MEDICAL SURFARI: BARE-BONE FACTS ON ARTHRITIS

Many of us who enjoy the change of the seasons enjoy the effects of winter -- watching the snow fall flocking the trees and dampening the sounds in our busy world. Winter brings with it many fond memories of holidays and family times, but for many others, these cold months bring joint pain and stiffness -- the result of arthritis.

Nearly 40 million Americans (one in seven) have arthritis. About 6 million Americans are self-diagnosed as they believe they have arthritis, but have not yet seen a physician to be sure. Arthritis, the No. 1 cause of disability in America, affects women more than men. It limits everyday activities -- such as dressing, climbing stairs, getting in and out of bed, or walking -- for about 7 million Americans. The estimated annual cost for arthritis to the economy is $54.6 billion in medical care and indirect costs, such as lost wages.

There are many types of arthritis which may affect people at any age (even children) but it is most common in people beyond middle age. Many people have evidence of joint deterioration upon X-ray, but only about one third of those over 60 have symptoms. Clearly, aging is a leading risk factor for arthritis, but research has shown that osteoarthritis is not an inevitable part of aging.

The hallmark of arthritis is the breakdown of joint cartilage -- the cushion between two bones at a joint that acts as a shock absorber. As cartilage deteriorates, bones begin to rub together, which may cause changes in the bone resulting in "bone spurs." This may cause the joint to lose some of its normal alignment resulting in pain and reduced range of motion. This disease may affect any joint, but often affects the hands and weight-bearing joints, such as the knees, hips, ankles, and the back. Osteoarthritis of the knee alone accounts for as much disability in older Americans as conditions like diabetes, heart disease, hip fractures, and depression.

You may wonder, why does the cartilage break down? Some people are born with defective cartilage or slight defects in the way their joints fit together that may, over time, cause the cartilage to wear away. People who have sustained injuries to a joint may also be at increased risk of developing osteoarthritis at the affected joint. Obesity may also contribute to osteoarthritis, especially within weight-bearing joints, as it increases the "wear and tear changes" within these joints.

Regardless of the cause, damaged and unrepaired cartilage often results in osteoarthritis within the affected joint. Strengthening muscles surrounding a beleaguered joint can help protect joints by absorbing shock and improving stability.

Although there is no known cure for osteoarthritis, for many people, taking the following steps significantly reduces pain and disability. Consult your physician about these alternatives.

-- Exercise: This will strengthen associated muscles, improve stability, and maintain joint flexibility which often lessens pain and decreases the risk of muscle and joint injuries.

-- Maintain healthful weight: Excess pounds place extra stress on weight-bearing joints.

-- Make lifestyle adaptations: Toilet seat adapters and wall bars in the bathtub can make these necessities easier and less painful.

-- Use pain-management techniques and medications: Hot baths, showers, and heat packs can be used to relax sore muscles and relieve joint pain and soreness. Anti-inflammatory medications and cold gel packs are often a good first line of defense against the discomfort of arthritis.

-- Take charge with education: Learn about self-help courses available through the Arthritis Foundation. To find out about a course in your area, contact the Arthritis Foundation at 1-800-283-7800.

World Wide Web Resources: Visit these reliable sites for more information.

Fast Facts

http://www.arthritis.org/facts/

Get your fast facts on arthritis, as well as other musculoskeletal diseases such as fibromyalgia, gout, and lupus.

Juvenile Arthritis

http://www.arthritis.org/ajao/index.shtml

This site is filled with good information and resources. Juvenile arthritis affects an estimated 285,000 children in the United States. Quality of life for children with rheumatic diseases is so important, and this site promotes this through improved medical care, advocacy, research, education and support groups.

HealthGain

http://www.healthgain.com/

Its major interest is facilitating communications between consumers and healthcare providers. This electronic records system looks like an ATM machine. You may select programs to help yourself in understanding and managing your diseases.

Pediatric Rheumatology

http://www.wp.com/pedsrheum/

This site is dedicated to children with arthritis and related conditions including scleroderma, dermatomyositis, and kawasaki disease.

The Road Back

http://www.roadback.org/

Information provided at this site is a bit different from other arthritis support groups. Rather than helping you "cope" or "learn to live with" your disease, it offers information on "treatments" and "breakthroughs."

Dr. Scott Gibbs is a neurosurgeon and editor-in-chief of Mosby's Medical Surfari. You may e-mail questions to him at drgibbs@semissourian.com or write in care of the Southeast Missourian, P.O. Box 699, Cape Girardeau, Mo., 63701.