearable. You may not be able to make arthritis pain totally go away or do everything that you once could. But you can make the most of what you can do, which includes fully utilizing the medical and alternative therapies available to you, leading a joint-healthy lifestyle, and maintaining a positive attitude.
This article is only for information purposes. This article is not intended to give medical advice and is not a substitute for professional medical advice. Please, follow any tip given in this article only after consulting your doctor. The author is not liable for any outcome or damage resulting from information obtained from this article.
This article is free for republishing.
Published 7/30/2007