Treatment of Arthritis

Arthritis is Slowing America Down

This article originally appeared in Be Well, a health information newsletter published for members of the Greater Marlborough community.

As this country's baby boomers continue the inevitable march into their fifties and sixties, the cry of "Oh, my aching back" (or knees, hips, etc.) is growing steadily louder.

The number of arthritis cases, already a serious chronic health problem, is increasing at an alarming rate. According to the Arthritis Foundation, 66 million Americans, or one in three adults, have arthritis or chronic joint symptoms. This is an increase of 23 million sufferers in just the last seven years.  In fact, arthritis is now second only to heart disease as the leading cause of work disability and interference with activities of living.

Arthritis actually refers to more than 100 different diseases that affect the joints or the tendons, ligaments and bursa sacs around the joints. The most common form is osteoarthritis, a degenerative joint disease in which the spongy cartilage that covers the ends of bones wears away, causing bone to rub against bone. The result is stiffness, pain and loss of mobility. A second type of arthritis, rheumatoid arthritis, is actually an autoimmune disease that causes the joint linings to become inflamed. One of the most serious and disabling types of arthritis, rheumatoid arthritis affects mostly women in their prime.

Although the cause of osteoarthritis is still not completely known, it is thought that age, obesity, injury, overuse and genetics can all play a role in its development. Researchers indicate that obesity and genetics can be key factors.

For every pound of weight a person gains, he or she adds three pounds of pressure
to the knees and six times the pressure on the hips.

"When you look at older people who have had arthritis for many years, the single biggest factor in terms of whether they are disabled or not is their body mass index, which is one measure of obesity," explains Anupam Mathur, MD, an internist and rheumatologist on staff at Marlborough Hospital. "Extra weight is very strongly linked to deterioration of the weight-bearing joints."

Dr. Mathur also believes that genetics plays an important role in the development of arthritis. "If you look closely at a patient's family history, you will almost always find a parent or close relative with arthritis," he says.  "In fact, my experience is that 90 percent of osteoarthritis patients have a family history of the disease. In a sense they are genetically unblessed."

The first step in treating arthritis is to get an accurate diagnosis and begin early, aggressive treatments. A proper diagnosis is critical, since there are different types of treatment plans for different types of arthritis. Although there is no cure yet for osteoarthritis, the rate of joint degeneration can be slowed down. Most treatment plans are highly individualized based on the patient's specific condition and usually entails some combination of medications; lifestyle changes, such as losing weight and quitting smoking; and an exercise program. For the most advanced cases, joint replacement surgery may become necessary.

Marlborough Hospital's Physical Rehabilitation Center offers a professionally developed treatment program for degenerative joint diseases. According to Director Annette Casco, PTA, the program consists of therapeutic exercises for strength and flexibility as well as treatments, such as ultrasound and electrical stimulation, to minimize pain.

"By strengthening the muscles that support the affected joint, you can relieve some of the pressure and minimize the pain," says Ms. Casco. "We also work on flexibility to help the patient improve his or her mobility."

Dr. Mathur feels that to turn the corner in the battle against arthritis, a profound shift in thinking must first take place. "We need to look at arthritis as a joint failure, in much the same way we look at heart or kidney failure," he says. "We need to be proactive and adopt preventive strategies versus being reactive and trying to treat it once the damage has occurred. These are real-life issues."  

Signs and Symptoms of Osteoarthritis
According to the Arthritis Foundation, the following are common symptoms of osteoarthritis:

  • Joint soreness after periods of overuse or inactivity
  • Stiffness after periods of rest that goes away quickly when activity resumes
  • Morning stiffness, which usually lasts no more than 30 minutes
  • Pain caused by the weakening of muscles surrounding the joint due to inactivity