Thursday May 1, 2014
Do you know Camille Church of Merrillville, IN? She is one of the many faces of arthritis, a debilitating disease impacting nearly 53 million Americans. That’s one in every five adults who suffers from this painful disease that is the nation’s number one cause of disability. Some may find it surprising that arthritis is an umbrella term that represents over a 100 medical conditions. Furthermore, two-thirds of those affected by arthritis are under the age of 65, including roughly 300,000 children. If you aren’t one of the 53 million affected, chances are you probably know someone who is.
"[Having arthritis] has taught me to appreciate every day that God has given to me. It has taught me to live, give and enjoy my son, my family and friends as often as possible. We need to work together for more research funding" says Camille. That’s why Camille joined forces with the Arthritis Foundation, a national non-profit organization committed to raising awareness and improving the lives of those affected by this unacceptable disease. For more than six decades the Arthritis Foundation has helped pave the pathway to a better tomorrow for millions of people impacted by arthritis through the funding of research that aims at providing patients with better access to healthcare, new treatments and ultimately cures. Initiated by the Arthritis Foundation in 1972, May serves as the official month of arthritis awareness.
What is arthritis and who treats it?
Arthritis is in the family of rheumatic diseases, which are identified with painful conditions usually caused by inflammation, swelling, and pain in the joints or muscles. The word “arthritis” literally means joint inflammation: arth (joint) and itis (inflammation), and the common thread is pain. While many believe it to be a disease that impacts only seniors, arthritis can develop as early as infancy- in fact one child in every 1000 develops some type of juvenile arthritis (JA).
The medical specialty of rheumatology leads the treatment of arthritis and other rheumatic diseases. A rheumatologist is an internist or pediatrician who undergoes additional training and experience in the diagnosis and treatment of arthritis and other diseases of the joints, muscles and bones. Rheumatologists help individuals diagnose, treat, and medically manage their arthritis and will collaborate with other health care providers to offer the best treatment available.
Three types of arthritis you should know about
Affecting nearly 27 million people in America, OA is known to be one of the most common forms of arthritis. It is a chronic condition in which the material that cushions the joints, called cartilage, breaks down causing bones to rub against each other, which in turn causes stiffness, pain and loss of joint movement. Common risk factors include increasing age, obesity, previous joint injury, overuse of the joint, weak thigh muscles, and genetics.
Symptoms: Sore or stiff joints, particularly in the hips, knees, and lower back, after inactivity or overuse, stiffness after resting that goes away after movement, and increased pain after activity or toward the end of the day.
Treatment: While there is no cure for OA, medications are available to help alleviate pain. Physical therapy (PT) or occupational therapy (OT) may be recommended to help improve strength and function.
Rheumatoid arthritis (RA)
Identified as an autoimmune disease, RA causes the body’s immune system, which protects your health by attacking foreign substances like bacteria and viruses, to mistakenly attack your joints. This abnormal immune response causes inflammation that can damage joints and organs-including your heart. Early diagnosis and prompt treatment is the key to preventing joint destruction and organ damage. RA affects about 2 million people in America, with nearly three times as many women as men with the disease.
Symptoms: Pain, fatigue and warm, swollen, reddish joints. Symptoms can vary day to day, including sudden increases called flares and long periods of joint stiffness in the morning.
Treatment: There is no cure for RA, but a number of medications are available to help ease the symptoms.
Juvenile arthritis (JA)
JA is an umbrella term used to describe the multitude of autoimmune and inflammatory conditions that develop in children ages 16 and younger. Though arthritis typically affects the joints, JA can also affect other areas of the body including the eyes, skin and gastrointestinal tract. Though no known cause has been pinpointed for most types of JA some research points toward a genetic predisposition, including a combination of inherited genes causing an onset when trigged by other factors.
Symptoms: The most common form, juvenile idiopathic arthritis (JIA), is diagnosed when a child has initial swelling in one or more joints for at least six weeks.
Treatment: Unfortunately there is no cure for JA, and every treatment plan is unique and requires the efforts your child’s full health care team, which may include a pediatrician, rheumatologist, dentist, ophthalmologist, nurse practitioner and physical therapist, among others.
Diagnosis and the role of medical imaging
If you think you or your child may have symptoms that point to arthritis, discuss your concerns with your primary physician immediately. He/she will likely refer you to a rheumatologist who will perform a complete physical exam, discuss your conditions, and possibly use other diagnostic steps such as laboratory work and other medical imaging tests to confirm the diagnosis.
Imaging tests allow your doctor to see structures inside of your body non-invasively and painlessly. For decades X-ray images have been used to help detect and monitor many forms of arthritis, however new research points to more sensitive types of imaging that may offer a more timely diagnosis and treatment.
As reported in "Arthritis Today," the Arthritis Foundation's official magazine, in some cases such as the early stages of RA, X-rays may appear normal although the disease is active. “Both MRI [magnetic resonance imaging] and ultrasound are more sensitive at detecting bone erosion than X-ray. In addition, they also reveal inflammation, which we could not see directly before and had to rely on blood tests and using our fingers to feel the joints,” says rheumatologist Philip Conaghan, MD, PhD, professor of musculoskeletal medicine at the University of Leeds and president of the International Society for Musculoskeletal Imaging in Rheumatology.
Both ultrasound and MRI can detect synovitis, inflammation of the lining of the joints, and tendon abnormalities. In addition, MRI detects areas of increased fluid (edema) in bone marrow that is a predictor for the development of bony erosions.
"I will send a patient for an MRI evaluation if the patient has multiple swollen and tender joints, normal X-rays, and a combination of normal and abnormal lab tests for inflammation. If there is bone marrow edema and bony erosions not seen on X-ray I’ll treat them more aggressively," says Orrin Troum, MD, clinical professor of medicine at the Keck School of Medicine/University of Southern California.
Both MRI and computerized axial tomography (CT) scan are listed, among a few others, as approved imaging tests to help in the diagnosis and treatment of arthritis in the hands, knees, ankles, hips and back. While a musculoskeletal MRI can be quite expensive and requires an experienced radiologist to read, patients have affordable options available through independent outpatient imaging centers, such as Northwestern Medical Imaging (NMI).
Will technology enable an early OA diagnosis?
“Arthritis Today” reported a new OA detection method was identified by scientists at the annual meeting of the American Chemical Society in Philadelphia. The new method uses a modified form of MRI to determine the concentration of molecules known as glycosaminoglycans (GAGs) in the joint cartilage. GAGs are responsible for many of the mechanical properties of cartilage tissue, including its toughness and elasticity.
"One of the things that is known is that the concentration of GAGs goes down in [osteoarthritic cartilage], but the reason for this is not really known" says says Alexej Jerschow, PhD, whose lab at New York University developed the new test. Jerschow believes the new technique could be available to patients in four to six years.
Warning Signs: Your role as a patient
Whether it’s dull, sharp, or burning, pain is a symptom telling you that something is wrong. “Pain is the natural protective response for the body,” says Doreen Stiskal-Galisewski, PhD, chair of the department of physical therapy at Seton Hall University in South Orange, NJ. Pain informs you that there is a problem in your body, so you can address the issue and take steps to heal it.
Three myths about arthritis
Myth #1: Arthritis is aches and pains associated with age.
Fact: While it’s true that arthritis becomes more common as people age, it may begin at any age, including childhood. Conversely, some elderly people never develop arthritis.
Myth #2: Arthritis isn't a serious health problem.
Fact: Collectively, the various types of arthritis and rheumatic diseases are the most common chronic health condition in the population.
Myth #3: People with arthritis should avoid exercising.
Fact: U.S. Department of Health and Human Services reports strong evidence indicating that exercise provides considerable disease-specific benefits for people with OA and rheumatic conditions.
What to discuss with your doctor
The Arthritis Foundation suggests the following five things you should do to ensure you make the most of the time you have with your doctor at each visit:
Write down your concerns. Having a list of questions and concerns ensures you don’t forget to bring them up. “It’s important for people to organize their thoughts about what they want to accomplish at a visit,” says Daniel Clauw, MD, professor of medicine in the Division of Rheumatology at the University of Michigan in Ann Arbor.
List your pills. Make a list of medications you take and their dosages to avoid potential problems with new treatments.
Log your symptoms. “[A doctor’s appointment is] a 12-minute snapshot into someone’s life, and it’s not necessarily reflective of what’s happened in the three to six months between visits,” says Dr. Clauw.
Discuss side effects. If you have medication side effects, tell your doctor. “If someone just has nausea from one codeine product, I can try another one,” explains rheumatologist Robert Shaw, MD, at Carroll Arthritis in Westminster, MD.
Know what brought you in. When seeing a new specialist, “it would [be] helpful if the patient brought a note from the referring doctor as to why they’ve been sent,” says Dr. Shaw.
To learn more about taking control of your arthritis visit http://www.arthritistoday.org/.
What can you do to help the cause?
Throughout May, the Arthritis Foundation urges taking action to help raise awareness and reduce the impact of the nation’s leading cause of disability. There is a lot you can do to help the cause from improving your health through fitness and nutrition, to speaking out about the seriousness of arthritis, to participating in your nearby Walk to Cure Arthritis, the annual event by the Arthritis Foundation which raises awareness and funds for research, education and programming to aid the one in five adults currently living with the disease.
This year NMI joined forces with the Arthritis Foundation to help them get the word out about the facts about arthritis, the importance of early diagnosis and treatment, and how you can give back to your impacted community members. Read more about your local Walk to Cure Arthritis below.
The AF Walk to Cure Arthritis | May 31, 2014 | Midlothian Meadows | Markham, IL
Beginning in the 1990s, the Walk to Cure Arthritis, formerly the Arthritis Walk, raised over $3.7M in its first year. Last year, over 20 years later and with more than 175 events across the country, it raised over $10M. Once held in Merrillville, IN, your local Arthritis Foundation Walk became part of The Walk to Cure Arthritis South Suburbs in 2012.
Offering a 5K (3.1 mile) course, this event will be a fantastic time for families from NW Indiana to Joliet, IL. Featuring a Canine Corner, Children’s Corner, Mission and Advocacy Moments, speakers, sponsor village and team tailgating, this family and dog-friendly event included over 150 participants and raised nearly $20,000 last year. Now you can help the Arthritis Foundation reach this year’s goal of $25,600 by participating! Learn more about The Walk to Cure Arthritis South Suburbs at http://SouthSuburbsIL.WalktoCureArthritis.org.
More about the Arthritis Foundation
The mission of the Arthritis Foundation is to improve lives through leadership in the prevention, control and cure of arthritis and related diseases. The Arthritis Foundation is committed to raising awareness and reducing the unacceptable impact of arthritis, a disease which must be taken as seriously as other chronic diseases because of its devastating consequences.
We are leading the way to conquer the nation's leading cause of disability through increased education, outreach, research, advocacy and other vital programs and services. Our goal is to reduce by 20 percent the number of people suffering from arthritis-related physical activity limitations by 2030. We build involvement in the cause via advocacy, events, fundraising appeals, media relations and consumer information.
To learn more about the Arthritis Foundation visit https://www.arthritis.org/.