| Reiter's Syndrome
Reiter's syndrome is a combination of urethritis, conjunctivitis,
and arthritis. The arthritis affects the spine and peripheral
joints. The disease occurs most commonly in young male adults,
and the first attack usually lasts only a matter of weeks
or months.
Although Reiter's syndrome is not considered a venereal disease,
it appears to result from infection or exposure to
an infectious agent during sexual contact. Research
has shown that the majority of patients with the disease have
genetic predisposition to it.
Polymyalgia Rheumatica
Polymyalgia rheumatica usually afflicts people aver the age
of 50; it causes stiffness and severe aching in the shoulders
and hips. Sometimes other joints ache as well, and a few may
be swollen. If the disorder is not diagnosed and treated early,
symptoms may worsen and include fever, fatigue, weight loss and inflammation of the arteries. On rare occasions, the artery
to the eye is affected, resulting in blindness.
The cause of polymylagia is unknown. Without treatment, the
disease may last for three years or more and can involve considerable
pain and disability. Fortunately, the condition is dramatically
relieved almost immediately with corticosteroid treatment.
Prednisone is generally given and most patients are well within
days and can resume normal activities. The drug does not cure
the disease, but it eliminates the symptoms. Long-term treatment
is usually necessary. The disease tends to disappear after
a period of months or years.
Gout
Gout is the easiest form of arthritis to detect and treat
and the most understood. It most commonly affects the joints
of the feet, particularly the big toe, although other joints
are frequently involved. Most cases of gout occur in men.
It is caused by excess uric acid deposited in the tissues.
Crystals of uric acid form in the joints causing inflammation
and severe pain.
Drugs such as probenecid and allopurinol are used to reduce
the excessive amount of uric acid in the blood and tissue.
Colchicine is often used to relieve pain during an attack
and to help prevent recurrences. Since gout is affected to
some extent by lifestyle, patients should be encouraged to
initiate some management themselves. They may need to avoid
or limit their consumption of alcoholic beverages, and should
maintain a normal weight, get sufficient exercise, and try
to avoid using drugs that are not absolutely necessary, as
they may elevate the uric acid level.
Ankylosing Spondylitis
Ankylosing spondylitis (AS) is an inflammatory arthritis
of the spine. It may be a systemic disorder, and it affects
males more often than females. Diagnosis is usually made during
young adulthood. The disorder is characterized by back pain,
stiffness, and loss of spinal mobility due to involvement
of spinal joints. Later these joints tend to become fused
and rigid. The hips and shoulders may also become inflamed
and stiff.
While not fatal, this is a serious disease, which if left
untreated can result in permanently deformed posture. In its
initial stages, AS can be confused with many other causes
of chronic back pain. Consequently, those afflicted with the disease
are frequently misdiagnosed. They can spend thousands of dollars
over a period of years in search of a proper diagnosis, all
the while their symptoms are worsening.
The disease is treated with pain-relieving and anti-inflammatory
drugs. Exercise, posture training, and orthopedic correction
are also important aspects of therapy. An inherited blood
component known as HLA-B27 occurs in over 90% of patients
with spinal arthritis. This component is therefore now considered
to be a 'marker' or early warning sign for identifying those
who may develop the disease in the future. About one-fifth of persons with the marker develop arthritis
of the spine.
Certain antirheumatic drugs are effective in combating spinal inflammation. Practice of appropriate exercises and
development of constructive habits of body use in everyday
activities are significant preventive measures as AS progresses.
For this reason, early recognition of the disease is important.
Juvenile Arthritis
Juvenile arthritis, for the most part, is similar to arthritis
in adults. It is estimated that 250,000 young people
in the US have some form of arthritis.
The complications of juvenile arthritis can be quite variable.
These diseases cause growth disturbances and result in high
fever and skin rash more frequently than is the case among
older patients. Disorders in other body tissues and organs
also accompany the disease. Some 30% of patients develop permanent
joint changes. The majority of cases can be controlled with
proper treatment. Aspirin or one of its newer equivalents
are frequently prescribed as they have the fewest side effects.
Lyme Disease
Lyme disease is caused by a tick-borne spirochete, Borrelia
burgdorferi which was isolated in 1982 by a scientist
at the National Institute of Allergy and Infectious Diseases
(NIAID). The disease was first identified in 1975 in Connecticut;
it has been reported in thousands of people living along the
Atlantic coast, in some Midwestern and Western states, and
in numerous foreign countries.
The first sign of infection is usually a crimson rash shaped
somewhat like a bull's eye. Symptoms can progress to chills,
fatigue, and backaches.
If left untreated, a second set of symptoms can develop,
including severe headaches, shortness of breath, irregular
heartbeat and dizziness. Third-stage symptoms, occurring
as much as two years after infection, can include arthritis-like
swelling of the joints, usually painful and sometimes disabling.
Inspecting oneself frequently for ticks and removing them
promptly may lower the risk of infection and should be recommended
to residents of regions where Lyme disease is prevalent.
When the disease is treated early with antibiotics, physicians
believe that most people recover without developing complications.
Left untreated, there is general agreement that the risk of
long-term problems increases, but just how much is a matter
of debate.
Coping with Arthritis
Arthritis should be diagnosed and treated by a qualified
physician; a person with arthritis should not try to treat
themselves. The first place to start is with a family
doctor, either a general practitioner or an internist. She
or he may refer the patient to a rheumatologist or, in some
cases, to an orthopedic surgeon.
Patients should be wary of remedies and devices that have
not been scientifically established. Each year people spend
hundreds of millions of dollars on drugs, devices, and treatments
for arthritis that have not been proven effective, and that
in some cases can actually be harmful. Contrary to popular
belief, there is no such thing as a special arthritis diet.
Although in some cases certain adjustments in normal diet
patterns should be made, no diet in itself will cure arthritis.
The arthritis patient should, however, get sufficient rest,
particularly during periods when joints are painful and inflamed.
Proper exercise is also very important. Therapeutic exercises,
individually prescribed for the specific condition, are essential
not only for the maintenance of joint function, but also for
strengthening the muscles that support the joints.
For those patients who are unable or unwilling to exercise
by themselves, physical therapy can be administered in a hospital
clinic or at home. The therapist may provide various forms
of treatment with heat or massage, or teach patients how to
exercise joints by moving them through their full range of
motion, or teach them how to maintain good posture.
After proper medical attention, patients can learn everything
they need to know for care at home, whether independently
or with the assistance of family members.
To aid the arthritic person in performing activities of daily
living - dressing, eating, cooking, writing, and so forth
- there are numerous simple and inexpensive devices that can
be very helpful and can make the difference between self-sufficiency
and dependence. Long-handled combs, shoehorns, kitchen utensils,
and heightened chairs and toilet seats are just a few examples.
Clothes are available without buttons, snaps, or hooks, which
are sometimes impossible to manipulate with stiff, swollen
hands.
Joint
Replacement
Be sure to visit the Glucosamine
Product Guide for a review of commercially available glucosamine
products. |
