Arthritis
is one of the most common diseases in this country. It affects
millions of adults and half of all people age 65 and older.
Arthritis causes pain and loss of movement.
It can affect joints in any part of the body. It often is a chronic
disease, which means that it can affect you over a long period
of time. The more serious forms can cause swelling, warmth, redness,
and pain.
There are more than 100 different kinds of arthritis
and many different symptoms and treatments. Scientists do
not know what causes most forms of arthritis. They understand
some better than others.
Common Forms of Arthritis
The three most common kinds of arthritis in older
people are osteoarthritis, rheumatoid arthritis, and gout.
Osteoarthritis (OA) is the most common type
of arthritis in older people. It mostly affects cartilage—the
tissue that cushions the ends of bones within the joint. OA often
affects the hands and the large weight-bearing joints of the body,
such as knees and hips.
OA occurs when cartilage begins to fray, wear,
and decay. In some cases, all of the cartilage may wear away
between the bones of the joint, leaving bones that rub against
each other. Symptoms can range from stiffness and mild pain that
comes and goes, to severe joint pain.
OA can cause:
Scientists think there may be several causes
for OA in different joints. OA in the hands or hips may run
in families. OA in the knees is linked with being overweight.
Injuries or overuse may cause OA in joints such as knees, hips,
or hands.
Treatment. Rest, exercise, a healthy, well-balanced
diet, and learning the right way to use your joints are key parts
of any arthritis treatment program. Treatment is different for
each kind of arthritis.
Right now there are no treatments that cure OA,
except surgery to replace joints. But improving the way you use
your joints through rest and exercise and keeping your weight
down will help you control the pain.
There are some drugs that help people manage
OA pain. They are called COX-2 inhibitors and NSAIDs (nonsteroidal
anti-inflammatory drugs such as ibuprofen and naproxen). These
drugs reduce swelling without use of stronger drugs like cortisone
or other steroids. COX-2 inhibitors are a newer type of drug.
They work like NSAIDs but may cause fewer side effects.
Another new treatment involves shots of hyaluronic
acid (hyaluronic acid viscosupplementation) to the area around
the knee joint. The treatment adds fluid to replace natural fluids
that the body has lost. It can help people with arthritis keep
movement in the knee without pain.
Rheumatoid Arthritis (RA) is an inflammatory
disease that causes pain, swelling, stiffness, and loss of function
in the joints. People with RA often have a wide range of other
symptoms such as feeling tired, running a fever, or generally
not feeling well.
RA may occur in a balanced pattern throughout
the body. For example, if one knee or hand is involved, the
other one is too. The disease often affects wrist and finger joints
closest to the hand.
Treatment. RA treatments can help relieve your
pain, reduce swelling, slow down or stop joint damage, increase
your ability to function, and improve your sense of well being.
Treatment may include antirheumatic drugs, called DMARDs (disease-modifying
antirheumatic drugs), which can slow the disease. Doctors will
sometimes have you take other drugs, called corticosteroids to
relieve swelling while you wait for DMARDs to take effect. Other
drugs called biologic response modifiers, sometimes work for people
with mild-to-moderate RA who have not been helped by other treatment.
Gout is one of the most painful rheumatic diseases.
It is caused by deposits of needle-like crystals of uric acid
in the connective tissue, joint spaces, or both. These deposits
lead to inflammatory arthritis, which causes swelling, redness,
heat, pain, and stiffness in the joints.
Gout affects the toes, ankles, elbows, wrists,
and hands. Swelling may cause the skin to pull tightly around
the joint and make the area red or purple and very tender. Medicines
can stop gout attacks and prevent further attacks and joint damage.
Treatment. With the right treatment, most
people with gout feel better. Treatment can help ease the pain
that comes with acute attacks, prevent future attacks, and keep
new uric acid deposits and kidney stones from forming.
The most common treatment for an acute attack of
gout uses high doses of NSAIDs and shots of glucocorticoids drugs
into the affected joint to lessen swelling. You may start to feel
better within a few hours of treatment. The attack usually goes
away fully within a few days.
Warning Signs
The warning signs of arthritis are:
Swelling in one or more joints,
Stiffness around the joints that lasts for at least
1 hour in the early morning,
Constant or recurring pain or tenderness in a joint,
Difficulty using or moving a joint normally,
Warmth and redness in a joint.
If any one of these symptoms lasts longer than 2 weeks, see your
regular doctor or a doctor who specializes in arthritis (a rheumatologist).
The doctor will ask questions about the history of your symptoms
and do a physical exam. The doctor may take x-rays or do lab tests
before developing a treatment plan.
What Else Can You Do?
Along with taking the right medicines, exercise
is key to managing arthritis symptoms. Daily exercise, such as
walking or swimming, helps keep joints moving, reduces pain, and
strengthens muscles around the joints. Rest also is important
for joints affected by arthritis.
Three types of exercise are best for people with
arthritis:
Range-of-motion exercises (for example, dancing)
help keep normal joint movement and relieve stiffness. This type
of exercise also helps you stay flexible.
Strengthening exercises (for example, weight
training) help keep or increase muscle strength. Strong muscles
can help support and protect joints affected by arthritis.
Aerobic or endurance exercises (for example,
bicycle riding) improve cardiovascular fitness, help control weight,
and improve overall function. Some studies show that aerobic exercise
also may reduce swelling in some joints.
The National Institute on Aging (NIA) has a 48-minute video showing
you how to startand stick with a safe exercise program. The Institute
also has an 80-page companion booklet. Call 1-800-222-2225 (TTY:
1-800-222-4225) for more information. Before beginning any exercise
program, talk with your doctor or health care worker.
Along with exercise, some people find other ways
to help ease the pain around joints. These include applying heat
or cold, soaking in a warm bath, swimming in a heated pool, and
controlling or losing weight. Weight control is key for people
who have arthritis because extra weight puts extra pressure on
many joints. Weight loss can lower stress on joints and help prevent
more damage.
Your doctor may suggest surgery when damage to the
joints becomes disabling or when other treatments fail to reduce
pain. Surgeons can repair or replace damaged joints with artificial
ones. In the most common operations, doctors replace hips and
knees.
