Arthritis Month: A Time For Learning New Ways To Manage

 Women Have Highest Rate of Rheumatoid Arthritis

By the year 2020, arthritis will likely affect one in five Americans, or almost 60 million people, according to estimates from both the Arthritis Foundation and the Centers for Disease Control and Prevention (CDC).

About 20.7 million adults in the US have the most common form of arthritis, osteoarthritis, also called degenerative joint disease. Most persons over the age of 75 are affected with osteoarthritis in at least one joint, making this condition a leading cause of disability in the US.

Osteoarthritis is a condition in which the cushioning cartilage between bones wears away, according to the American Academy of Orthopaedic Surgeons. The incidence of osteoarthritis does increase significantly as people age.

Rheumatoid arthritis, the most crippling form of arthritis, affects approximately 2.1 million Americans, and two to three times more women are affected than men. Further, the average onset for rheumatoid arthritis is between the ages of 20 and 45 years old.

"We're going to see the numbers continue to increase over the next decade or two as the baby boomers age," says Dr. John Klippel, medical director of the Arthritis Foundation. "People are living longer. We're an aging society. That is the problem."

Ignore It, But It Will Not Go Away

An Arthritis Foundation survey conducted last year revealed that 53 percent of respondents were showing some symptoms of arthritis, yet many were not aware of the significance. The survey also found that 67 percent of respondents were at risk for arthritis, but 52 percent did not know it. More than half said they had no plans to see their physician about the health of their joints.

Health officials hope to combat that lack of awareness during May, which has been designated National Arthritis Month.

Arthritis is actually an umbrella term for more than 100 different conditions ranging from lupus to carpal tunnel syndrome to rheumatoid arthritis. Right now, about 43 million Americans suffer from some form of arthritis, making it a leading cause of disability in the US.

"Once you get into your late 40s and 50s, you start seeing osteoarthritis really increase, so by the time you look at people in their 70s, the vast majority of arthritis that occurs is osteoarthritis," Klippel says.

There is no cure for osteoarthritis, so physicians say the best they can do is manage its painful symptoms.

"Standard therapy is very limited because we don't have an established regimen of halting the disease," says Dr. Sicy Lee, a clinical assistant professor of medicine at the Hospital for Joint Diseases in New York City. "We emphasize slowing down the progression of the disease and making the patient more comfortable and more functional."

Addressing the Pain and Discomfort

Several drugs - both prescription and over-the-counter - are available to deal with the symptoms of osteoarthritis. These include both NSAIDs (non-steroidal anti-inflammatory drugs) including the newer Cox-2 inhibitors, and analgesics such as acetaminophen.

There have also been advances with viscosupplements, artificial joint fluids that are injected into the knee. So far, viscosupplements are approved only for the knee joint.

Dietary supplements to help arthritis sufferers are also moving closer to the mainstream. Glucosamine and chondroitin have received particular attention.

"There's increasing evidence that not only do they relieve the signs and symptoms of arthritis but may actually protect the cartilage and prevent damage to the cartilage," Klippel says.

Finding ways to maintain and enhance quality of life are also critical, Lee says. Trained physical therapists can actually go to your home and assess things such as doors, doorknobs, chairs, and hinges, and suggest changes that will make life easier.

"A lot of it is actually education for the patient to reduce daily stress," Lee says. For an older person, strategies might include taking the escalator or elevator instead of the stairs, having faucets that swivel instead of turn, and taking advantage of machines, such as can openers and windows that glide instead of slide.

For some people with severe arthritis that impedes their ability to get around or even get out of a chair, surgery to replace damaged joints may become an option.

"One of the real major advances has been in the areas of surgery, particularly total joint replacement," Klippel says. "It's done in roughly half a million people each year in this country and has substantially improved mobility and quality of life, so surgery becomes a very important option."

Researchers are also exploring ways to get the body's natural cartilage to regenerate and repair itself as well as developing drugs that might stimulate the growth of cartilage.

"Osteoarthritis is not inevitable," Klippel says. Attention to physical fitness and weight can prevent the onset of the disease and stem its progression. "Given the size of the problem, the public is going to have to realize quickly the importance of staying fit and keeping weight under control if they are going to prevent osteoarthritis," Klippel says.

Always consult your physician for more information.

Online Resources

American Academy of Orthopaedic Surgeons

Arthritis Foundation

Centers for Disease Control and Prevention (CDC)

DES Update, Centers for Disease Control and Prevention (CDC)

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), of the National Institutes of Health (NIH)

National Women's Health Information Center