ARTHRITIS: WHAT IS IT? ARTHRITIS OR RHEUMATISM? WHO'S AT RISK FOR ARTHRITIS? ARTHRITIS: SYMPTOMS INFECTIOUS ARTHRITIS OSTEOARTHRITIS RHEUMATOID ARTHRITIS JUVENILE RHEUMATOID ARTHRITIS ARTHRITIS: TREATMENT ASPIRIN AND ARTHRITIS CHORES MADE EASIER FOR ARTHRITIS SUFFERERS ALTERNATE AND NATURAL THERAPIES

ARTHRITIS: WHAT IS IT?

Approximately 40 million people in the United States have arthritis. It is a disorder of the joints that connect the bones of the body. The name arthritis means joint inflammation or swelling.
Joints are located wherever two or more bones meet. Cartilage and a lubricating fluid form a smooth gliding surface for the bones of the joint. Ligaments hold the joint together. When joints become injured or diseased, they swell. Over 100 types of arthritis affect the joints and connective tissues of the body.

Inflammation is a normal part of the body's defense system. It is a natural reaction to injury. Inflammation causes swelling, pain, and redness. It also decreases motion in the affected area. With arthritis, inflammation becomes part of the problem. It causes tissue damage that the body tries to handle by creating more inflammation. This painful cycle of destruction changes the bones and other joint tissues and limits their function.

The cause of arthritis is unknown, although clues are being uncovered. For example, people with certain gene types are prone to certain forms of arthritis. There also seems to be infections that trigger the onset of arthritis.

Each type of arthritis has different symptoms and patterns and each requires different treatments. The most common forms of arthritis are osteoarthritis and rheumatoid arthritis, followed by spinal arthritis, lupus, gout, scleroderma, and juvenile arthritis.

Some forms of arthritis go through cycles of getting better and worse. A flare-up means the disease is more active. During this time, there is increased morning stiffness, more pain and swelling in the joints, involvement of new joints, and increased tiredness and fatigue. Flare-ups can occur after eating a specific food. Milk is the most common offender. Other foods that can cause flare-ups are shrimp, wheat products, and certain meats.

Treatment for most forms of arthritis includes drugs, exercise, and rest. Joint protection and surgery are sometimes needed as well.

ARTHRITIS OR RHEUMATISM?

You may have heard a grandparent complain, "Oh, my rheumatism is acting up again!".
This was a common complaint for warm, stiff, and swollen joints and muscles. Many people believed that rheumatism was brought on by bad weather or strenuous activity. The cure was a hot bath and willow bark tea or aspirin. This term has fallen out of favor over the past years.
We are now able to be more specific in our diagnoses. Before, it was easy to lump all conditions that shared arthritis symptoms together. If one had any muscular or joint problem, people called it "rheumatism." Now, physical exams, X-rays and lab tests are used to tell what specific kind of arthritis a person has. Over 100 types of arthritis affect the joints and connective tissues of the body.
Do not assume that you have "rheumatism" because it runs in your family. If you or a loved one have joint problems for longer than two weeks, see a healthcare provider for a proper diagnosis. For more information about arthritis, call the Arthritis Foundation at (800) 283-7800.

WHO'S AT RISK FOR ARTHRITIS?

Arthritis affects one in every seven Americans. It affects people of all ages. It most often begins as a person gets older. Arthritis causes pain, stiffness, and swelling in or around joints. These symptoms can develop suddenly or slowly. Only a doctor can tell if such symptoms are truly arthritis.
The causes of most forms of arthritis are unknown, although we are learning more. People who are overweight have a higher chance of developing arthritis. Excess weight increases the risk for developing arthritis in the knees. This may also apply to the hips and hands. Women are at special risk for this. In men, excess weight increases the risk for developing gout. See a doctor or registered dietitian for help in losing weight.

Joint injuries caused by accidents or overuse increase the risk for some types of arthritis. Certain genes can be inherited that may increase the risk for some types of arthritis. More research is needed to find out how to reduce the risk from these factors.
Stress does not cause arthritis and reducing stress will not cure the disease. It is true, however, that pain from any cause can be made worse by a person's reaction to stressful events or feelings. This normal reaction varies in severity from person to person. It is helpful to learn ways to control stress.
Arthritis is not caused by eating certain foods. However, some foods may irritate existing conditions. A small percentage of people with rheumatoid arthritis experience a flare-up after eating a specific food. Milk is the most common offender.

ARTHRITIS: SYMPTOMS

Arthritis refers to the more than 100 kinds of diseases that cause pain and swelling, and limit movement in joints and connective tissue. Arthritis is the number one cause of severe pain and disability that limits physical activity. In the United States, 40 million Americans have arthritis. Three million of these people are severely affected. It is usually chronic, meaning that it lasts a lifetime. The specific causes are not known for most types of the disease but much is known about the symptoms, and how to treat them.

Physicians diagnose the specific type of arthritis based upon the pattern of symptoms, medical history, physical exam, X-rays and lab tests.

The main symptoms of arthritis are:

• joint pain
• joint stiffness
  
• inability to move the joint freely and
  
• joint swelling
  

Other symptoms can include:

• fever
  
• fatigue
  
• flu-like symptoms
  
• skin rash and
  
• nodules in the skin
  

The key to effective treatment of symptoms is a personal plan devised for you by your health care provider. Symptom treatment usually includes:

• medicine
  
• exercise
  
• rest
  
• use of heat and cold
  
• joint protection techniques and
  
• sometimes surgery
  

Many things can be done to reduce the impact of arthritis on everyday life. Arthritis symptoms can be controlled with proper diagnosis and design of a treatment plan.

INFECTIOUS ARTHRITIS

Infectious arthritis is joint inflammation due to an infection in a joint. It is almost always curable. When diagnosed and treated promptly, there is usually no lasting joint damage. If not treated early, then joint damage may occur.

Infectious arthritis can be caused by:

• bacterial illnesses such as gonorrhea, staph infections, and Lyme Disease or
  
• viral infections such as hepatitis, mumps, German measles, and mononucleosis
  

Bacterial infections are treated with drugs. A viral infection will usually go away on its own.
Infectious arthritis most often affects only one joint, although two or three joints may be involved. The shoulders, hips, and knees are most often affected. Red tender bumps about the size of a quarter may occur on the skin of the lower legs. Other symptoms include fever, and ankle or other joint swelling and pain.

People who are at higher risk for this disease include those who have:

• diabetes
  
• sickle cell anemia
  
• severe kidney disease
  
• HIV or AIDS
  
• some kinds of cancer
  
• an abnormal heart valve or
  
• an IV drug use problem
  

Certain drugs can decrease a person's ability to resist infections. For example, people who receive repeated steroid shots into the same joint risk getting an infection in that joint.
Certain jobs can expose workers to infectious arthritis. People more likely to get it include those who work with animals, plants or soil. These include farmers, gardeners, and fishermen. Infectious arthritis is not contagious. For more information, call the Arthritis Foundation at (800) 283-7800.

OSTEOARTHRITIS

Osteoarthritis is the most common type of a degenerative joint disease or arthritis. It usually begins in people over the age of 60.

Osteoarthritis progresses slowly. It begins with joint pain and stiffness. Later the joint enlarges and movement becomes limited. The cartilage breaks down first. Cartilage is the joint's cushion that covers the ends of bones allowing free movement. It becomes rough, frays, or wears away, leaving bones to grind against each other. As a result, the joint becomes irritated and inflamed. Sometimes the irritation causes abnormal bone growths known as spurs that increase swelling. The disease normally affects the feet, knees, hips, and fingers. Only one to a few joints are affected at one time.
Excessive or unusual wear of the joints can start the disease. This includes being overweight, poor posture, injury, repetitive strain from work, sports, or recreation, or a combination of these.
The most common symptoms of osteoarthritis are pain and stiffness. Using the affected joint causes pain. This is especially true with finger joints and those that bear the body's weight. Enlargement of the fingers at the last joint may result, but seldom leads to disability. Pain and swelling increase with joint usage. These symptoms may be relieved somewhat with rest.

The development of osteoarthritis speeds up when an injury or overuse affects a weight-bearing joint. In young people, injuries and overuse can activate the disease. The weight-bearing joints of the knees, hips and spine are the most likely joints to be afflicted. However, wrists, elbows, and shoulders may be affected as well. Over the course of a normal lifetime, cartilage wears down considerably.

Treatment focuses on relieving pain and improving joint function. A wide range of drugs and procedures are available. Losing weight and protecting joints from overuse are important. Canes and splints offer protection. Physical therapy provides relief from pain and muscle spasms, and maintains joint range of motion. Surgery is occasionally used to repair or replace the affected joint.

RHEUMATOID ARTHRITIS

Rheumatoid Arthritis is a disease that affects not only joints, but may also affect the heart, lungs, and eyes. This disease is very painful. Flare-ups are frequent and long lasting. The initial area of attack is the membrane that lines the joint. Cartilage is the joint's cushion that covers the ends of bones allowing free movement. Over time, arthritis breaks down cartilage as well as the ligaments, muscles, and bones.

Rheumatoid arthritis causes generalized stiffness and aching. It tends to affect more than one joint. Smaller joints such as the wrists, hands, feet, or ankles are the most common sites for this condition. The hips, knees, or elbows may also suffer. Many joints can be affected at the same time. It is common to have the disease in both feet or both hands at the same time.

Primary symptoms include swelling and pain in the smaller joints of the hands and feet. Generalized aching or stiffness occurs, especially after sleeping or lack of use. The affected joints are swollen, painful, and warm to touch during flare-ups. Another symptom is a series of small lumps that range in size from a pea to a walnut. These may develop under the skin near the elbow, the ears or nose, the back of the scalp, over the knee, or under the toes. The lumps are usually not painful or harmful.
Rheumatoid arthritis is often a chronic problem that can result in progressive joint destruction, deformity, and disability. The disease can occur at any age. It is more likely to develop between ages 20 and 50 years. Women are affected three times more often than men.

Treatment focuses on relieving pain and improving joint function. A wide range of drugs and procedures are available. This includes a balance of rest and exercise. Exercise is regular, gentle, and progressive. It may include physical therapy and swimming. Surgery can be used to prevent or repair damage.

JUVENILE RHEUMATOID ARTHRITIS

Arthritis affects 1 out of 1000 children a year. One child in 10 thousand children will have a severe form of the disease. Arthritis in children is similar to arthritis in adults. It can start anytime after birth. Arthritis may affect one or many joints and any size joint.

Onset and severity of symptoms varies between types. Over 30 percent of children develop permanent joint changes. In addition, the growing child may experience abnormal bone growth. For example, the disease may increase growth in one leg bone but not in the other, producing one leg that is longer than the other. Another risk is when a child keeps a joint from moving to avoid pain. Lack of movement can weaken and shorten muscles causing a deformity over time.

Treatment includes:

• drugs to reduce swelling and pain
  
• range of motion exercises and
  
• splints to prevent loss of motion and deformity
  

A balance between normal activity and rest is necessary. This will avoid fatigue and excessive stress on affected joints. To maintain a healthy attitude, do not isolate a child from his or her normal routine. The outlook for juvenile arthritis is often better than that for an adult with arthritis. Many children recover completely.

ARTHRITIS: TREATMENT

Treatments for arthritis depend on the type of arthritis and the needs of the person affected. Arthritis simply means joint inflammation. More than 100 arthritic diseases may affect the joints and connective tissues of the body.

While no cure exists for arthritis, proper treatment can allow normal activity and decrease symptoms.

Becoming involved in your own arthritis care is crucial. Working closely with your health provider, together you can design a treatment strategy that you can follow. Three types of treatments may be offered. The first treats the underlying condition. An example of this is gold or methotrexate therapy which is used for very specific diagnoses. The second type of treatment is aimed at decreasing the inflammatory symptoms. An example of this would be drugs that decrease the swelling such as ibuprofen, or naproxen. The last type of treatment is aimed at maintaining function. An example of this would be physical therapy, exercise, or massage. It may take time to find the right combination of treatments that will produce the best results.

Canes and splints may be needed to reduce joint strain. Learning how to perform activities in a less stressful manner will help to avoid pain. Surgery may occasionally be needed and may include the removal of damaged linings, realignment or replacement, or the fusion of bones.
For more information, call the Arthritis Foundation at (800) 283-7800.

ASPIRIN AND ARTHRITIS

Many arthritis drugs are used to decrease joint swelling. Swelling and warmth are the result of the body mounting an immune response (fighting off foreign things). In the case of arthritis, the immune system is confused, and begins to fight its own tissues within the joints. This results in pain, swelling, heat, redness, and sometimes stiffness of the joint. Aspirin is an important drug used to decrease these symptoms.

Small amounts of aspirin help relieve headaches, mild pain, and fever. Higher doses taken around the clock relieve some of the pain, heat, redness, and swelling of arthritis.

Aspirin may be sold over the counter, but its use should not be taken lightly. For some people it may cause side effects. It can irritate the lining of the stomach, and may cause ulcers. People who bleed easily should not take aspirin, because it thins the blood and may cause bruising of the skin. Your healthcare provider can determine the best dose of aspirin for you.

Generic name aspirin is cheaper and works just as well as brand name aspirin. Before you buy large quantities of aspirin, see if you have side effects from the aspirin chosen or prescribed. Be sure not to take large doses of aspirin unless under a doctor's care.

Not all aspirin is the same. A variety of forms of aspirin have been developed to help avoid stomach side effects. These include liquid forms, buffered tablets, enteric coated tablets, and timed-release tablets. Differences in the way aspirin tablets dissolve may cause some brands to irritate the stomach more than others. In addition, different brands of aspirin contain different doses. Some aspirin is called "arthritis strength" or "extra strength" because each tablet contains a higher than average dose. Call your doctor if you do not think your dosage of aspirin is helping. Do not change your dose before speaking with your doctor.

Do not take aspirin with alcohol, coffee, tea, or other drinks with caffeine, because the combination may make stomach problems worse. Always take aspirin with a full meal and plenty of liquids. Finally, to avoid bleeding during or after surgery, do not take aspirin 10 to 14 days before surgery.

CHORES MADE EASIER FOR ARTHRITIS SUFFERERS

For many arthritis sufferers, performing daily activities and chores is painful and tiring. The good news is there are many ways to meet these challenges. Here are some tips that will decrease the stress to your body.

Proper body mechanics are important to reducing pain. Begin by using good posture to protect the neck, back, hips, and knees. If standing for long periods is painful, lean against a wall or put one foot up on a stool. When lifting something that is low or on the ground, bend your knees and lift by straightening your legs, not your back. Use a device to reach with instead of bending to get something from the floor or cupboards. These devices can be bought from a medical supply store. If you have to bend, keep your back straight. Sit to do work such as sorting, folding, and ironing clothing.

Organize your work and storage areas. Keep all equipment and tools within easy reach and at a comfortable level. Use a lazy Susan or plastic bins to keep things close by. Use lightweight tools with built- up or extended handles for gardening and other yard work. Wear good walking shoes that fit and provide good support. Elastic shoelaces or velcro closures make putting on shoes easier.
Self-help devices make tasks easier and more efficient. But always try to use your own range of motion and strength first. Self-help devices can provide leverage to give more force. Use a pizza cutter instead of a knife to cut. If your range of motion is limited, long- handled shoe horns and bath brushes can extend your reach.

Try these helpful hints while working in the kitchen:

• When baking, place the mixing bowl in the sink while stirring. A damp cloth underneath will help keep it from slipping.
  
• Hold mixing spoons like a dagger to take stress off your hands.
  
• Use lightweight baking dishes, plates, pots, and pans, and serve from them.
  
• Use a wheeled cart to move heavy items from place to place.
  
• Sit on a high stool while cooking or washing dishes.
  

See a healthcare provider to learn how to use the body with minimal joint stress for less pain, easier movement, and even more energy.

ALTERNATE AND NATURAL THERAPIES

We shall shortly be bringing you details of traditional and exciting new
alternate therapies and cures for arthritis.