Many people think arthritis is a disease of old age, but inflammatory or rheumatoid arthritis can actually occur at any age and is even found in children. In fact, there are more than 100 types of arthritis that together affect more than 46 million people
in the United States. While osteoarthritis is the most common, rheumatoid arthritis (RA) affects more than 1.3 million people and is still the leading cause of job-related disabilities. Osteoarthritis is a degenerative disease that occurs with age when the cushioning cartilage surrounding the joints wears down. When this comfortable padding wears away, what’s left is constant bone-on-bone contact that causes pain, stiffness and loss of mobility. Referred to as the “wear and tear” disease, osteoarthritis is often caused by overuse, injury or heredity. It’s typically seen in adults ages 45 to 50.
RA is a less common chronic disease that occurs when the lining of the joints, the synovium, becomes inflamed. This results in chronic pain, swollen joints, reduced mobility and, in severe cases, disability. RA is also considered a systemic disease that can affect other organs and parts of the body. Due to this systemic nature, it has serious implications for overall health and productivity. Because the impact of RA can be so dramatic, early diagnosis is critical. Left untreated, RA can lead to permanent joint damage, which may cause those affected to change jobs or dramatically
alter their lifestyles. But when diagnosed early, there are a growing number of excellent treatments available to combat the disease and, in some cases, even reverse its effects. After 30 years in this field of medicine, it has been exciting to watch the developments in treatments for patients living with this disease. There is an early window of opportunity with RA—within the first three to six months—when we have the best chance to halt its progression and even eliminate the inflammation. However, treatment at any stage of the disease can still result in dramatically improved outcomes. This doesn’t cure the disease, but suppresses it enough so that patients don’t suffer irreversible joint damage. Those most likely to get the disease have a family history of RA. The disease is three times more common in women than men. While we don’t know the exact cause or what triggers the onset of symptoms, most people report painful, swollen joints and sometimes fatigue, weight loss, anemia or depression.
Treatment for RA includes a multitude of medications, new therapies and a number of surgical options. Traditional therapy for the past 25 years has been with drugs called “disease modifying drugs,” such as methotrexate, sulfasalazine, plaquenil or leflunomide. These drugs can be augmented with anti-inflammatory pain relievers such as Ibuprofen or analgesics such as Tylenol. Staying active is also important to keep the muscles around the joints strong and flexible. Your doctor can help you find the right type of exercise that won’t overstress sensitive joints and will allow you to remain active. Over the past 10 years, a new therapy has been introduced that uses biologic agents that pinpoint and block proteins in the immune system to reduce the inflammation that damages the joints. Often one of the medications mentioned above, such as methotrexate, can be successfully combined with this new therapy to provide aggressive and effective treatment for patients. In the best outcomes, we even see repair of joints. For those who have damaged joints from all types of arthritis, surgery can also be a treatment option. Arthroscopic surgery might be considered if damage is limited, such as repairing tears
or removing loose cartilage. Joint replacement surgery may be considered for those with advanced cases. Joint replacement involves the removal and replacement of a joint with man-made material. Due to the numerous levels of treatment available today, we are now able to provide nearly every RA patient with some level of relief. While it used to severely restrict a person’s ability to move comfortably or continue to work, those with newly diagnosed RA can now hope to enjoy active, productive lives. For more information, visit www.arthritis.org.
