Client Education

Health, Fitness and Nutrition

ARTHRITIS

By: National Institute on Aging

About half of all people age 65 and older have arthritis, of which there are some 100 forms. The medical world does not know what causes most forms of arthritis, for which there are many symptoms and treatments. However, some forms are more understood than others.

As sufferers know, arthritis causes pain and loss of movement. It can affect joints in any part of the body, and it's 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.

Osteoarthritis, 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 believe 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 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 — which include medicines, special exercise, use of heat or cold, weight control, and surgery — work to reduce pain and swelling, to keep joints moving safely and to avoid further damage to joints.

• Medicines help relieve pain and reduce swelling. Acetaminophen or ACT should be the first drug used to control pain in patients with osteoarthritis. 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.

Common Warning Signs of Arthritis

• Swelling in one or more joint(s)
• 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 two 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.

Resources:

National Institute of Arthritis and Musculoskeletal and Skin Diseases

Building 31, Room 4C05

Bethesda, MD 20892

(301) 496-8188

The Arthritis Foundation

P.O. Box 19000

Atlanta, GA 30325

(800) 283-7800

National Institute on Aging

U. S. Department of Health and Human Services

Public Health Service

National Institutes of Health

1996