It might start with pain, stiffness, swelling, or less range of motion in a joint. As it progresses, the pain escalates. Chances are, you could have arthritis.
There are more than 100 types of arthritis and related conditions.
But while patients often think of arthritis as a single disease, it’s definitely not. Actually, there are more than 100 types of arthritis and related conditions, according to Terence Starz, MD, clinical professor of medicine at the University of Pittsburgh School of Medicine. Dr. Starz is also on the board of the Western Pennsylvania Arthritis Foundation and an Arthritis Foundation expert source.
The Arthritis List
Topping that list are osteoarthritis (OA) and rheumatoid arthritis (RA). OA, the most common kind, affects more than 32.5 million Americans, according to the CDC. RA is an autoimmune and inflammatory condition, and is much less common, affecting about 1.3 million in the U.S.
While there are more than 100 different conditions under the arthritis umbrella, ‘’they have in common one symptom – pain,” Starz says. “And that’s what brings people to medical attention usually.”
The other big motivator for getting people to seek medical attention is when the symptoms interfere with activity levels, so a daily walk, jog or bicycling outing is too painful to continue.
For anyone who suspects they have arthritis, “the most important place to begin is knowing the correct diagnosis,” Starz says.
Diagnosis: First, Starz explains the differences between OA and RA. OA affects cartilage and bone. Rheumatoid arthritis, or RA, affects the lining of your joints, the synovium. As for cause? “We still don’t know exactly what causes these problems,” Starz says. Genetics and environmental factors play in. But there’s still a lot to learn.
Osteoarthritis is known historically as the wear-and-tear disease, while RA is known as an inflammatory issue, but scientists know now you also can have inflammation with osteoarthritis, Starz says.
To diagnose OA, your doctor will examine your joint for tenderness, swelling and flexibility, and may order other exams or additional tests, such as X-rays, MRI and bloodwork, to rule out other issues.
Diagnosing RA is trickier, because the symptoms in the early stages of RA mimic other conditions. But a thorough exam, blood testing and imaging tests can also be used to confirm the diagnosis.
Studies have gone back and forth about ethnic and racial differences in OA and RA. Pain severity and disability may be higher in African Americans with osteoarthritis than in whites with OA, some research suggests. Likewise, RA may affect African-Americans disproportionately, other research suggests. And RA is much more common in women than in men.
Living with Arthritis
And is there a cure for OA or RA? “The answer to that is no,” Starz says.
However, once diagnosed, people can take a number of actions to modify the disease and the pain.
Lifestyle Improvements: For OA, reducing stress on the joints is important. “Weight reduction is very important,” Starz says, and studies have long proven that. Few want to hear they need to lose weight. However, researchers have found that for every pound of weight lost, there is a 4-fold reduction exerted on the knee per step. In a day, that can make quite a difference in stress (and pain) on the joints.
Modifying activities can also help, such as switching from running to lower impact exercise. Many people don’t like the idea of using a cane for walking, but it can reduce stress on the joints, Starz says. Increasing muscle strength through physical therapy is another way to reduce stress on the joints.
Treatments: Over-the-counter medicines such as nonsteroidal anti-inflammatories (Advil, Motrin, Aleve) or the pain reliever acetaminophen (Tylenol) can help reduce the pain of OA, Starz says.
An important advance for treating RA are the so-called DMARDS, or disease-modifying anti-rheumatic drugs. They aim to slow or stop the inflammation that makes the disease worse.
Unfortunately, no DMARDs are available for OA, Starz says.
For severe arthritis, a joint replacement may be recommended, Starz says. This involves partial or total replacement of a joint—such as hip, knee, shoulder, wrist—with a metal, plastic or ceramic prosthesis.
Other Arthritis Treatments
Under Study: What about stem cells and other treatments touted, especially for OA? Many aren’t ready for prime time, but could have potential. The Arthritis Foundation offers a roundup of treatments under study, with pros, cons and other details. Definitely a stay-tuned situation.
The Arthritis Foundation has said that Tai Chi can help ease arthritis pain and increase joint flexibility. Check out our Health and Fitness Page for Senior Planet’s online Tai Chi classes with Trainer Josy! Learn more here.
Do you have arthritis? What works for you? Let us know in the comments!
Kathleen Doheny is a Los Angeles-based independent journalist, specializing in health, behavior, fitness and lifestyle stories. Besides writing for Senior Planet, she reports for WebMD, Medscape, Endocrine Web, Practical Pain Management, Spine Universe and other sites. She is a mom, mother-in-law and proud and happy Mimi who likes to hike, jog and shop.
Doheny photo: Shaun Newton
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