DEAR DR. GOTT:
I have rheumatoid arthritis (RA) and my greatest wish is for you to write one column on this subject. I am sure you will please millions of people with RA by informing people of the difference between arthritis and RA.
Everyday I run into people that notice when I limp or move slowly in pain and ask what’s wrong. I inform them I have rheumatoid arthritis and before I can finish my sentence they are telling me how they have the same thing and start telling me how bad it is in their knee, etc.
When I question them, I realize they have normal aging and osteoarthritis. People do not understand RA patients and the difference because both have arthritis in the name.
Please dedicate one column to this subject. Your column will help educate the public as it has helped educate me on so many disorders.
DEAR READER:
I will gladly take your request because you make an excellent point; many people are not aware that there are several types of arthritis. I will start with typical age-related osteoarthritis.
Osteoarthritis is the result when the lining of joints begins to wear out. The most common cause of this is the aging process but athletes, landscapers and manual laborers also are prone to developing this condition earlier in age because of the constant wear and tear on their joints.
As the lining wears away, pain and stiffness develop because there is no longer a cushion to protect the sensitive nerves, muscle and bones. Osteoarthritis commonly develops in the knees, hips, wrists and hands as these areas are the most used in everyday activities.
Treatment consists of over-the-counter medications such as, acetaminophen and ibuprofen, hot or cold packs, menthol or capsaicin rubs, and topical castor oil. Low-impact exercise such as walking, water aerobics and swimming are also beneficial. Alternative treatments include glucosamine and chondroitin supplements, MSM and others may provide relief to some sufferers.
If symptoms become severe and interfere with daily activity, joint replacement may be an option. Commonly replaced joints are knees, hips and shoulders. This drastic measure is usually reserved for individuals who are affected at a younger age or lead an active life.
Rheumatoid arthritis on the other hand is not the result of age-related deterioration, rather it is caused by the bodies’ own defenses. Mild cases can last from a few months to a year or two while severe cases can last for several years or even a lifetime and lead to serious joint damage. Others may have repeated flare ups followed by periods of remission.
The most common symptoms include joint pain, swelling and stiffness. Some may experience fatigue, fever, weight loss, firm bumps of tissue under the skin on the arms, red, puffy hands and joint tenderness. Symptoms generally appear in small joints such as the wrists, hands, ankles and feet first. Over time the knees, hips, jaw, shoulders, neck and elbows may become effected.
Rheumatoid arthritis is caused by the body’s white blood cells (infection fighters) when they move from the blood stream to the membranes that around the joints (synovium). They then appear to cause the synovium to become inflamed which releases proteins that, if untreated, leads to thickening of the membrane. Cartilage, bone, ligaments, and tendons can also become affected which, over time, leads to malignment of the joint and the bone to lose its proper shape.
Doctors do not know what causes this process to start but suspect it may be the result of a combination of factors such as lifestyle choices, genetics, and environment. Risk factors include smoking, family history, age, and gender. Rheumatoid arthritis commonly affects women between the ages of 40 and 60. It is not thought that RA is passed from one parent to the child but that a predisposition to the disorder is passed down.
There is no cure for RA but several treatments are available. Ibuprofen and naproxen sodium are helpful in reducing inflammation in mild cases and are available over-the-counter or in stronger doses as prescriptions. Some individuals may need temporary treatment with steroids. Other medications include disease-modifying antirheumatic drugs (to limit joint damage), immunosuppressants (to bring the immune system under control), TNF-alpha inhibitors (to block the inflammatory agent associated with RA) and anakinra (to stop a chemical signal from causing inflammation).
Both osteo- and rheumatoid arthritis can be diagnosed and treated by a general practitioner or internist. Rheumatoid sufferers, however, should also be seen by a rheumatologist who specializes in disorders of the joints and bones. Only severe or disabling symptoms caused by osteoarthritis may require the assistance of this type of specialist.
In summary, osteoarthritis is a common, age-related deterioration of the joints. Rheumatoid arthritis is caused by an auto-immune response and can occur in anyone at any age.
To give you related information, I am sending you copies of my Health Report “Understanding Osteoarthritis” and “Managing Chronic Pain”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 per report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).
About Dr. Gott