Arthritis is a disease that impacts more than 50 million Americans, making it the number one cause of disability in the country. That means 1 in every 5 adults, 300,000 children and countless families are affected by arthritis. – Arthritis Foundation, 2016
Dr. Miguel Rodriguez of SIMED Arthritis Center breaks down some of the components of how arthritis works and why it’s such a debilitating disease.
How does someone develop arthritis?
“You can break up arthritis into two different types, there is osteoarthritis and inflammatory arthritis. Osteoarthritis is a result of wear and tear that ends up happening as a function of age or it could be a result of long term repercussions of having some type of trauma to the body. For example, if you break your ankle and as it heals you continue to walk on it, you can develop arthritis in your ankle. Then there is inflammatory arthritis which is generally classified as an auto immune disease so that means that someone’s own immune system is reacting against their own joints” says Dr. Rodriguez.
Are there certain predisposition to arthritis?
So again we are breaking it up into two different types of Arthritis. Obesity is a big modifiable risk factor for osteoarthritis. The wear and tear of weight bearing joints can be accelerated by obesity. As we get older, we will all eventually develop osteoarthritis.
Inflammatory arthritis can be passed down genetically from family members. Then there are certain things like Gout, which can be from being overweight or having bad kidney function.
Are there precautions someone can take to reduce their chance of arthritis?
It helps to maintain a healthy lifestyle. Staying active is important to keep your weight down. For every pound you lose, your taking four pounds off the knees.
What are some ways to cope with the symptoms of arthritis?
In general you want to try and stay active. Physical Therapy can be helpful to demonstrate safe exercise and stretches that can help decrease joint pain and improve conditioning. Topical creams can be beneficial for pain relief, and for some people, acupuncture helps.
What types of medications are there for arthritis and what do they do?
With Osteoarthritis you are trying to relieve pain so you start off with over the counter medicine like Tylenol(acetaminophen),which is your safest oral medication. Then you have anti-inflammatory medicines such as, Advil(Ibuprofen) and Aleve(Naproxen). Some of these anti-inflammatories are also available in prescription strength. Then you have opiates for extreme pain associated with osteoarthritis.
We consider rheumatoid arthritis a prototypical inflammatory arthritis. To treat patients, we generally start off with steroids in order to get the inflammation under control. Then we use different medications to keep the inflammation under control while we take away the steroids.
DMARD’s Biologic s are exciting newer medications we use to control the autoimmune reaction either individually or in combination to control their inflammatory arthritis. By getting control of the inflammatory symptoms, we are able to decrease or hopefully get people off their steroids.
What are the symptoms of Rheumatoid arthritis?
Joint swelling is the biggest symptom of rheumatoid arthritis. The joints will be visibly swollen, generally the hands will be most affected. This can really impact your day to day routine. For example, if you have to be at work at 8 o’clock, you may need to get up earlier to wait out the stiffness. The stiffness can last up to an hour after waking up. This is something you can help to differentiate between inflammatory arthritis and osteoarthritis.
What type of doctor should someone go to if they think they are developing arthritis?
You can see a Primary Care doctor if you think you are developing arthritis and they can refer you to see a specialist if need be. Your Primary Care doctor can send you to a rheumatologist, a specialist in arthritis. The Rheumatology works with other specialists if the arthritis results in complications requiring surgery or other interventional procedures.
Is there any research going on for arthritis relief?
There is a lot of research going on for rheumatoid and inflammatory arthritis. For these types of arthritis, they are generally caused by the immune system so there are different ways of working on modulating the system to stop the long term damage from the chronic inflammatory process.
Can arthritis be "cured"?
No unfortunately it cannot be cured. However, the idea is to be able to control the systems. So the rheumatoid arthritis will hopefully become in like diabetes or hypertension in some patients. Which means they will have to take medicine all the time but they won’t have any symptoms, or long term complications.
I understand some of the newer arthritis medications cant be taken by mouth. How are these medications administered?
An infusion room is where patients can receive medicines called biologics which are medicines used to control inflammatory arthritis. These medicines are given through an IV and block specific parts of the immune system that are responsible for the swelling or inflammation that cause rheumatoid arthritis. Many rheumatologist, including here at SIMED arthritis center, have infusion rooms incorporated in their clinics.
Can people develop both types of arthritis?
Yes, people can develop both inflammatory and osteoarthritis. People with inflammatory arthritis continue to age and their joints experience the typical wear and tear that leads to osteoarthritis.
As a Doctor how do you diagnose one over the other?
As a Rheumatologist the most important thing we do is have the patient give us a detailed health history and we do a physical exam. This helps differentiate if the problem is an ongoing issue between inflammatory arthritis and osteoarthritis. The doctor can tell the difference between the two by palpating the stiff joints as well as looking at the pattern of the joints involved.
Dr. Rodriguez encourages you to take control of your arthritis this year! If you’re not sure how to start you can begin by scheduling an appointment with a Primary Care physician or a Rheumatologist today! Click here to request an appointment online.