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Monday, July 29, 1996 &nbsp;&nbsp;&nbsp;&nbsp;Page: 





Arthritis can become crippling disease &nbsp;&nbsp;&nbsp; 
 The term arthritis generally refers to inflammation, pain and swelling of
one or more joints of the body. The causes for arthritis are many and the
cures are few. This makes arthritis one of the costliest and most
patient-unfriendly chronic disorders that primary care physicians must
confront every dayTypical symptoms of arthritis are stiffness and difficulty
in moving joints. Some people claim that their aching joints can predict
changes in the weather. This is more than an old wives' tale as changes in
barometric pressure cause changes in pressure within joints. &nbsp;&nbsp;&nbsp; Arthritis can vary in intensity from mild discomfort to a crippling and
painful disease that severely limits activity. &nbsp;&nbsp;&nbsp; 
 From the first signs of arthritis, to establishing a diagnosis, to a plan
for treatment and self-care, ongoing collaboration between patient and
physician is vital. &nbsp;&nbsp;&nbsp; 
 Osteoarthritis (OA) is the most common form of arthritis affecting nearly
everyone. The incidence of OA increases with age. Primary OA often develops in
the small joints of the fingers and toes. Secondary OA develops in joints that
may have been affected by injury, or wear and tear, especially the hip, knee,
and spine. &nbsp;&nbsp;&nbsp; 
 Primary symptoms of OA are pain and loss of joint mobility. The deformity
produced by osteoarthritis may not be proportional to the symptoms that the
patient experiences. In addition, what is seen on x-ray may be out of
proportion to the degree of discomfort experienced by the patient. &nbsp;&nbsp;&nbsp; 
 Degeneration of the joints begins with abnormalities in the smooth, rubbery
pad (cartilage) that cushions the ends of the bone. This area becomes soft,
pitted, and less elastic. With years of use sections of cartilage may wear
creating a painful contact between the ends of the bones. Eventually the joint
may lose its normal shape. The ends of the bones may thicken, and bone spurs
(protrusions or spikes) may form. These pointed growths on the ends of a bone
may be noticeable externally, especially in the fingers. &nbsp;&nbsp;&nbsp; 
 Prompt treatment can ease pain and save joint motion. Aspirin or similar
medications are most often prescribed to relieve pain and reduce inflammation. &nbsp;&nbsp;&nbsp; 
 Aspirin-like medications, such as Motrin (ibuprofen), are known as
non-steroidal anti-inflammatory medications (NSAIDs). &nbsp;&nbsp;&nbsp; 
 Treatment may also include exercise to strengthen muscles and correct
posture, or splints and braces to rest the affected joints. Weight loss may
help overweight OA sufferers. In extreme cases, joint surgery (such as hip or
knee replacement) may be needed. &nbsp;&nbsp;&nbsp; 
 As with all forms of arthritis, OA is chronic. It may let up for a while
but it won't go away. Early medical treatment can help prevent rapid
deterioration in some patients. &nbsp;&nbsp;&nbsp; 
 Rheumatoid arthritis (RA) is the second most common form of arthritis and
it is potentially more serious than other forms of the disease. It is also the
most disabling. Unlike OA, which predominately strikes older people, RA can
occur at any age and affects women more often than men. It is the most common
form of arthritis in children. The cause of the disease is unknown, and the
course is unpredictable with symptoms appearing and disappearing suddenly. &nbsp;&nbsp;&nbsp; 
 RA often presents as an inflammation of the membranes that line the joints,
especially the small joints of the hands and feet. Symptoms are stiffness,
warmth, swelling, and pain, especially in the morning. Early in the disease
the symptoms lessen with activity as the day progresses. &nbsp;&nbsp;&nbsp; 
 As RA advances the sacs that line the joint cavity become red and swollen,
and then thicken. Soon cartilage and bones are worn away and the bones may
become fused by scar tissue resulting in rigid joints. Muscle spasms caused by
pain add to the disability &nbsp;&nbsp;&nbsp; 
 RA can also affect the entire body including the lungs, heart, and muscles.
The RA sufferer may experience fever, fatigue, anemia, weight loss, and muscle
wasting. The RA patient must see a physician regularly to monitor this
condition and allow for appropriate treatment depending on the stage of the
disease. &nbsp;&nbsp;&nbsp; 
 On the basis of careful examination and testing, treatment varies with each
type of arthritis. Usually included are a balanced program of rest to limit
pain and inflammation, along with exercise to keep the joints mobile. &nbsp;&nbsp;&nbsp; 
 Arthritis can be both demoralizing and depressing. &nbsp;&nbsp;&nbsp; 
 Emotional support from family and the medical team is extremely important.
Patients should be cautioned to avoid self medication and self treatment which
can delay appropriate medical care. As with other chronic disorders your
family physician, internist, or pediatrician (primary care physicians) are in
the best position to monitor this condition over an extended period of time. &nbsp;&nbsp;&nbsp; 
 Herbert M. Weinman of Dallas is a family physician and vice president of
Provider Services for Blue Cross of Northeastern Pennsylvania. &nbsp;&nbsp;&nbsp;

Arthritis Can Become Crippling Disease 
The Term Arthritis Generally Refers To Inflammation, Pain And Swelling Of One 
Or More Joints Of The Body. The Causes For Arthritis Are Many And The Cures 
Are Few. This Makes Arthritis One Of The Costliest And Most Patient-unfriendly 
Chronic Disorders That Primary Care Physicians Must Confront Every Day.