Detailed Information on the Common Arthritis Types
An Overview of Arthritis & Related Disorders
Article provided by: Colorado HealthSite
Used with permission.This article contains information on arthritis including: Arthritis Forms and Management Options, Rheumatoid Arthritis, Osteoarthritis, Scleroderma, Sjogren’s Syndrome, Reiter’s Syndrome, Polymyalgia Rheumatica, Gout, Ankylosing Spondylitis, Juvenile Arthritis, Lyme Disease, Coping with Arthritis, and even Joint Replacement.Its Forms and Management OptionsArthritis is among the oldest known afflictions affecting human beings. It has been found in the mummies of Egypt and in skeletons in excavations of other ancient civilizations.The term “arthritis” literally means joint inflammation, but it is often used more broadly to indicate any of the more than 100 so called rheumatic diseases. Such disorders can affect not only the joints but other connective tissues in the body. These include important supporting structures, such as muscles, tendons, ligaments as well as the protective coverings of internal organs.The rheumatic diseases vary greatly from person to person and from one disease to another. Their effects vary from a slight pain, stiffness and swelling to crippling pain and deformity. Therapies range from a warm bath and massage, changes in lifestyle and combinations of anti-inflammatory drugs or surgery.Today, about 15% of Americans, some 37 million, are afflicted with arthritis or a related disorder. Although medical science has not yet found a cure for all forms of arthritis, scientists have achieved major advances in understanding these diseases and in controlling and preventing them.Arthritis and related musculoskeletal disorders cost the nation an estimated $31 billion annually in medical expenditures and associated economic losses, according to the National Arthritis Data Workgroup convened by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). The Workgroup projects that by the year 2016, these disorders will account for over $105 billion of the nation’s health costs. Because a large percentage of those with arthritis and related disorders are 65 years of age or older, much of this economic burden falls on public resources such as Medicare and Medicaid. However, no measure of economic impact can adequately represent the personal and social burden of arthritis.As scientific knowledge about the rheumatic diseases has grown, their complexity has become more apparent. In fact, authorities now list more than 100 different disorders that fall under the heading of the rheumatic diseases. Each is a distinct disease with different causes and different prospects for recovery. Several of the most common disorders are discussed below.Rheumatoid ArthritisRheumatoid Arthritis (RA) is the most difficult of the rheumatic diseases to control and can do the most damage to the joints. According to the Arthritis Foundation, in 1988 it affected over 2.1 million people in the United States, two-thirds of whom are women. The condition generally starts between the ages of 20 and 50, although it can begin at any age.
RA usually affects many joints, most commonly the small joints of the hands. The affected joints become inflamed, painful, swollen and deformed. In addition, there may be general symptoms such as weakness, fatigue and loss of appetite. The disease tends to be both chronic and irregular and therefore severely disabling. It can flare up suddenly, and just as quickly go into remission. Emotional stress appears to play a role. While stress is not a direct cause of rheumatoid arthritis, it can hasten progression of the disease and make it worse.
Although it is not possible today to cure rheumatoid arthritis, it is possible for patients to cope successfully with their affliction with the help of their physicians and other specialists. The prime objective of treatment is prevention of joint destruction. The possibility of remission of the disease makes it important that all efforts be made to prevent joint destruction during the active stage. Once damage has occurred, it may be irreversible.
Since rheumatoid arthritis is usually chronic and may last a lifetime, physicians try to avoid the use of toxic drugs as much as possible. The patient is usually started on large doses of aspirin, which is the most reliable and least toxic of all antiarthritic drugs. It helps provide sustained control of symptoms with the lowest risk of undesirable side effects.
Two new therapies are currently being investigated by NIAMS grantees. Dr. Jon Levine, University of California, San Francisco, has discovered that a substance found in the nervous system may play an important role in promoting the inflammatory component of arthritis. To determine whether inhibiting this substance could reduce this problem, the researchers gave 24 patients with active RA either a placebo or a drug called quanethidine (a regional nerve blocker). After 14 days, the researchers found that quanethidine decreased the patients’ pain and increased their finger-pinch strength, whereas those who were given the placebo had no appreciable change.
In another study designed to develop new therapies for RA, Dr. David Trentham and associates at Beth Israel Hospital-Boston, found that patients given the immunosuppressive drug Cyclosporin A, which is used by organ transplant recipients, had significantly less pain and joint swelling. The researchers reported that Cyclosporin A is clinically effective in patients with RA who don’t respond to other treatments, but its therapeutic value is limited by its toxicity to the kidney and other organs. Lower doses of the drug may reduce its toxicity.
Other drug therapies that are sometimes used include chloroquine, gold and gold compounds, penicillamine, immunosuppressives and corticosteroids. These treatments have quite serious side effects, however, and are used only when the rheumatoid arthritis cannot be controlled with more conservative measures.
Besides medications, doctors usually recommend a balance of rest and exercise. Rest can mean having the patient lie down when tired, or it can mean resting swollen, painful joints. A prescribed plan of physical activity generally involves regular, gentle, and slowly progressive exercises.
Osteoarthritis
The most common form of arthritis, afflicting more than 16 million Americans, is a degenerative joint disease called osteoarthritis (OA). OA primarily affects cartilage, the protective material that covers and cushions the ends of the bones. This causes the cartilage to fray, wear, ulcerate, and in extreme cases, disappear entirely. Thus leaving a bone-on-bone joint. At the edges of the joint, bony spurs may form. Disability results most often from disease in the weight-bearing joints (i.e., knees, hips, and spine).
Elderly people are the most frequent victims of osteoarthritis. Excessive or unusual wear of the joints is an important contributing factor and results from obesity, poor posture, injury, strain from one’s occupation or recreation or a combination of these factors. The most common symptoms are pain and stiffness. Pain is usually experienced when joints are used, especially finger joints and those that bear the body’s weight. Enlargement of the fingers at the last joint often occurs. Such enlargements are common and are called Heberden’s nodes. Although permanent, these nodes seldom lead to disability.
The same general methods of treatment and care that are used for rheumatoid arthritis are equally effective in treatment of osteoarthritis. Drug therapy is not nearly as important, although painkillers and anti-inflammatory agents are helpful in some people. Surgical correction of deformed weight-bearing joints, especially hips, has been effective in helping many osteoarthritis patients to walk again without pain.
Scleroderma
Scleroderma is characterized by excessive deposits of collagen (a structureal protein) in the skin and various other organs such as the heart, kidneys, lungs, and gastrointestinal tract. These deposits can cause thickening and hardening of the affected organs. The disease often begins with Raynaud’s phenomenon, blanching and cooling of fingers and toes on exposure to cold or during emotional episodes. Raynaud’s phenomenon, which occurs in about 5% of the population, results from abnormal changes in the small blood vessels of the hands and feet that prevent the blood from flowing properly.
Sjogren’s Syndrome
Sjogren’s syndrome is marked by dryness of the eyes and mouth, caused by the destruction of the lymph glands that secrete tears and saliva. It may be a primary disease, or it may be secondary to certain rheumatic diseases, such as rheumatoid arthritis, lupus and scleroderma. Patients with this disease may also be at increased risk for developing lymphomas, as well as inflammatory blood vessel disease and nervous system dysfunction. Sjogren’s syndrome is common in women but not well recognized in men.
