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The Burden of Arthritis

According to the Centers for Disease Control and Prevention (CDC), self-reported doctor-diagnosed arthritis collectively affects nearly 43 million Americans--or about 1 in 5 adults. Another 23 million have chronic musculoskeletal symptoms that suggest they, too, may have arthritis. This makes arthritis one of the most common illnesses in the United States and a leading cause of disability. As the population ages, the CDC says that the number of Americans affected will increase dramatically. "People ignore arthritis both as public and personal health problems because it doesn't kill you," says Capt. Charles G.

Helmick, M., a medical epidemiologist at the CDC. "But what they don't realize is that, as people work and live longer, arthritis can affect their quality of life and lead to limitations in activities and work and eventually disability." link to long descriptionArthritis limits everyday activities for 8 million Americans, according to statistics compiled by the CDC.

Each year, arthritis results in 750,000 hospitalizations and 36 million outpatient visits. In 1997, medical care for arthritis cost over $51 billion. The disease affects people of all ages. Nearly two-thirds of those with arthritis are younger than 65. Arthritis may affect people of all racial and ethnic groups. It is more common among women and older Americans. Arthritis symptoms include joint pain, stiffness, inflammation, and limited movement of joints. When a joint is inflamed, it may be swollen, tender, red, or warm to the touch. In a healthy joint, the ends of the bones are covered by cartilage, a spongy material that allows almost frictionless motion between bones. In fact, Birbara says the amount of heat produced when bones normally meet is less than when two pieces of ice are rubbed together.

The joints are enclosed in a capsule and lined with tissue called the synovium. This lining releases a slippery, lubricating fluid that helps the joint move smoothly and easily. Muscles and tendons support the joint and help it move. With arthritis, the cartilage may be damaged or worn away by degenerative processes or by inflammation, making movement painful and difficult. If left undiagnosed and untreated, arthritis may progress to cause irreversible damage to the joints. Some rheumatic diseases are systemic, meaning they can affect the whole body. Diseases such as systemic lupus erythematosus (SLE) can cause arthritis as well as damage to virtually any bodily organ or system, including the heart, lungs, kidneys, blood vessels, skin, and brain, and may result in debilitating, and often life-threatening, complications. According to the Arthritis Foundation, the most common form of the disease--osteoarthritis (OA)--affects about 21 million people in the United States. Also called "degenerative joint disease," OA is caused by the breakdown of cartilage and bones from the wear and tear of life, resulting in pain and stiffness. OA usually affects weight-bearing joints such as the knees and hips, but an inherited form commonly affects the hands and spine.

Pain and stiffness are the earliest symptoms in OA, which affects both men and women and usually occurs after age 45. Other risk factors include joint trauma, obesity, and repetitive joint use. In most cases, OA can be detected by X-rays. Treatments include medications, education, physical activity or exercise, heat or cold, joint protection, pacing activities, weight loss if overweight, self-care skills, and sometimes surgery. Shirley has the second most common type--rheumatoid arthritis (RA)--an autoimmune disease that occurs when the body's immune system mistakenly attacks the synovium and can lead to damage of both cartilage and the adjacent bone. RA may affect any joint but most commonly starts with inflammation in the hands and feet. While the cause remains elusive, doctors suspect that genetic factors are important in RA. Recent studies have begun to tease out those specific genetic characteristics that make a person susceptible to developing RA. However, the inherited trait alone does not appear to fully account for the development of the illness. Researchers think this trait, along with some other unknown factor--probably in the environment--triggers the disease.

But RA can be difficult to diagnose early because it may begin gradually with subtle symptoms that usually wax and wane. According to the Arthritis Foundation, this form of arthritis affects more than 2 million people in the United States and is more common in women than men. Ironically, even when the disease appears to be relatively inactive--as measured by the patient's pain, swelling, and stiffness--joint deterioration is likely to be progressing. In early disease, most of the disability that patients experience is due to inflammation. In later disease, however, it is the loss of joint integrity that creates disability. This often necessitates surgical joint reconstruction or replacement procedures. Treatments for RA also include medications, exercise, rest, joint protection, and self-care skills. Managing Arthritis and Rheumatic Conditions For years, the pain and inflammation of arthritis have been treated using medications, local steroid injections, and joint replacement--all with varying success. Seldom did the therapies make the pain go away completely or for very long, nor did they affect the underlying joint damage.


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