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October 17, 2018

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MountainView Hospital

Exploring ways to manage your arthritis

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The Centers for Disease Control and Prevention estimated that from 2013-15, 54.4 million U.S. adults — about 22.7 percent — had been told by a doctor that they had some form of arthritis. That number is expected to reach 78 million by 2040.

Despite its prevalence, arthritis is a commonly misunderstood term that refers not to one single disease, but to a network of more than 100 conditions.

“Arthritis is benign mild to moderate inflammation in the small, medium and large joints,” said Ali Rahimi, MD, physician with MountainView Medical Associates and internal medicine program director at the Sunrise Health System Graduate Medical Education Consortium.

The most common types of arthritis include osteoarthritis and rheumatoid arthritis.

Common types of arthritis

Osteoarthritis is a degenerative condition that causes cartilage to disintegrate over time. This usually occurs as a result of general wear and tear to the skeletal system, though it can be caused by an injury or infection as well.

Rheumatoid arthritis (RA) is an autoimmune disease that causes the immune system to mistakenly attack the joints as if they were a foreign invader. This causes chronic inflammation that can lead to the breakdown of the soft tissue lining of the joint. Eventually, RA can lead to the erosion of the cartilage inside the joint as well as the bone.

Gout and lupus arthritis are other common types of arthritis caused by an autoimmune disease.

Symptoms

All types of arthritis tend to have similar symptoms within the joints. “Osteoarthritis can present suddenly — referred to as acute osteoarthritis — with severe symptoms. In many cases, there is an accumulation of fluid in the joint,” Rahimi said.

Common symptoms include:

• Pain

• Swelling

• Redness

• Weakness

• Stiffness/limited mobility

Risk factors and causes

Anyone can get arthritis, but some people have a heightened risk because of genetics, lifestyle/environmental factors or both. Two of the largest risk factors are age and gender — people over 65 are considered high-risk, especially for osteoarthritis, and women have higher rates of arthritis than men, especially for rheumatoid arthritis.

Other risk factors for osteoarthritis include “obesity, immobility and a sedentary lifestyle,” Rahimi said. Genetic risk factors include a family history with arthritis and other associated conditions.

Treatment and management

Arthritis cannot be prevented or cured, but there are many treatment options that can help alleviate symptoms and slow the progression.

“I encourage people to consult with a physician to design a regimen to fit the individual,” Rahimi said. Because arthritis can be different for everyone, successfully managing the condition requires a combination of methods.

Committing to an exercise routine and maintaining a healthy weight are necessary for all arthritic patients. You can work with your care team to find exercises that improve joint function, as well as simply promoting regular physical activity. Additionally, physical therapy may help improve your range of motion and strengthen the muscles surrounding the joint.

Promoting bone health is important, especially for postmenopausal women. “Estrogen has some protective effects on bones and joints, and a lack of estrogen may be an underlying cause of arthritis in women,” Rahimi said. He recommends optimizing calcium and vitamin D consumption.

Reducing inflammatory lifestyle factors can be helpful — avoid smoking, alcohol and foods that trigger flare-ups.

Depending on the patient’s pain level, pain relievers such as acetaminophen can be helpful for some, whereas more severe pain may require stronger medication. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can help reduce pain and inflammation.

Corticosteroids also are powerful anti-inflammatories that suppress the immune system. Other medications are tailored specifically toward RA and are able to slow the immune system responses that attack the joints.

“In acute phases of the disease, removing fluid from the large joint might be helpful,” Rahimi said. This process is called joint aspiration.

Surgical options can be beneficial for some patients and are generally considered the most advanced line of treatment. Joint repair can be performed using minimally invasive methods to smooth and realign troubled areas of the joint — improving the functionality and reducing pain.

Full joint replacement surgery is common as well, especially for older patients with advanced forms of the disease that have left them with little or no cartilage within the joint.

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