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Arthritis Frequently Asked Questions
Frequently Asked Questions
1. What is arthritis? Arthritis literally means joint inflammation, but it is often used to identify a group of more than 100 rheumatic diseases that may cause pain, stiffness, and swelling in the joints and in areas close to the joints. Joints are places in the body where two bones meet.
Arthritis is often a chronic disease, which means that it can affect you over a long period of time. Many forms of arthritis cause swelling, redness, heat, and pain.
2. How many people have arthritis? More than 40 million people in the United States have some form of arthritis, and many have chronic pain that limits daily activity. Osteoarthritis is by far the most common form of arthritis, affecting more than 20 million people.
Rheumatoid arthritis is the most disabling form of arthritis. More than 2 million people have this disease. Gout occurs in approximately 840 out of every 100,000 people. It is rare in children and young adults.
3. What is osteoarthritis? Osteoarthritis is the most common form of arthritis among older people. It affects hands, low back, neck, and weight-bearing joints such as knees, hips, and feet.
Osteoarthritis occurs when cartilage, the tissue that cushions the ends of the bones within the joints, breaks down and wears away. This causes bones to rub together, causing pain, swelling, and loss of motion of the joint.
4. How common is osteoarthritis in older adults? The chance of developing osteoarthritis increases with age. By age 65, half of the population has x-ray evidence of osteoarthritis in at least one joint, most often in the hips, knees, or fingers.
5. Does having osteoarthritis impact activities of daily living? Yes. Osteoarthritis is one of the most frequent causes of physical disability among older adults. Many people with osteoarthritis find their movements or activities limited to some degree because of stiffness, limited range of motion, and pain.
6. What causes osteoarthritis? Osteoarthritis often results from years of wear and tear on joints. This wear and tear mostly affects the cartilage, the tissue that cushions the ends of bones within the joint. Osteoarthritis occurs when the cartilage begins to fray, wear away, and decay.
Putting too much stress on a joint that has been repeatedly injured may lead to the development of osteoarthritis, too. A person who is overweight is more likely to develop osteoarthritis because of too much stress on the joints. Also, improper joint alignment may lead to the development of osteoarthritis.
7. How can I reduce my chances of developing osteoarthritis? Maintaining a healthy weight, avoiding injury, and engaging in moderate daily physical activity are all ways to decrease your chances of developing osteoarthritis.
8. What are some common symptoms of osteoarthritis? Common symptoms of osteoarthritis include joint pain, swelling, or tenderness; stiffness after getting out of bed; and a crunching feeling or sound of bone rubbing on bone. Not everyone with osteoarthritis develops symptoms. In fact, only a third of people with x-ray evidence of osteoarthritis report pain or other symptoms.
9. How is osteoarthritis diagnosed? No single test can diagnose osteoarthritis. When a person feels pain in his or her joints, it may or may not be osteoarthritis.
The doctor will use a combination of tests to try to determine if osteoarthritis is causing the symptoms. These may include a medical history, a physical examination, x-rays, and laboratory tests. A patient's attitudes, daily activities, and levels of anxiety or depression have a lot to do with how much the symptoms of osteoarthritis affect day-to-day living.
10. Is there a cure for osteoarthritis? There is no cure for osteoarthritis and no way to reverse the joint damage once it occurs. However, current treatments can relieve symptoms.
Exercise is one of the best treatments. Exercise can improve mood and outlook, decrease pain, and assist in maintaining a healthy weight.
Warm towels, hot packs, or a warm bath or shower can provide temporary pain relief. Medications such as non-steroidal anti-inflammatory drugs, or NSAIDs, help reduce pain and inflammation that result from osteoarthritis.
11. Can glucosamine and chondroitin sulfate relieve symptoms of osteoarthritis? For some people, glucosamine and chondroitin sulfate may help relieve the symptoms of osteoarthritis. Scientific studies have shown that these supplements may have some benefit for people with osteoarthritis. However, the effectiveness of these supplements is still under investigation.
The NIH is currently funding the Glucosamine and Chondroitin Arthritis Intervention Trial, or GAIT, to test whether or not glucosamine and/or chondroitin have a beneficial effect for people with knee osteoarthritis. The results of the recently completed first phase of the study indicate that these supplements have a limited effectiveness for most patients with osteoarthritis.
12. What is rheumatoid arthritis? Rheumatoid arthritis is an inflammatory disease that causes pain, swelling, stiffness, and loss of function in the joints. It can cause mild to severe symptoms.
People with rheumatoid arthritis may feel sick, tired, and sometimes feverish. Sometimes rheumatoid arthritis attacks tissue in the skin, lungs, eyes, and blood vessels.
The disease generally occurs in a symmetrical pattern. If one knee or hand is involved, usually the other one is, too. It can occur at any age, but often begins between ages 40 and 60. About two to three times as many women as men have rheumatoid arthritis.
13. What causes rheumatoid arthritis? Scientists believe that rheumatoid arthritis results from the interaction of many factors such as genetics, hormones, and the environment. Although rheumatoid arthritis sometimes runs in families, the actual cause of rheumatoid arthritis is still unknown.
Research suggests that a person's genetic makeup is an important part of the picture, but not the whole story. Some evidence shows that infectious agents, such as viruses and bacteria, may trigger rheumatoid arthritis in people with an inherited tendency to develop the disease. The exact agent or agents, however, are not yet known.
It is important to note that rheumatoid arthritis is not contagious. A person cannot catch it from someone else.
14. What are some common symptoms of rheumatoid arthritis? Rheumatoid arthritis is characterized by inflammation of the joint lining. This inflammation causes warmth, redness, swelling, and pain around the joints.
The pain of rheumatoid arthritis varies greatly from person to person, for reasons that doctors do not yet understand completely. Factors that contribute to the pain include swelling within the joint, the amount of heat or redness present, or damage that has occurred within the joint.
15. How is rheumatoid arthritis diagnosed? Rheumatoid arthritis can be difficult to diagnose in its early stages because the full range of symptoms develops over time, and only a few symptoms may be present in the early stages.
As part of the diagnosis, your doctor will look for symptoms such as swelling, warmth, pain, and limitations in joint motion throughout your body. Your doctor may ask you questions about the intensity of your pain symptoms, how often they occur, and what makes the pain better or worse.
There is no single, definitive test for rheumatoid arthritis. One common test is for rheumatoid factor, an antibody that is eventually present in the blood of most rheumatoid arthritis patients. An antibody is a special protein made by the immune system that normally helps fight foreign substances in the body. Not all people with rheumatoid arthritis test positive for rheumatoid factor, however, especially early in the disease.
Another test is the citrulline antibody test. Other common tests include one called the erythrocyte sedimentation rate that indicates the presence of inflammation in the body, a white blood cell count, and a blood test for anemia.
X-rays are often used to determine the degree of joint destruction. They are not useful in the early stages of rheumatoid arthritis before bone damage is evident, but they can be used later to monitor the progression of the disease.
16. How is rheumatoid arthritis treated? Medication, exercise, and, in some cases, surgery are common treatments for this disease. Most people who have rheumatoid arthritis take medications. Some drugs only provide relief for pain; others reduce inflammation.
People with rheumatoid arthritis can also benefit from exercise, but they need to maintain a good balance between rest and exercise. They should get rest when the disease is active and get more exercise when it is not.
In some cases, a doctor will recommend surgery to restore function or relieve pain in a damaged joint. Several types of surgery are available to patients with severe joint damage. Joint replacement and tendon reconstruction are examples.
17. What are some non-drug therapies that can help people with rheumatoid arthritis? Both rest and exercise can help people with rheumatoid arthritis. Rest helps reduce active joint inflammation and pain and fights tiredness. Exercise can help people sleep well, reduce pain, and maintain a positive attitude. An overall nutritious diet with the right amount of calories, protein, and calcium is important.
Some people find that using a splint for a short time around a painful joint reduces pain and swelling by supporting the joint and letting it rest. Assistive devices may help reduce stress and lessen pain in the joints. Examples include zipper pullers and aids to help with moving in and out of chairs and beds.
18. What kind of surgery is available for people with rheumatoid arthritis or osteoarthritis? Several types of surgery, including joint replacement and tendon reconstruction, are available to people with rheumatoid arthritis and osteoarthritis. A doctor may perform surgery to smooth out, fuse, or reposition bones, or to replace joints.
The purpose of these procedures is to reduce pain, improve joint function, and improve a person's ability to perform activities of daily living. For people with arthritis, surgery is one way to help relieve pain and disability.
If you are considering surgery for osteoarthritis or rheumatoid arthritis, there are important factors to discuss with your doctor beforehand. These include your age and occupation, the extent of your disability and pain, and how much the disease interferes with your everyday life.
Today, most surgery for osteoarthritis involves replacing the hip or knee joint. Surgeons may replace affected joints with artificial ones called prostheses.
19. What is gout? Gout is one of the most painful rheumatic diseases. It occurs when needle-like crystals of uric acid build up in connective tissue, in the joint space between two bones, or in both.
Adult men, particularly those between the ages of 40 and 50, are more likely than women to develop gout. Women rarely develop the disease while still menstruating.
Sometime during the course of the disease, gout will affect the big toe in about 75 percent of patients. Gout frequently affects joints in the lower part of the body such as knee, ankles, or toes.
20. What causes gout? Researchers have discovered several key risk factors for developing gout. In addition to inherited traits, diet, weight, and alcohol play a role in the development of gout. Up to 8 percent of people with gout have a family history of the disease.
Most people with gout have too much uric acid in their blood, a condition called hyperuricemia. Uric acid is a substance that results from the breakdown of purines, which are part of all human tissue and are found in many foods. Hyperuricemia occurs when high levels of uric acid build up in the bloodstream.
21. What are some common symptoms of gout? Gout frequently first attacks the joints in the big toe. The affected joint may become swollen, red, or warm. Attacks usually occur at night.
22. How is gout diagnosed? To confirm a diagnosis of gout, the doctor inserts a needle into the inflamed joint and draws a sample of synovial fluid, the substance that lubricates a joint. A laboratory technician places some of the fluid on a slide and looks for uric acid crystals under a microscope. If uric acid crystals are found in the fluid surrounding the joint, the person usually has gout.
23. What are the most common treatments for an acute attack of gout? Physicians often prescribe high doses of non-steroidal anti-inflammatory drugs, or NSAIDs, or steroids for a sudden attack of gout. NSAIDs are taken by mouth and corticosteroids are either taken by mouth or injected into the affected joint. Patients often begin to improve within a few hours of treatment, and the attack usually goes away completely within a week or so.
