Dr. MJ Bazos MD,
Patient Handout
Arthritis
Advice
Half of all people age 65 and older have
arthritis. There are over 100 different forms of arthritis and many different
symptoms and treatments. We do not know what causes most forms of arthritis.
Some forms are better understood than others.
Arthritis causes pain and loss of
movement. It can affect joints in any part of the body. Arthritis is usually
chronic, meaning it can occur over a long period of time. The more serious forms
can cause swelling, warmth, redness, and pain. The three most common kinds of
arthritis in older people are osteoarthritis, rheumatoid arthritis, and gout.
Common Forms of Arthritis
Osteoarthritis (OA), at one
time called degenerative joint disease, is the most common type of arthritis in
older people. Symptoms can range from stiffness and mild pain that comes and
goes to severe joint pain and even disability.
OA usually affects the hands and the large
weight-bearing joints of the body: the knees and hips. Early in the disease,
pain occurs after activity and rest brings relief; later on, pain occurs with
very little movement, even during rest.
Scientists think that several factors may
cause OA in different joints. OA in the hands or hips may run in families. OA in
the knees is linked with being overweight. Injuries or overuse may cause OA in
joints such as knees, hips, or hands.
Rheumatoid arthritis (RA) can
be one of the more disabling forms of arthritis. Signs of RA often include
morning stiffness, swelling in three or more joints, swelling of the same joints
on both sides of the body (both hands, for example), and bumps (or nodules)
under the skin most commonly found near the elbow. RA can occur at any age and
affects women about three times more often than men.
Scientists don't know what causes RA
but think it has something to do with a breakdown in the immune system, the
body's defense against disease. It is also likely that people who get RA have
certain inherited traits (genes) that cause a disturbance in the immune system.
Gout occurs most often in older
men. It affects the toes, ankles, elbows, wrists, and hands. An acute attack of
gout is very painful. Swelling may cause the skin to pull tightly around the
joint and make the area red or purple and very tender. Medicines can stop gout
attacks, as well as prevent further attacks and damage to the joints.
Treatments
Treatments for arthritis work to
reduce pain and swelling, keep joints moving safely, and avoid further damage to
joints. Treatments include medicines, special exercise, use of heat or cold,
weight control, and surgery.
Medicines help relieve pain and
reduce swelling. Acetaminophen or ACT should be the first drug used to control
pain in patients with osteoarthritis (OA). Patients with OA who don't respond to
ACT and patients with RA and gout are most commonly treated with nonsteroidal
anti-inflammatory drugs such as ibuprofen. People taking medicine for any form
of arthritis should limit the amount of alcohol they drink.
Exercise, such as a daily walk
or swim, helps keep joints moving, reduces pain, and strengthens muscles around
the joints. Rest is also important for the joints affected by arthritis.
Physical therapists can develop personal programs that balance exercise and
rest.
Many people find that soaking in
a warm bath, swimming in a heated pool, or applying heat or cold to the area
around the joint helps reduce pain. Controlling or losing weight can reduce the
stress on joints and can help avoid further damage.
When damage to the joints becomes
disabling or when other treatments fail to reduce pain, your doctor may suggest
surgery. Surgeons can repair or replace damaged joints with artificial ones. The
most common operations are hip and knee replacements.
Unproven Remedies
Arthritis symptoms may go away by
themselves but then come back weeks, months, or years later. This may be why
many people with arthritis try quack cures or remedies that have not been proven
instead of getting medical help. Some of these remedies, such as snake venom,
are harmful. Others, such as copper bracelets, are harmless but also useless.
The safety of many quack cures is unknown.
Here are some tip-offs that a remedy
may be unproven: claims that a treatment like a lotion or cream works for all
types of arthritis and other diseases too; scientific support comes from only
one research study; or the label has no directions for use or warnings about
side effects.
Common Warning Signs
of Arthritis
•Swelling in one or more joints
•Morning stiffness lasting 30 minutes or
longer
•Joint pain or tenderness that is constant
or that comes and goes
•Not being able to move a joint in the
normal way
•Redness or warmth in a joint
•Weight loss, fever, or weakness and joint
pain that can't be explained
If any
one of these symptoms lasts longer than 2 weeks, see your regular doctor or a
doctor who specializes in arthritis (a rheumatologist). The doctor will ask
questions about the history of your symptoms and do a physical exam. The doctor
may take x-rays or do lab tests before developing a treatment plan.