Finding A Path with Less Pain and More Freedom

Finding-Path-with-Less-PainFrom the Fall 2011 StayHealthy publication

Arthritis is an umbrella term used for inflammation of one or more joints. There are literally hundreds of types of arthritis, but the two that physicians see most commonly include osteoarthritis, a degenerative arthritis, and rheumatoid arthritis, an inflammatory arthritis. No matter which type of arthritis you may have, the first step is getting an accurate diagnosis before your doctor can recommend a program for treatment.

Osteoarthritis

Osteoarthritis (OA) is the most common form of arthritis, affecting 27 million Americans according to the Arthritis Foundation. Usually beginning after age 40, OA is a breakdown in cartilage – the part of the joint that cushions the bone. The breakdown is a result of aging or repeated heavy use. As the cartilage deteriorates, bone rubs against bone causing pain and/or stiffness.

Because OA is a disease and not a part of the natural aging process, not everyone will develop it,” commented Rheumatologist Karen Kovalow-St. John, MD. She went on to say OA typically occurs in the major weight- bearing joints – hips and knees – but can also occur in other joints as a result of injury or unusual physical stress. “The majority of people with OA seek treatment from their primary care physician, and then are referred to an orthopedic surgeon if joint replacement becomes necessary.”

Treating OA

While there is no cure for OA, it can be treated to ensure an improved quality of life.

OA treatment centers on pain relief. Topical pain relievers and analgesics reduce pain; while nonsteroidal anti-inflammatory drugs (NSAIDs) help reduce inflammation, pain and swelling. Oral or injectable corticosteroids may also provide relief.

One of the best ways to keep the pain and stiffness at bay is to stay active and keep your weight in check,” said Kovalow- St.John. “Exercise helps improve flexibility and strengthen muscles, and shedding extra pounds eases the strain on the joints.” She shared that every pound lost reduces the burden on the knees by a factor of four pounds.

Rheumatoid Arthritis

Rheumatoid Arthritis (RA) is an autoimmune disease affecting nearly 1.5 million Americans according to the Arthritis Foundation

RA causes the body’s immune system to attack the membrane that lines the joints. As a result, fluid builds up in the joint causing pain and loss of function.

RA is a chronic disease,” explained Kovalow-St. John. “It can affect many different joints and damage cartilage, bone, tendons and ligaments.” Over time, the inflammation that characterizes RA can also affect internal organs as well as the joints. If left untreated, RA can cause joint deformity and disability.


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Treating RA

The main treatment goals with RA are to control inflammation and slow or stop the progression of the disease.

Amazing strides in the treatment of RA have been made over the last 20 years. In some cases, we’re even seeing remission of the disease,” Kovalow-St.John commented.

Treatment is multifaceted, consisting of medications, occupational or physical therapy and regular exercise. The new generation of drugs is called “biologics.” They are most often used in tandem with traditional disease modifying antirheumatic drugs (DMARDs) such as methotrexate.

Kovalow-St. John shared that there is ongoing research in the field of arthritis. “I encourage anyone who thinks they have some form of arthritis to see their physician to have it evaluated. Early detection and treatment are important in avoiding further joint damage.”

Osteoarthritis Rheumatoid Arthritis
Generally less severe than RA More severe than OA
Caused by wear and tear on the body Caused by immune system attacking the body
Generally affects people over age 40 Can affect people of any age. Most commonly affects those between ages 20 and 60
Usually only affects the joints Symptoms can be felt throughout the body
Commonly found in men and women Affects more women than men