Understanding Rheumatoid Arthritis

What is it?

Rheumatoid Arthritis affects one to two percent of the population. It appears to hit women the hardest, with an estimated 2.1 million female sufferers in the United States alone. Although it normally shows up between ages 20 and 40, rheumatoid arthritis can strike anytime.

This type of arthritis is a systemic autoimmune disease potentially affecting the entire body and involving many different joints. When the body's immune system is not functioning correctly, healthy joint tissue comes under attack. Joint damage and inflammation of the joint linings cause pain, stiffness and swelling.

Symptoms

Early in the disease, people suffer from inflammation, pain, and stiffness. Symptoms often begin in the hands or feet, but can also impact elbows, shoulders, neck, knees and hips. Accompanying this can also be fever, poor appetite, fatigue and anemia and rheumatoid lumps, which form under the skin.

Causes

A specific cause has yet to be pinpointed, although researchers have identified a genetic marker that is probably influential in the start of the disease. The earlier a diagnosis is made the better, because arthritis can often be controlled with swift drug intervention.

I n 1999, a study published in the Journal of Rheumatology found that smoking cigarettes or cigars raises the risk for rheumatoid arthritis by about 50 percent.

Treatment

Medications are usually aimed at alleviating the symptoms. Aspirin is usually the first drug to try, since it is inexpensive and effective.

A class of drugs called NSAIDs, nonsteroidal anti-inflammatory drugs, are the next course of action. However, response to NSAIDs can vary, so experimentation is usually called for. In the long term they are known to cause side effects, particularly stomach upset and gastrointestinal bleeding. Fortunately, a new class of drug is now on the market, COX-2 inhibitors, which help pain reduction without the side effects of NSAIDS. The newer drugs are more expensive, but their dosage is lower than other medications.

More powerful anti-rheumatic drugs are used when the anti-inflammatory drugs fail to provide adequate help. Antimalarial compounds containing hydroxychloroquine sulfate have produced a good response in. Others, such as the corticosteroid prednisone can result in rapid symptomatic improvement until treatment is discontinued. Finding the right balance between dosage and relief is important when using steriods, as long term use carries many side effects.

Other treatment options

Exercise, periods of rest and physical therapy all contribute to coping with rheumatoid arthritis. Exercise is beneficial for keeping joints mobile, strengthening muscles around joints, and maintaining overall health and wellbeing. Although sufferers may not feel like exercising, just a few simple movements a day can make a difference in the severity of symptoms as well as improve mood and self-esteem.

Rest is vital to the recovery of inflammed joints to prevent further damage.

Devices

Splints are easily available in the local pharmacy and provide joint support and protection during flare-ups. They are most effective for hands and wrists and can be tailored to the individual. Other readily available devices help sufferers perform everyday chores, such as can openers, jar openers, door handles, and faucet turners.

Understanding Osteoarthritis

What Is It?

Osteoarthritis literally means "degenerative joint disease." It affects more than 16 million Americans and is the most common form of arthritis. After the age of 45 it occurs ten times more commonly in women than men. Onset of this disease is increasingly common with age, and symptoms usually creep up on people slowly.

Causes

The most common causes of osteoarthritis are injuries, joint overuse and aging. Scientists also suspect that inherited gene defects may be another factor, and they are currently investigating this link. Studies point to the conclusion that this disease tends to run in families, possibly through a recessive gene.

Cartilage

Osteoarthritis affects the protective material around joints called cartilage, which covers and cushions the ends of the bones. In a healthy person, cartilage is flexible and hardwearing. However, eventually cartilage frays, wears down, and may even disappear completely, leaving behind a joint consisting of bone meeting bone with no padding. Consequently, the other sections of the joint such as the tendons, ligaments and muscles, become weaker until the joint itself becomes deformed.

Prevention

Currently, the only known methods of prevention are avoiding repetitive joint injury and weight control.

Symptoms

Pain, swelling and stiffness are the most common results of joint deterioration, and they often become worse with time. Morning stiffness and excessive pain in one joint are typical early warning signs. Symptoms may appear in the hands, knees, hips, back and neck. The affected joint's range of motion will also become increasingly limited.

Treatments:

Although Osteoarthritis is a chronic disease that may last a lifetime, several approaches to treatment are effective.

Exercise

It used to be thought that exercise causes 'wear and tear' on the body, especially in joints. Now, however, being inactive is considered detrimental to joint health. Experts now recognize the importance of exercise for strengthening joints, both before and after symptoms of arthritis appear. Swimming, walking, low-impact aerobics and range-of-motion exercises are beneficial to dealing with joint pain and stiffness.

Medications

Cortisone is used to reduce inflammation and improve joint mobility. The most commonly used corticosteroids are Prednisone, methylprednisone, Decadron and Aristocort. Occasionally, the hormone is injected into the joint to stop pain. However, the use of any corticosteriods should be discussed extensively with a doctor, as they do have side effects (depending on the dosage and length of time they are used.)

Acetaminophen is commonly used for pain relief, although it is dangerous in doses higher than 4,000 mg daily and poses a risk for patients with liver disease.

Nonsteroidal anti-inflammatory drugs (NSAIDs) may also be used, although inflammation is less of a problem in this kind of arthritis. A new kind of NSAID called COX-2 inhibitors recently came onto the market with the promise of fewer gastrointestinal side effects. Please read our in-depth articles in the library for more information.

Hyaluronan and Viscosupplementation. Hyaluronan, a naturally occurring substance in synovial fluid reduces joint pain by enriching the natural properties of synovial fluid. Vicosupplementation is the name of the therapy in which hyaluronan is injected into the knee. Synvisc and Hyalagan are two brand names to look for, and are recommended for the treatment of OA in the knee after traditional therapies are unsuccessful.

Weight reduction

Being overweight is a definite risk factor for developing osteoarthritis. The increased load on joints may accelerate the breakdown of cartilage; for example, it is estimated that people with the highest body weight in the population have up to ten times the risk of developing knee osteoarthritis than those with the lowest weight. Weight issues are an important part of arthritis management. Successful strategies include calorie reduction, increased physical activity, and general adjustments in eating and exercise habits.

Heat and Ice

Warm baths, heat lamps and warm compresses can relieve pain. Heat also reduces stiffness and increases movement. Other people find relief in cold packs, especially for inflammation. In either case, remove the compress or ice after 20 minutes.

Topical Products

Topical products are sometimes used to provide temporary relief from arthritis pain. Capsaicin, a compound found in hot peppers, reduces pain when applied to the affected area three or four times a day. Other products, called counterirritants, use camphor, menthol or turpentine oil to mask the pain. Skin irritation may develop, but otherwise there are few side effects.

Surgery

In severe cases, surgery can help to repair torn cartilage and remove loose bone fragments. There are several different types of procedures, from arthroplasty, where the entire damaged joint is replaced, to osteotomy, which removes damaged bone tissue.