More than 24 million adults with arthritis are physically limited by the disease. That number represents a 20 percent increase from 2002 to 2014, according to new data from the U.S. Centers for Disease Control and Prevention. Some have trouble holding a cup and others find it hard to walk to their car. About 54 million adults have arthritis, or about one in four, and the CDC says they can do more to improve their symptoms. Dr. Lynn M. Ludmer, a rheumatologist at Mercy Medical Center, says that exercise can reduce pain and prevent progression of the disease.
What is arthritis and how many people have it?
Simply put, arthritis refers to joint pain. Many people are surprised to learn that there are more than 100 different kinds of arthritis. The most common type is a degenerative disease called osteoarthritis which effects up to 50 percent of the adult population. Less common types of arthritis include inflammatory (rheumatoid, psoriatic), metabolic (gout) and even infectious (Lyme, parvovirus).
Most of us know someone with "knobby" knuckles which is a manifestation of osteoarthritis in the hand. Osteoarthritis results from deterioration of joint cartilage and underlying bone. It commonly affects the hands, knees, hips and spine. About 54 million adults in the United States have osteoarthritis resulting in an economic burden of more than $120 billion a year in medical bills and lost wages. In contrast, rheumatoid arthritis effects only 1-2 percent of the population, but carries a price tag over $20 billion annually.
At what age does arthritis typically strike adults and can younger people get it?
Inflammatory arthritis does not discriminate and can strike any at age, including infancy. Years ago there was a popular ad campaign featuring a photo of a young child in a wheelchair with the slogan "This little old lady has rheumatoid arthritis." Osteoarthritis is more common with age, symptoms usually start after age 40. By age 85 it is estimated that 50 percent of the population has osteoarthritis of the knee and 25 percent have hip arthritis. The onset of osteoarthritis can be accelerated in people with a history of trauma, such as professional athletes. Genetic factors can also lead to earlier osteoarthritic symptoms. Recent studies show Americans are developing degenerative arthritis at a younger age. This earlier onset is thought to be related to the obesity epidemic. Statistics estimate that two in three adults are overweight and one in three are obese.
How can it affect physical ability or limit activity?
Symptoms of arthritis include joint pain, stiffness, swelling and loss of motion. Managing simple activities of daily living can be difficult depending on which joints are involved. Gripping a coffee cup or pen can be hard for those with arthritis in the hands. Walking up steps, bending and stooping can be problematic in those patients with knee symptoms. Hip arthritis can make it difficult to put on shoes and socks.
What can people do to improve symptoms on their own?
The first step for people with persistent or recurrent joint symptoms is to get a proper diagnosis. This is important since the various types of arthritis are treated differently. Usually this begins with a trip to a primary care doctor. Often a physical exam will clarify the problem, but sometimes blood work and imaging studies are needed. If an inflammatory arthritis is suspected then referral to a rheumatologist may be indicated. If the diagnosis of osteoarthritis is made then a good starting point is over the counter anti-inflammatory or analgesic medications. Unfortunately, there are no medications currently on the market which slow the progression of osteoarthritis. In contrast modern treatments for rheumatoid arthritis help control damage to the joints. Given its economic impact, there is great enthusiasm to develop such drugs to treat osteoarthritis.
It is important not to underestimate the role that lifestyle changes can make in easing the pain and preventing the progression of osteoarthritis. Several studies show that even modest amounts of weight reduction in the 10 pound range can improve knee pain and delay the need for joint replacement surgery. Obviously more robust weight loss can lead to even better results. It is a common misconception that patients with arthritis should not exercise. In fact regular exercise has been shown to reduce arthritis symptoms by 40 percent and delay the progression of osteoarthritis in the knees and hips. Exercise can include aerobic conditioning as well as strength and balance training. Low impact exercise such as walking, biking and the elliptical are good choices for many patients. Aquatic based exercise programs are a good alternative for those who find it too painful to exercise on land. The old adage "use it or lose" is especially applicable to arthritis patients.
Are there specialists or programs that can help?
Absolutely. The Arthritis Foundation has a terrific website www.arthritis.org with links to a tool kit for living with arthritis, toll free help line and support networks. The American College of Rheumatology's website www.rheumatology.org also has excellent information for patients on a variety of arthritic conditions and treatments. When professional help is needed rheumatologists diagnose and direct treatment for patients with inflammatory and other forms of arthritis. In addition, orthopedists perform joint and spine surgery in patients with advanced disease. Physical and occupational therapists can help those who would benefit from assistive devices and need a supervised therapeutic exercise program. While we may still have a long way to go in finding the cure for arthritis, patients have many resources available to them to enhance their quality of life.