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Arthritis: the crippling disease
Causes vary, but there are treatments that work

By Margit B. Weisgal, Contributing Writer

The ladies sat around the table one lunch time, as the discussion turned to aches and pains. One held up her hand, each finger crooked at the last knuckle, each one listing toward the left. “I may have to give up knitting,” she moped. “I’m not happy.” Another talked about her difficulty driving, saying “I’m at a point where I have to lift my leg into the car.” A third was now using a walker to get around. They all had arthritis, all in different places in their bodies, all whose lives were affected by the limitations it caused.

Arthritis is actually a symptom, but it’s also the term used to refer to any disorder that affects your joints – any place where two bones meet, such as your knee or elbow or hip, although you can have arthritis in your hands – your knuckles – because there, too, bones meet. It refers to an inflammation at the meeting point. Rheumatic diseases – such as rheumatoid arthritis – are autoimmune diseases and affect, in addition to joints, your tendons, ligaments, bones and muscles.

The Arthritis Foundation (www.arthritis. org) defines it as “an informal way of referring to joint pain or joint disease. There are more than 100 different types of arthritis and related conditions.” The most common form, affecting one in four people, is osteoarthritis or OA. Second is rheumatoid arthritis (RA) which affects one in 100. In the Arthritis Foundation’s 2018 publication, Arthritis by the Numbers, it says, “A recent study says as many as 91 million Americans may really have arthritis – when you add together those who are officially diagnosed plus those who report obvious symptoms but haven’t been diagnosed.”

As scary as these data are, these numbers are expected to increase significantly as the population ages. For those over 65, 50% of men may have OA and two-thirds of women.

“There are many differences between osteoarthritis and rheumatoid arthritis, the two most common forms of arthritis,” explains Dr. Ana-Maria Orbai, assistant professor of medicine and director of the psoriatic arthritis program at Johns Hopkins University School of Medicine. “Osteoarthritis occurs around the age of 40 to 45 due to wear and tear on your joints. Because of the number of people affected, it is a significant public health problem and the number one cause of work disability and chronic pain. Approximately two-thirds of those affected are women. Incidences of other forms of arthritis are much less common.”

How does this wear and tear happen?

“In your joints, a membrane covers the cartilage, a cushion between the joints, with a thin layer of fluid to prevent friction,” Orbai describes. “With repeated trauma, the membrane and cartilage no longer provide that cushioning and, as of today, there is no way to regenerate cartilage. Also, if this wear and tear happens in your knee or hip, one eventual solution to pain may be a joint replacement.”

Comorbidity is the presence of two chronic diseases or conditions at the same time. Arthritis is found in almost 50% of patients with heart disease, 47% of adults with diabetes and 31% of those who are obese. “Knowing this information,” says Orbai, “it’s important for those diagnosed with arthritis to be screened for heart disease, diabetes, and other health problems, such as osteoporosis.”

Orbai also talks about what the future will be like. “There is a lot of research into regenerative medicine for different types of tissues. We also have the tools and technology to do more than before, including 3-D printing and new ways of culturing cells. There have been huge scientific and technological advances in the last few years and translation to clinical care will hopefully happen in the near future.”

To prevent OA, there are some actions you can take: maintain a normal weight, be careful when you exercise, and don’t run on concrete as it has a greater impact on your joints. No matter what, you should exercise since it keeps your joints lubricated and helps your bones stay strong.

Anything that helps with balance is also good, such as Tai Chi and yoga.

With stronger muscles, your joints are more protected. Brisk walking is great if you have the right gear, specifically shoes that absorb the shock, that cushion you