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Family Health Magazine
FAMILY MEDICINE

Arthritis and You
Understanding a common condition

Arthritis refers to a group of more than 100 diseases that cause pain, swelling and limited movement in or around the joints. The condition affects one in six Canadians and has no known cause or cure. It is not simply a disease of the elderly. Juvenile arthritis affects many kids, and most people with rheumatoid arthritis are between the ages of 30 and 50. Still, we often think of arthritis as a natural part of aging, and that nothing can be done about it.

Arthritis is a serious disease. Without proper care and treatment it can mean severe disability and less quality of life. The discomfort from arthritis changes from day to day. Most people with arthritis have ebbs and peaks of remissions and flares. Some days are easier than others.

Warning signs of arthritis:

• swelling in one or more joints
• morning stiffness
• recurring pain or tenderness in any joint
• inability to move a joint normally
• redness and warmth in a joint
• any of these symptoms lasting more than two weeks.

Osteoarthritis

Osteoarthritis is the most common form of arthritis. Statistics show that by the time we reach age 64, we all have some signs of the disease. In most people osteoarthritis causes mild discomfort and stiffness, while in others it is painful and crippling. Osteoarthritis occurs when cartilage and other tissues that make a joint work properly break down. It often appears in weight-bearing joints such as the hips, knees, ankles and back.

Osteoarthritis may affect only one joint in the body or several joints at a time. It usually develops slowly and is most often diagnosed by x-ray. X-rays can show the narrowing of joint space and possibly small bony growths that appear where cartilage has been destroyed.

Treatment for osteoarthritis can include several approaches. Most importantly, joints should be exercised through their full range of motion several times a day. Since damage to joints happens more quickly if you are overweight, treatment may also include proper nutrition and weight control.

Since there is little or no inflammation in most cases of osteoarthritis, anti-inflammatory medications are often not needed. Pain control medication may be used to help relieve discomfort. Remember, pain signals the body that something is wrong and that the joint needs some protection.

Rheumatoid arthritis

Rheumatoid arthritis affects one in 100 Canadians. It is one of the most destructive forms of arthritis. In severe cases and without proper treatment, it can result in joint deformities, loss of mobility and severe disability.
In this form of arthritis the lining of the joint, called the synovial membrane, becomes inflamed. The joint becomes swollen and often warm to the touch. Joints in the wrists, knuckles and feet are most commonly affected.

Rheumatoid arthritis is diagnosed by physical examination supported by blood tests. Treatment usually includes medication to help slow the progress of the disease. Many anti-inflammatory medications are now on the market. Most people try at least three or four before finding one that works. Those with rheumatoid arthritis often experience cycles of pain, depression and fatigue.

Treatment

Although there is no cure for arthritis, great strides have been made in diagnosis, treatment and understanding of the disease. Those with arthritis can now expect a much better quality of life. Although we still have a long way to go in the fight against arthritis, the progress researchers have made allows many people to live active, well-adjusted lives.

Treatment for arthritis is something you must discuss with your health care team. It may include a combination of medications, physiotherapy, joint protection, exercise programs, self-management and non-traditional treatment. Therapists can help you develop a program of rest, exercise and joint protection.

Many people dealing with a chronic disease feel out of control. Taking part in your treatment plan helps you regain some control, which has a large impact on your well-being. Remember, you are the main player in your treatment program. Be sure you understand what is suggested and what to expect.

Medications

If your doctor prescribes a medication for your arthritis, ask what it does, how long it should take before you feel an improvement, and about possible side effects. Medications, especially those for inflammatory types of arthritis, help control the disease. Many have serious side effects and should be discussed thoroughly with your doctor.

Joint protection

Often devices are necessary to help protect your joints. Canes can help take the stress off a painful knee or hip, splints help keep the wrist joints in alignment or rest a painful joint. Occupational therapists can show you proper joint protection techniques along with easier ways to do daily activities.

Surgery

Surgery can improve quality of life for many people with arthritis. Total joint replacements of the hips and knees are relatively common surgical procedures that provide pain relief and help increase mobility.

Physiotherapy and exercise

Exercise is extremely important for your arthritis. It strengthens weakened muscles and maintains or increases mobility in joints. Your doctor may suggest physiotherapy to help you learn exercises for your specific problems. Many facilities now offer special exercise programs for people with arthritis. Exercising does not mean you must do a strenuous aerobics program! It means gentle stretching, range of motion exercises, and enough movement to increase your heart rate. Most importantly, it also means fun and socialization.

Arthritis self-management

The Arthritis Self-Management Program is designed to help you to understand and cope with your arthritis. In this group program, classes of eight to 15 meet at Arthritis Society locations for two hours, once a week, for six weeks. There is a small fee and each participant receives The Arthritis Helpbook.

Classes combine presentations and audience participation. Since class leaders all have arthritis themselves, they know and understand what participants are going through. Here, you can learn strategies for increasing mobility and decreasing pain through proper exercise, relaxation, pain management and communication.

Non-traditional treatments

You will hear many suggestions as to what will make the pain of arthritis disappear, or inflammation decrease, or swollen fingers work better. Many 'products' cost a great deal of money. Statistics show that four times as much is spent on unproven remedies than on medical research. Diet 'cures' for arthritis appear constantly in magazines and books, as do many other devices and treatments. People often try these cures when they are in the most pain.

Remember, arthritis peaks and ebbs. Your arthritis may have improved without the help of an unproven remedy. Before spending your hard-earned money, learn about the disease and what has or has not been proven by well-planned research. Some remedies are risky. If you are interested in a treatment, be sure to ask your doctor about it or contact the Arthritis Society. Even if you choose to try an unproven remedy, you should stay on your medically prescribed treatment program.

Proper diagnosis of arthritis is necessary for you to start treatment to improve your quality of life. Since each form of arthritis affects people differently, the same type of arthritis can have a unique effect in different people. Though you may have no difficulty opening a door, someone else with the same type of arthritis might find this action impossible. Treatment programs also affect everyone differently. For instance, the medication that works for your friend with arthritis may not help you at all. Remember, if you choose to try something new, be sure you discuss it with your health care team first.