Arthritis

by CDC

Forty-three million Americans report that a doctor told them they have arthritis or other rheumatic conditions. Arthritis is the leading cause of disability in the United States, limiting the activities of more than 16 million adults. The CDC Arthritis Program is working to improve the quality of life for people affected by arthritis and other rheumatic conditions by working with states and other partners to increase awareness about appropriate arthritis self management activities and expanding the reach of programs proven to improve the quality of life for people with arthritis.

The word arthritis actually means joint inflammation. The term arthritis is used to describe more than 100 rheumatic diseases and conditions that affect joints, the tissues which surround the joint and other connective tissue. The pattern, severity and location of symptoms can vary depending on the specific form of the disease. Typically, rheumatic conditions are characterized by pain and stiffness in and around one or more joints. The symptoms can develop gradually or suddenly. Certain rheumatic conditions can also involve the immune system and various internal organs of the body.

A brief overview of the most common forms of arthritis will be discussed in this section. For a more detailed discussion of each of these conditions, follow the links provided for you.

Arthritis Types

A brief overview of the most common forms of arthritis will be discussed in this section. For a more detailed discussion of each of these conditions follow the links provided for you.

• Osteoarthritis.
• Systemic Lupus Erythematosus.
• Rheumatoid Arthritis.
• Gout.
• Fibromyalgia.

Osteoarthritis (OA)

Osteoarthritis is a disease characterized by degeneration of cartilage and its underlying bone within a joint as well as bony overgrowth. The breakdown of these tissues eventually leads to pain and joint stiffness. The joints most commonly affected are the knees, hips, and those in the hands and spine. The specific causes of osteoarthritis are unknown, but are believed to be a result of both mechanical and molecular events in the affected joint. Disease onset is gradual and usually begins after the age of 40. There is currently no cure for OA. Treatment for OA focuses on relieving symptoms and improving function, and can include a combination of patient education, physical therapy, weight control, and use of medications.

Rheumatoid Arthritis (RA)

Rheumatoid arthritis is a systemic inflammatory disease which manifests itself in multiple joints of the body. The inflammatory process primarily affects the lining of the joints (synovial membrane), but can also affect other organs. The inflamed synovium leads to erosions of the cartilage and bone and possibly joint deformity. Pain, swelling, and redness are common joint manifestations. Although the definitive causes are unknown, RA is believed to be the result of a faulty immune response. RA can begin at any age and is associated with fatigue and prolonged stiffness after rest. There is no cure for RA, but new drugs are increasingly available to treat the disease. In addition to medications and surgery, good self-management, including exercise, are known to reduce pain and disability.

Gout

Gout is a rheumatic disease resulting from deposition of uric acid crystals (monosodium urate) in tissues and fluids within the body. This process is caused by an overproduction or under excretion of uric acid. Certain common medications and dietary foods are known to be contributory factors. Acute gout will typically manifest itself as an acutely red, hot, and swollen joint with excruciating pain. These acute gouty flare-ups respond well to treatment with oral anti-inflammatory medicines and may be prevented with medication and diet changes. Recurrent bouts of acute gout can lead to a degenerative form of arthritis called gouty arthritis.

Systemic Lupus Erythematosus (SLE)

Systemic Lupus Erythematosus is an autoimmune disease in which the immune system produces antibodies to cells within the body leading to widespread inflammation and tissue damage. The causes of SLE are unknown but are believed to be linked to genetic, environmental, and hormonal factors. SLE may be characterized by periods of illness and remissions. SLE has a variety of clinical manifestations and can affect joints, skin, brain, lungs, kidneys, and blood vessels. People with SLE may experience fatigue, pain or swelling in joints, skin rashes, and fevers. SLE predominately affects women between the ages of 15 and 40 and blacks more than whites. A team approach in treating lupus if often warranted due to the number of organ systems involved.

Fibromyalgia

Fibromyalgia is a syndrome predominately characterized by muscular pains and fatigue. The causes of fibromyalgia are unknown; however researchers hypothesize that genetics and, physical and emotional stressors are possible contributory factors to the development of the illness. There are difficulties in diagnosing fibromyalgia, since its clinical picture can overlap other illnesses and there are no definitive diagnostic tests. Patient education, pharmacologic agents, and other nonpharmacologic therapies are used to treat fibromyalgia. Exercise has been found to improve outcomes for people with fibromyalgia.

Management

The focus of treatment for arthritis is to control pain, minimize joint damage, and improve or maintain function and quality of life. According to the American College of Rheumatology, the treatment of arthritis might involve the following:

• Medication.
• Nonpharmacologic therapies.
• Surgery.

In conjunction with medical treatment, self-management of arthritis symptoms is very important as well.

The Arthritis Foundation Self Help Program, developed by Dr. Kate Lorig of Stanford University, is an effective self-management education program. The program helps people develop the skills needed to manage their arthritis on a day to day basis and gain the confidence to carry it out.

Arthritis Risk Factors

Certain factors have been shown to be associated with a greater risk of arthritis. Some of these risk factors are modifiable while others are not.

Non-modifiable risk factors

• Age: The risk of developing most types of arthritis increases with age.

• Gender: Most types of arthritis are more common in women; 60% of all people with arthritis are women. Gout is more common in men.

• Genetic: Specific genes are associated with a higher risk of certain types of arthritis, such as rheumatoid arthritis (RA) and systemic lupus erythematous (SLE).

Modifiable risk factors

• Overweight and Obesity: Excess weight can contribute to both the onset and progression of knee osteoarthritis.

• Joint Injuries: Damage to a joint can contribute to the development of osteoarthritis in that joint.

• Infection: Many microbial agents can infect joints and potentially cause the development of various forms of arthritis.

• Occupation: Certain occupations involving repetitive knee bending are associated with osteoarthritis of the knee.

About the Author

www.cdc.gov
The Centers for Disease Control and Prevention (CDC) is one of the 13 major operating components of the Department of Health and Human Services (HHS), which is the principal agency in the United States government for protecting the health and safety of all Americans and for providing essential human services, especially for those people who are least able to help themselves.