A Major Pain in the Joints

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BY BAYLOR SCOTT & WHITE MEDICAL CENTER - WAXAHACHIE

When you think of costly health conditions, what comes to mind? Heart disease? Diabetes? Obesity? Probably not arthritis.

However, arthritis is among the most widespread, costliest – but often overlooked – conditions affecting Americans. According to a 2013 National Institutes of Health study, 55 million adults in the United States had physician-diagnosed arthritis costing an estimated $300 billion, including medical expenses and lost wages.

Many people think of arthritis as pain in the joints that only old people get. That’s another misconception.

“There are more than 100 types of joint diseases that affect men and women of all ages,” explains Sunny Patel, MD, a rheumatologist on the Baylor Scott & White Medical Center – Waxahachie medical staff. “Understanding the type of arthritis is a crucial step in preventing and treating long-term complications.”

In broadest terms, there are two categories of arthritis: osteoarthritis and inflammatory arthritis.

DIFFERENT PATHS, DIFFERENT PLACES

The most common type of arthritis is osteoarthritis, which results from the breakdown of cartilage located at the ends of bones. This leads to uneven joint movement, loss of shock absorption and bone rubbing against bone. Inflammatory arthritis – such as rheumatoid arthritis, psoriatic arthritis and

gout – are caused by the body’s own immune system attacking and inflaming joint tissue.

Dr. Patel says that osteoarthritis mostly affects larger joints like the knees and hips and is usually acquired over the course of a lifetime, particularly in those who are obese, with prior trauma to the joint or have jobs requiring repetitive movements. Inflammatory arthritis more frequently attacks smaller joints like those in the hand, wrist or foot, and the causes behind it can be more complex.

“Patients with inflammatory arthritis are often genetically predisposed individuals who are thought to have an environmental or infectious trigger activate the underlying disease process leading to joint destruction,” says Dr. Patel. Treating this form of arthritis often involves immunosuppressant medications.

There are limited treatment options for osteoarthritis. For patients with severe cases, joint replacement may be an option. However, Dr. Patel says that physical and occupational therapy also can help patients with all forms of the disease.

SUMMER LIVING

During the summer months, people are often more active especially outdoors. Light to moderate activity is important for patients with arthritis.

“Patients think – or maybe have even been told – that they shouldn’t do activity if they have arthritis. In fact, it’s the opposite,” advises Dr.

Patel. “Rheumatologists encourage patients with all types of arthritis to engage in activity and exercise.”

Patients with arthritis shouldn’t exercise to the point of pain, but they should do what they can. Dr. Patel recommends stretching for 10-15 minutes before exercising, staying hydrated to prevent cramps and, for those with arthritis, wearing shoe insoles or other support devices that help lessen stress on joints.

“Pool exercises are great because you’re not putting a lot of load-bearing weight on your joints,” he adds.

For patients who are overweight with – or at risk of – osteoarthritis, exercising also can be an important part of a weight-loss program. And it doesn’t take drastic weight loss to improve joint health. Weight loss of just five percent translates into a 20 percent improvement in function, making it a great investment in both joint and overall health.

TIME TO SEE A SPECIALIST?

Dr. Patel says that over-the-counter anti-inflammatory medications, rest and heating pads can help with the occasional joint pain nearly everyone experiences at some point. However, a call to your primary doctor or rheumatologist is in order for people experiencing:

» Joint swelling (particularly joints that are red or warm to touch)

» Prolonged morning stiffness in joints and muscles

» Persistent joint issues lasting beyond three days

» Joint deformities (curvature of fingers/wrist, malalignment of joints)

» Joint pain accompanied by fever, weight loss, fatigue and rash

Physicians provide clinical services as members of the medical staff at one of Baylor Scott & White Health’s subsidiary, community or affiliated medical centers and do not provide clinical services as employees or agents of those medical centers or Baylor Scott & White Health.