Arthritis and Seniors

by National Institute on Aging

Arthritis Advice

Arthritis is not just a word doctors use when they talk about painful, stiff joints. In fact, there are many kinds of arthritis, each with different symptoms and treatments. Most types of arthritis are chronic. That means they can go on for a long period of time.

Arthritis can attack joints in almost any part of the body. Some forms of arthritis cause changes you can see and feel - swelling, warmth, and redness in your joints. In some the pain and swelling last only a short time, but are very bad. Other types cause less troublesome symptoms, but still slowly damage your joints.

Common Kinds of Arthritis

Arthritis is one of the most common diseases in this country. Millions of adults and half of all people age 65 and older are troubled by this disease. Older people most often have osteoarthritis, rheumatoid arthritis, or gout.

Osteoarthritis (OA) is the most common type of arthritis in older people. OA starts when cartilage begins to become ragged and wears away. Cartilage is the tissue that pads bones in a joint. At OA's worst, all of the cartilage in a joint wears away, leaving bones that rub against each other. You are most likely to have OA in your hands, neck, lower back, or the large weight-bearing joints of your body, such as knees and hips.

OA symptoms can range from stiffness and mild pain that comes and goes with activities like walking, bending, or stooping to severe joint pain that keeps on even when you rest or try to sleep. Sometimes OA causes your joints to feel stiff when you haven't moved them in a while, like after riding in the car. But the stiffness goes away when you move the joint. In time OA can also cause problems moving joints and sometimes disability if your back, knees, or hips are affected.

What causes OA? Growing older is what most often puts you at risk for OA. Other than that, scientists think the cause depends on which part of the body is involved. For example, OA in the hands or hips may run in families. OA in the knees can be linked with being overweight. Injuries or overuse may cause OA in joints such as knees, hips, or hands.

Rheumatoid Arthritis (RA) is an autoimmune disease. In RA, that means your body attacks the lining of a joint just as it would if it were trying to protect you from injury or disease. For example, if you had a splinter in your finger, the finger would become inflamed - painful, red, and swollen. RA leads to inflammation in your joints. This inflammation causes pain, swelling, and stiffness that lasts for hours. This can often happen in many different joints at the same time. You might not even be able to move the joint. People with RA often don't feel well. They may be tired or run a fever. People of any age can develop RA, and it is more common in women.

RA can attack almost any joint in the body, including the joints in the fingers, wrists, shoulders, elbows, hips, knees, ankles, feet, and neck. If you have RA in a joint on one side of the body, the same joint on the other side of your body will probably have RA also. RA not only destroys joints. It can also attack organs such as the heart, muscles, blood vessels, nervous system, and eyes.

Gout is one of the most painful forms of arthritis. An attack can begin when crystals of uric acid form in the connective tissue and/or joint spaces. These deposits lead to swelling, redness, heat, pain, and stiffness in the joint. Gout attacks often follow eating foods like shellfish, liver, dried beans, peas, anchovies, or gravy. Using alcohol, being overweight, and certain medications may also make gout worse. In older people, some blood pressure medicines can also increase your chance of a gout attack.

Gout is most often a problem in the big toe, but it can affect other joints, including your ankle, elbow, knee, wrist, hand, or other toes. Swelling may cause the skin to pull tightly around the joint and make the area red or purple and very tender. Your doctor might suggest blood tests and x-rays. He or she might also take a sample of fluid from your joint while you are having an attack.

Other forms of arthritis include psoriatic arthritis (in people with the skin condition psoriasis), ankylosing spondylitis (which mostly affects the spine), reactive arthritis (arthritis that occurs as a reaction to another illness in the body), and arthritis in the temporomandibular joint (where the jaw joins the skull).

Warning Signs

You might have some form of arthritis if you have:

• Lasting joint pain,
• Joint swelling,
• Joint stiffness,
• Tenderness or pain when touching a joint,
• Problems using or moving a joint normally, or
• Warmth and redness in a joint.

If any one of these symptoms lasts longer than 2 weeks, see your regular doctor or a rheumatologist. If you have a fever, feel physically ill, suddenly have a swollen joint, or have problems using your joint, see your doctor sooner. Your health care provider will ask questions about your symptoms and do a physical exam. He or she may take x rays or do lab tests before suggesting a treatment plan.

Treating Arthritis

Each kind of arthritis is handled a little differently, but there are some common treatment choices. Rest, exercise, eating a healthy, well-balanced diet, and learning the right way to use and protect your joints are key to living with any kind of arthritis. The right shoes and a cane can help with pain in the feet, knees, and hips when walking. You can also find gadgets to help you open jars and bottles or to turn the door knobs in your house more easily.

In addition, there are also medicines that can help with the pain and swelling. Acetaminophen can safely ease arthritis pain. Some NSAIDs (nonsteroidal anti-inflammatory drugs), like ibuprofen and naproxen, are sold without a prescription. Other NSAIDs must be prescribed by a doctor. But in 2005, the U.S. Food and Drug Administration (FDA) warned people about the possible side effects of some NSAIDs, both those sold with or without a prescription. You should read the warnings on the package or insert that comes with the drug. Talk to your doctor about if and how you should use acetaminophen or NSAIDs for your arthritis pain. You can also check with the FDA for more information about these drugs.

About the Author

www.nia.nih.gov
NIA, one of the 27 Institutes and Centers of NIH, leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life. In 1974, Congress granted authority to form NIA to provide leadership in aging research, training, health information dissemination, and other programs relevant to aging and older people.