THE KXVO CW15 OMAHA ENTERTAINMENT NEWS | Information about arthritis

By Louis Neipris, M.D., Staff Writer, myOptumHealth
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Arthritis is a broad term that means inflammation of the joint caused by overuse, disease or injury. But there are many types of arthritis. Some involve more than the joint. The effects can be far-reaching and may include tendons, muscles and other organs in the body. Arthritis or joint damage can be caused by injury, wear and tear or a glitch in your immune system that causes it to attack the body's own tissues.

The mystery of arthritis
If your doctor says you have arthritis, you've just scratched the surface. There's more digging to do. Two of the most common forms of arthritis in the U.S. are osteoarthritis and rheumatoid arthritis. But there are over 100 different types of arthritis, including gout, fibromyalgia and lupus.

Examining the big picture
Arthritis affects about 40 million people in the U.S. Nearly half of all people 65 years or older have some form of it. By the year 2020, doctors estimate that nearly 60 million people will have this joint disease. But, the fact that it affects millions doesn't help ease your pain and stiffness.

The clues: zeroing in on your risks
Some forms of arthritis are linked to specific risks. But only your doctor can pinpoint the exact type of arthritis you have. He or she will take into account your:

• Age. Middle-aged people are more prone to rheumatoid arthritis. Older people are more likely to develop osteoarthritis.
• Gender. Some types of arthritis are more common in men and others in women. Women are more prone to rheumatoid arthritis and lupus. Young men are more likely to develop ankylosing spondyltis, a type of arthritis that affects the back.
• Weight. Extra weight puts additional wear and tear on joints. It can contribute to osteoarthritis, especially of the hip and knee.

More clues: symptoms of arthritis
The symptoms of arthritis usually involve small or larger joints in the body and may include:

• Pain, with or without movement
• Stiffness, may be worse in the morning
• Swelling, could be due to fluid in joint space
• Bony enlargement or nodules
• Warmth and redness over the joint

One or more joints could be involved:

• Osteoarthritis usually involves the large joints, such as the hip or knee.
• Rheumatoid arthritis often involves the smaller joints in the hands or feet on both sides.

If your arthritis is an autoimmune disease, it means your immune system is somehow involved. These conditions include:

• Rheumatoid arthritis: may include generalized fever and malaise
• Systemic lupus erythematosus: may cause stroke and respiratory problems
• Fibromyalgia: characterized by trigger points, painful areas in muscles

The doctor and disease detective
Your doctor will ask you to describe your symptoms clearly. You will also be asked about any symptoms that seem unrelated like fever or breathing trouble. Piecing together these clues can help your doctor find the culprit.

After the doctor takes a careful history, he or she will examine your joints for swelling, tenderness, and pain. Your doctor will check to see how much you can move your joint (range of motion). If there is fluid in the joint, your doctor may remove the fluid and collect it for analysis. Lab tests of joint fluid often include:

• Microscopic examination. This test may find crystals, which is seen in gout.
• Culture. An infected joint is seen in septic arthritis.

Your primary doctor can evaluate and treat most cases of arthritis. Some people are referred to arthritis specialists called rheumatologists.

Cracking the case: finding the best treatment for your type of arthritis
The goals of treatment are not only to relieve pain, but to stop any joint damage and restore any lost function. A combination approach is often required.

• Oral medications
• • Nonsteroidal anti-inflammatory drugs (NSAIDs) and other pain relievers.
  • Disease modifying anti-rheumatic drugs. These drugs may slow or stop the immune system from attacking the joints. Some, called biologics, are genetically engineered drugs that block specific pathways of inflammation that cause damage to tissues.
• Physical or occupational therapy. A therapist works with you to recover lost movement or function through exercises and application of heat/cold and other methods. The therapist may also teach you to protect your joints by using your stronger joints to carry out tasks, and how to use assistive devices to make daily life easier.
• Joint injections. Corticosteroid medication blocks inflammation and can sometimes be injected directly into the joint space.
• Surgery. Joint replacement surgery is one option for severe arthritis of the hip or knee.

What can I do to self-manage my arthritis?
Exercise regularly. Once your pain is managed, ask your doctor what the best level of activity is for you. Choose an activity that won't stress your joints, such as walking, cycling or swimming. Getting exercise every day is shown to reduce the pain of arthritis and extend your range of motion. Exercise will also help you to reach or maintain a healthy weight, which can help with the pain of osteoarthritis.

Learn what you can. Learn about what type of arthritis you have and how the disease affects you. Enlist your family members or close friends in this effort so that they can become informed as well.

SOURCES:

• National Institute of Arthritis and Musculoskeletal and Skin Diseases. Arthritis: Questions and answers about arthritis and rheumatic diseases. Accessed: 04/22/2009

• Centers for Disease Control and Prevention. Arthritis FAQs. Accessed: 04/22/2009

• Arend WP, Lawry GV. Approach to the patient with rheumatic disease. In: Goldman L, Aussielo D, eds. Goldman: Cecil Medicine, 23rd ed. Philadelphia, PA: Saunders Elsevier; 2007.