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Arthritis Awareness

Arthritis is very common but is not well understood. Actually, “arthritis” is not a single disease; it is an informal way of referring to joint pain or joint disease. There are more than 100 different types of arthritis and related conditions. People of all ages, sexes and races can and do have arthritis, and it is the leading cause of disability in America. Nearly 53 million adults and 300,000 children have some type of arthritis. It is most common among women and occurs more frequently as people get older.

Common arthritis joint symptoms include swelling, pain, stiffness and decreased range of motion. Symptoms may come and go. They can be mild, moderate or severe. They may stay about the same for years, but may progress or get worse over time. Severe arthritis can result in chronic pain, inability to do daily activities and make it difficult to walk or climb stairs. Arthritis can cause permanent joint changes. These changes may be visible, such as knobby finger joints, but often the damage can only be seen on X-ray. Some types of arthritis also affect the heart, eyes, lungs, kidneys and skin as well as the joints.

There are different types of arthritis:

Degenerative Arthritis
Osteoarthritis is the most common type of arthritis. When the cartilage – the slick, cushioning surface on the ends of bones – wears away, bone rubs against bone, causing pain, swelling and stiffness. Over time, joints can lose strength and pain may become chronic. Risk factors include excess weight, family history, age and previous injury (an anterior cruciate ligament, or ACL, tear, for example).

When the joint symptoms of osteoarthritis are mild or moderate, they can be managed by:

  • balancing activity with rest
  • using hot and cold therapies
  • regular physical activity
  • maintaining a healthy weight
  • strengthening the muscles around the joint for added support
  • using assistive devices
  • taking over-the-counter (OTC) pain relievers or anti-inflammatory medicines
  • avoiding excessive repetitive movements

If joint symptoms are severe, causing limited mobility and affecting quality of life, some of the above management strategies may be helpful, but joint replacement may be necessary.

Osteoarthritis can prevented by staying active, maintaining a healthy weight, and avoiding injury and repetitive movements.

Inflammatory Arthritis
A healthy immune system is protective. It generates internal inflammation to get rid of infection and prevent disease. But the immune system can go awry, mistakenly attacking the joints with uncontrolled inflammation, potentially causing joint erosion and may damage internal organs, eyes and other parts of the body. Rheumatoid arthritis and psoriatic arthritis are examples of inflammatory arthritis. Researchers believe that a combination of genetics and environmental factors can trigger autoimmunity. Smoking is an example of an environmental risk factor that can trigger rheumatoid arthritis in people with certain genes.

With autoimmune and inflammatory types of arthritis, early diagnosis and aggressive treatment is critical. Slowing disease activity can help minimize or even prevent permanent joint damage. Remission is the goal and may be achieved through the use of one or more medications known as disease-modifying antirheumatic drugs (DMARDs). The goal of treatment is to reduce pain, improve function, and prevent further joint damage.

Infectious Arthritis
A bacterium, virus or fungus can enter the joint and trigger inflammation. Examples of organisms that can infect joints are salmonella and shigella (food poisoning or contamination), chlamydia and gonorrhea (sexually transmitted diseases) and hepatitis C (a blood-to-blood infection, often through shared needles or transfusions). In many cases, timely treatment with antibiotics may clear the joint infection, but sometimes the arthritis becomes chronic.

Metabolic Arthritis
Uric acid is formed as the body breaks down purines, a substance found in human cells and in many foods. Some people have high levels of uric acid because they naturally produce more than is needed or the body can’t get rid of the uric acid quickly enough. In some people the uric acid builds up and forms needle-like crystals in the joint, resulting in sudden spikes of extreme joint pain, or a gout attack. Gout can come and go in episodes or, if uric acid levels aren’t reduced, it can become chronic, causing ongoing pain and disability.

Diagnosing Arthritis
Arthritis diagnosis often begins with a primary care physician, who performs a physical exam and may do blood tests and imaging scans to help determine the type of arthritis. An arthritis specialist, or rheumatologist, should be involved if the diagnosis is uncertain or if the arthritis may be inflammatory. Rheumatologists typically manage ongoing treatment for inflammatory arthritis, gout and other complicated cases. Orthopaedic surgeons do joint surgery, including joint replacements. When the arthritis affects other body systems or parts, other specialists, such as ophthalmologists, dermatologists or dentists, may also be included in the health care team.

February Is American Heart Month: Are You at Risk for Heart Disease?

Heart disease is the leading cause of death for men and women in the United States. Every year, 1 in 4 deaths are caused by heart disease.

The good news? Heart disease can often be prevented when people make healthy choices and manage their health conditions. Communities, health professionals, and families can work together to create opportunities for people to make healthier choices

During the month of February, Americans see the human heart as the symbol of love. February is American Heart Month, a time to show yourself the love. Learn about your risks for heart disease and stroke and stay “heart healthy” for yourself and your loved ones.

Cardiovascular disease (CVD)—including heart disease, stroke, and high blood pressure— is a leading cause of disability, preventing Americans from working and enjoying family activities. CVD costs the United States over $300 billion each year, including the cost of health care services, medications, and lost productivity.

Understanding the Burden of CVD
CVD does not affect all groups of people in the same way. Although the number of preventable deaths has declined in people aged 65 to 74 years, it has remained unchanged in people under age 65. Men are more than twice as likely as women to die from preventable CVD.

Many CVD deaths could have been prevented through healthier habits, healthier living spaces, and better management of conditions like high blood pressure and diabetes.

Take It One Step at a Time

You can control a number of risk factors for CVD, including:

  • Diet
  • Physical activity
  • Tobacco use
  • Obesity
  • High blood pressure
  • High blood cholesterol
  • Diabetes

As you begin your journey to better heart health that can last a lifetime, keep these things in mind:

  • Try not to become overwhelmed. Every step brings you closer to a healthier heart, and every healthy choice makes a difference!
  • Partner up. The journey is more fun—and often more successful—when you have company. Ask friends and family to join you.
  • Don’t get discouraged. You may not be able to take all of the steps at one time. Get a good night’s sleep—also important for a healthy heart—and do what you can tomorrow.
  • Reward yourself. Find fun things to do to decrease your stress. Round up some colleagues for a lunchtime walk, join a singing group, or have a healthy dinner with your family or friends.

Plan for Prevention
Try out these strategies for better heart health. You’ll be surprised how many of them can become lifelong habits!

Work with your health care team. Get a checkup at least once each year, even if you feel healthy. A doctor, nurse, or other health care professional can check for conditions that put you at risk for CVD, such as high blood pressure and diabetes—conditions that can go unnoticed for too long.

Monitor your blood pressure. High blood pressure often has no symptoms, so be sure to have it checked on a regular basis. You can check your blood pressure at home, at a pharmacy, or at a doctor’s office.

Get your cholesterol checked. Your health care team should test your cholesterol levels at least once every 5 years. Talk with your health care professional about this simple blood test.

Eat a healthy diet. Choosing healthful meal and snack options can help you avoid CVD and its complications. Limiting sodium in your diet can lower your blood pressure. Be sure to eat plenty of fresh fruits and vegetables—adults should have at least five servings each day. Eating foods low in saturated fat, trans fat, and cholesterol and high in fiber.

Maintain a healthy weight. Being overweight or obese can increase your risk for CVD. To determine whether your weight is in a healthy range, health care professionals often calculate a number called body mass index (BMI). Doctors sometimes also use waist and hip measurements to measure a person’s body fat.

Exercise regularly. Physical activity can help you maintain a healthy weight and lower cholesterol and blood pressure. The Surgeon General recommends that adults should engage in moderate-intensity activity for at least 150 minutes per week. Remember to incorporate exercise into your day in different ways: take the stairs instead of the elevator, or rake the yard instead of using the leaf blower. Exercising with friends and family can be a great way to stay healthy and have fun.

Don’t smoke. Cigarette smoking greatly increases your risk for CVD. If you don’t smoke, don’t start. If you do smoke, quit as soon as possible. Your health care team can suggest ways to help you quit.

Limit alcohol use. Avoid drinking too much alcohol, which can increase your blood pressure. Men should stick to no more than two drinks per day, and women to no more than one.

Manage your diabetes. If you have diabetes, monitor your blood sugar levels closely, and talk with your health care team about treatment options.

Take your medicine. If you’re taking medication to treat high blood pressure, high cholesterol, diabetes, or another condition, follow the instructions carefully. Always ask questions if you don’t understand something. If you have side effects, talk with your health care team about your options.

Together, we all can prevent and manage heart disease, one step at a time.