What is Arthritis?

The term “arthritis” covers more than 100 diseases and conditions affecting joints, the surrounding tissues, and other connective tissues. Arthritis and other rheumatic conditions include osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, juvenile rheumatoid arthritis, gout, bursitis, rheumatic fever, Lyme arthritis, carpal tunnel disease and other disorders.¹

Defining arthritis in adults has evolved over time. Currently, arthritis is defined as doctor-diagnosed arthritis. Possible arthritis is characterized by pain, aching or stiffness in or around a joint within the past 30 days that has been present for 3 or more months.²

If possible arthritis is suspected, a medical diagnosis should be sought.

Who is Affected by Arthritis?

• 46 million adults age 18 and older report doctor-diagnosed arthritis and 19 million report arthritis-attributable activity limitations.³ Children are affected as well.
• Nearly two thirds of people with arthritis are younger than 65 years of age.⁴
• Arthritis affects all race and ethnic groups: 34.3 million white adults, 4.4 million black adults, 2.6 million Hispanic adults, and 1.3 million adults of other races have arthritis.
• Adults 65 and older, will account for 37.2% of arthritis cases in 2005, and will account for >51% of cases by 2030.⁵
• Arthritis is the leading cause of disability in the United States.⁶
• 8.2 million working aged U.S. adults (about 1 in 20) report work limitations due to arthritis or joint symptoms in 2002.⁴
• In 2002, nearly 4.4 million US adults had chronic joint symptoms, 4 or more joints affected and associated activity limitations, yet had not seen a health care provider for these symptoms.⁷
• Systemic Lupus Erythematosus (SLE) is a serious form of rheumatic disease that can affect several organs. Death rates from SLE are 3 times more likely in African American women aged 45-64 years than White women.⁸

Cost of Arthritis

• Each year, arthritis results in 750,000 hospitalizations and 36 million ambulatory care visits. Women accounted for 63% of these visits; 68% of these visits were by persons under 65 years of age.⁹
• Estimated medical care costs for arthritis total $80.8 billion; Total costs (medical care and lost productivity) were $128 billion.¹⁰

Risk Factors for Arthritis

• Women make up about 60% of arthritis cases. ⁴
• Older Age: Nearly half of the elderly population has arthritis. Risk increases with age.³
• Obesity: Obesity is associated with osteoarthritis in adults¹² and gout in men.¹³
• Joint Injuries: Sports, occupation and repetitive motion joint injuries increase the risk of arthritis.¹ Occupations such as farming, heavy industry, and those with repetitive motion are associated with arthritis.¹²

Effective Treatments for Arthritis

• The Arthritis Foundation Self Help Program (formerly ASHC) has proven to reduce arthritis-related pain by 20% and decrease physician visits by 40%. This course involves small group education with a focus on problem solving, exercise, relaxation and communication.¹⁴
• Physical activity in the form of regular, moderate exercise maintains joint health, relieves pain and improves function.^{14, 15}
• Physical activity can reduce the risk of functional decline by 38-41% and incident disability by 47% among adults with arthritis.^{16, 17} Several community-based physical activity programs are available for people with arthritis including the Arthritis Foundation Exercise Program and the Arthritis Foundation Aquatic Program
• Reducing excess body weight can reduce the risk of incident knee osteoarthritis and limit progression of disease. Losing as little as 11 pounds may reduce the risk of incident knee osteoarthritis by 50%.¹² Weight loss programs incorporating both exercise participation and dietary restriction are the most effective and result in significant improvements in pain and function.¹⁸
• Physical and rehabilitation therapy are effective in reducing pain and improving function and disability.¹⁹
• Medications for some types of arthritis can limit disease progression, control symptoms and prevent serious complications.¹
• Joint replacement therapy often reduces pain and improves activity.¹  

References

1. Arthritis Foundation, Association of State and Territorial Health Officials, Centers for Disease Control and Prevention. National Arthritis Action Plan: A Public Health Strategy. Atlanta, GA: Arthritis Foundation, 1999.
2. CDC.Prevalence of Doctor-Diagnosed Arthritis and Possible Arthritis — 30 States, 2002. MMWR 2004; 53:383.
3. CDC. Prevalence of Doctor-Diagnosed Arthritis and Arthritis-Attributable Activity Limitation – United States, 2003-2005. MMWR 2006; 55: 1089-1092.
4. Bolen J, Sniezek J, Theis K, Helmick CM, Hootman J, Brady T, Langmaid G. Racial and ethnic differences in the prevalence and impact of doctor-diagnosed arthritis. MMWR 2005;54:119-123.
5. Hootman JM, Helmick CG. Projections of US prevalence of arthritis and associated activity limitations. Arthritis & Rheumatism. 2006;54:226-229.
6. Prevalence of disabilities and associated health conditions–United States.1999.MMWR 2001; 50:120-5.
7. Hootman JM, Sacks JJ, Helmick CM, Murphy L, Bolen J, Sniezek J. Joints involved, severe pain, activity limitation and doctor-diagnosed arthritis among adults with chronic joint symptoms, United States, 2002. Arthritis and Rheumatism 2005;52-Supplement) 1775.
8. Sacks JJ, Helmick CG, Langmaid G, Sniezek JE. Trends in deaths from systemic lupus erythematosus –United States, 1979-1998. MMWR 2002;51:371-2.
9. Impact of arthritis and other rheumatic conditions on the health care system – United States. 1997. MMWR 1999; 48:349-53.
10. CDC. National and State medical Expenditures and Lost Earnings Attributable to Arthritis and Other Rheumatic Conditions – United States, 2003. MMWR 2007, 56; 4-7.
11. New York State Behavioral Risk Factor Surveillance System. 2005.
12. Felson DT, Zhang Y. An update on the epidemiology of knee and hip osteoarthritis with a view to prevention. Arthritis Rheum, 1998;41(8):1343-55.
13. Choi HK, Atkinson K, Karlson EW, Curhan G. Obesity, weight change, hypertension, diuretic use, and risk of gout in men: the health professionals follow-up study. Arch Intern Med 2005; 165(7):742-8.
14. Intervention Programs for Arthritis and Other Rheumatic Diseases. Health Education and Behavior 2003; 30(1): 44-63.
15. Roddy E, Zhang W, Doherty M, et al. Evidence-based recommendations for the role of exercise in the management of osteoarthritis of the hip or knee – the MOVE consensus. Rheumatology, 2005;44(1):67-73.
16. Feinglass J, Thompson JA, He XZ, et al. Effect of physical activity on functional status among older middle-age adults with arthritis. Arthritis Rheum, 2005;53(6):879-85.
17. Penninx BW, Messier SP, Rejeski WJ et al. Physical exercise and the prevention of disability in activities of daily living in older persons with osteoarthritis. Arch Intern Med, 2001;161(19):2309-16.
18. Messier SP, Loesser RF, Miller GD t al. Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis : the Arthritis, Diet, and Activity Promotion Trial. Arthritis Rheum, 2004;50(5):1501-10.
19. Harris GR, Susuman JL. Managing musculoskeletal complaints with rehabilitation therapy: Summary of the Philadelphia Panel evidence-based clinical practice guidelines on musculoskeletal rehabilitation interventions. J Fam Pract, 2002;51:1042-1046.

Types of arthritis

• Carpal tunnel syndrome
• Chronic back injury
• Fibromyalgia
• Gout
• Lyme disease
• Lupus
• Osteoarthritis
• Osteoporosis
• Raynaud’s Phenomenon
• Rheumatoid arthritis
• Repetitive stress injury

Symptoms of Osteoarthritis

• Pain, stiffness and swelling around a joint that lasts for more than two weeks
• Joint stiffness after sleeping or periods of inactivity
• Swelling and pain in a joint, particularly after use
• Discomfort in a joint before or during a change in weather
• A crackling or grinding sound when you move a joint
• Loss of joint flexibility and range of motion
• Bony lumps on the middle or end joints of your fingers or at the base of your thumb

Symptoms of rheumatoid arthritis

• Pain and swelling in your joints, especially the smaller joints of your hands and feet
• Aching or stiffness in your joints and muscles after sleeping or periods of rest
• Loss of motion in the affected joints
• Loss of strength in muscles attached to affected joints
• Fatigue and low-grade fever during flare-ups
• Loss of joint flexibility and range of motion
• Joint deformities

Arthritis Exercise basics

• Take a slow, but steady approach to exercise – don’t overdo it
• Set aside a few minutes at the start of your day and before bedtime for flexibility and range-of-motion exercises
• Schedule three, 45-  minute periods every week for strength and endurance exercises
• As an alternative, aim for 30 minutes of moderate endurance exercises every day
• Give yourself rest breaks each day to compensate for your increased activity
• If a joint is unusually painful, just do range-of-motion exercises and apply an ice pack before and after you exercise

Although arthritis can’t be cured or prevented, starting treatments early will keep the disease under control and prevent serious damage to your joints. There are also a number of lifestyle changes you can make to improve your mobility and reduce pain and stiffness. These suggestions will help you to manage your symptoms more effectively:

• Exercise regularly – The phrase “use it or lose it” takes on new meaning when it comes to arthritis. It’s important to move each joint through a full range of motion every day. If you don’t, your muscles, tendons and ligaments will become stiff, sore and progressively weaker. Even though your joints may be tender and sore, gentle exercise will ease the stiffness and help you feel better in the long run. It will also increase your strength and endurance, improve your flexibility, help you sleep better and keep your weight under control

• Eat a healthy diet – There’s no special diet that has been proven to treat arthritis. Over short periods of time, fasting, followed by a strict vegetarian diet may help reduce symptoms of swelling and redness in inflammatory types of arthritis (treatment must be supervised by a doctor or dietician). Omega-3 fatty acids, found in cold-water fish such as salmon and mackerel, may also help reduce joint pain and inflammation. But the best course of action is to eat a balanced mix of nutritious foods. A diet that emphasizes fruit, vegetables and whole grains will keep your weight under control and help you cope better with the symptoms of arthritis.

• Control your weight – Research has shown that losing even a few pounds can help reduce the symptoms of arthritis. Maintaining a healthy weight is particularly important for people with osteoarthritis because the disease affects their weight-bearing joints. Follow Canada’s Food Guide and reduce the amount of fat in your diet to less than 30% of your daily food intake (approximately 2 tablespoons a day). 

• Heat - Heat helps to relax painful, aching muscles and increases the flow of blood to your tissues. Try soaking in a hot bath or hot shower for 15 minutes to ease your aches away. A hot pack or electric heating pad is also very soothing. If you have poor circulation, heat may not be the right solution for you

• Cold – Applying cold helps reduce swelling in your joints and may dull the sensation of pain. When your joints are inflamed, try applying a cold pack, soaking them in cold water or massaging them with ice

• Relaxation techniques – Relaxing the muscles around an inflamed joint can help reduce pain. There are many ways to relax. You might find relief by listening to soothing music or relaxation tapes. Deep breathing exercises, meditation and visualization exercises (imagining a pleasant activity, such as lying on a beach) can also distract your mind and help soothe your aches and pains

• Manage fatigue – Prolonged feelings of tiredness and exhaustion are common symptoms of arthritis and often lead to depression. To avoid overdoing it, plan a daily schedule that alternates periods of activity with periods of rest. Prioritize important tasks and balance them with more leisurely and relaxing activities. As you go through your daily tasks, try to maintain good posture. By distributing your workload over various sets of strong muscles, you can help conserve energy and improve your endurance

• Medication – Your doctor may prescribe anti-inflammatory medication or pain relievers to help you cope with arthritis symptoms. Don’t wait for pain to intensify before taking your medications. If you take your medications regularly, you can keep your painful symptoms under contro

Rheumatoid arthritis is the most debilitating form of arthritis and the most common type of inflammatory joint disease. It attacks the joints and connective tissue of your body, causing redness, pain and swelling. Inflammation associated with this type of arthritis can also affect the eyes, lungs, heart and other internal organs.

Researchers think that rheumatoid arthritis results from a malfunction of the immune system. The role of the immune system is to fight off disease or germs. However, in the case of rheumatoid arthritis, it fails to recognize normal body tissue and starts to attack it. Over time, this relentless attack destroys cartilage, bone, tendons and ligaments.

Rheumatoid arthritis usually begins by inflaming the synovial membrane, which is a thin layer of tissue surrounding each joint. The disease causes the synovial membrane to grow and thicken. Gradually, the pressure from the thickening tissue damages the cartilage and bone, causing severe pain, loss of movement and joint deformity.

Because it can affect many organs in your body, rheumatoid arthritis is referred to as a systemic disease. Often, it is accompanied by flu-like symptoms, fatigue, aches and pains and weakness. Symptoms usually develop slowly but sometimes they can flare up suddenly, affecting many joints at once.

The disease usually begins by affecting your wrists, hands, feet and knees. As it progresses, your shoulders, elbows, hips, jaw and neck can also become involved. Small lumps may eventually develop under your skin, further deforming the joints.

Rheumatoid arthritis tends to affect both sides of your body at once – for example, if your right wrist is inflamed, your left wrist will probably be inflamed, as well.

Rheumatoid arthritis is two to three times more common in women than in men. It usually strikes people between the ages of 20 and 50, but can also affect young children and older adults. As with many types of arthritis, there may be a genetic connection. You may be more at risk if other members of your family suffer from this condition. Some researchers think that certain types of infections can trigger rheumatoid arthritis and that people who smoke for long periods of time may also be at higher risk for this type of arthritic condition.

Osteoarthritis is a degenerative joint disease and the most common form of non-inflammatory arthritis. Through constant wear and tear, osteoarthritis causes the destruction of cartilage, a tough, elastic material inside each joint. Cartilage cushions the ends of bones so that they glide smoothly over each other as you move. It also acts as a shock absorber, protecting the joint from the stress of daily activities.

As osteoarthritis progresses, pieces of cartilage break off and irritate muscles and other tissues surrounding the joint. Over time, the cartilage disintegrates, causing bones to grind painfully against each other. The damage to the joints forces muscles, tendons and ligaments to work in unnatural ways, which interferes with joint movements and causes swelling, stiffness and pain.

Osteoarthritis usually affects weight-bearing joints, such as hips, knees, feet and spine. It may also affect finger joints and the joints at the base of the thumb. Bumps and swelling can develop, especially on the fingers and feet. Damage progresses fairly slowly but, eventually, your joints will lose flexibility and range of movement, making it hard for you to perform daily activities. 

If you have a family history of osteoarthritis, you have a higher risk of developing this type of arthritic condition. The chances of getting osteoarthritis also seem to increase with age. Sometimes, osteoarthritis can develop as a result of injury, infection, other types of arthritis, or repetitive strain on the joints due to sports or work. Being overweight is another major risk factor for arthritis. Carrying extra weight on your body puts additional stress and strain on your     weight-bearing joints. Although there is no cure for osteoarthritis, early diagnosis and treatment can help lessen the pain and stiffness and improve mobility.

It might surprise you to know that you have 206 bones in your body and that they’re held together by over 100 connecting joints. This intricate network of connections provides a sophisticated and sturdy framework to shape your body and protect your vulnerable inner organs. Your bones and joints also form working mechanisms that allow you to jump, run and perform hundreds of complex actions every day.

Arthritis is a disease that attacks these crucial joints and undermines their ability to function effectively. It is a disease that’s been around for thousands of years – evidence of arthritis has even been found in the mummies of ancient Egypt! Today, arthritis millions of North Americans and is even the leading cause of long-term disability in Canada. 

What causes arthritis?

There are over 100 different types of arthritis, with symptoms that range from mild to crippling. Some types of arthritis cause inflammation in the lining of the joints and other internal organs. Other types of arthritis create wear and tear in the joints, causing them to weaken and break down. Depending on the type of arthritis you develop, symptoms can be limited to only a few joints or they may affect a wide range of systems in your body.

Two of the most common types of arthritic conditions are rheumatoid arthritis and osteoarthritis. Each condition affects the joints in a different way, but they both are responsible for causing serious pain, disability and loss of function.   Both types of arthritis will be discussed in here….rheumatoid tomorrow and osteoarthritis the day after.