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Arthritis

A Summary

by: George Pararas-Carayannis, Ph.D.*

(Excerpts from summary prepared under contract for the ReGenesis Medical Center/ Dec 2000)

* Disclaimer - I am not a medical doctor. All material provided at this website is for informational purposes only. Readers are encouraged to confirm the information contained herein with other sources. Patients and consumers should review the information carefully with their professional health care provider. The information is not intended to replace medical advice offered by physicians. I will not be liable for any direct, indirect, consequential, special, exemplary, or other damages arising therefrom.

Introduction

Arthritis is a disease that attack the joints and affects mostly the elderly. Arthritis means joint inflammation, but the term is used to describe nearly 100 different muscle, bone, and joint disorders, including osteoarthritis, rheumatoid arthritis, gout, lupus, and scleroderma. Very few of the forms of arthritis can be cured, but life changes can have a dramatic impact on how the disease affects those afflicted.

As of 1998, statistical data indicates that 43 million Americans are suffering from arthritis and other diseases of the joints. Since the disease is often a condition of age, by the year 2020, it is estimated that about 60 million people in the U.S. will be affected.

Joint Anatomy

Symptoms of Arthritis

Arthritis is a deterioration or erosion of the joint tissue. It is a debilitating disease that restricts activities. Although often crippling, arthritis varies enormously in severity and many sufferers have the condition quite mildly. People suffering from arthritis have three times as many unhealthy days -- both physically and mentally -- and a much worse "health related quality of life" than people without the disease.

Arthritis and Depression

Physical pain from all types of arthritic conditions affects significantly the mental health of sufferers frequently causing depression. Often, there may be a cascading effect -- arthritis causing the depression leading to a bad mental day, which contributes to increased arthritis pain, which depresses the person even more.

Diagnosing Arthritis

Diagnosis relies on accumulating information from the history, examination and investigations, especially certain blood tests and X-rays. Some patients develop characteristic nodules, particularly on the elbows. They are not usually painful, unless traumatized.

Types of Arthritis

Some examples of arthritis include osteoarthritis (OA), rheumatoid arthritis (RA), psoriatic arthritis, and gout. Each of these may affect patients differently and may have significantly different complications.

Osteoarthritis (OA)

Osteoarthritis (OA) is often described as an accelerated 'wear and tear' phenomenon affecting the joints. Thus, it primarily affects elderly individuals. While this is generally true, under certain circumstances, accelerated OA may also occur in relatively younger persons. Heredity may also be a factor in such cases.

Rheumatoid arthritis (RA)

Of all forms of arthritis, Rheumatoid Arthritis (RA) affects approximately 1-2 % of the general population and is found world-wide. RA is a chronic, systemic, inflammatory disease that chiefly affects the synovial membranes of multiple joints in the body. RA is the commonest form of inflammatory arthritis and it is three times as common in women than men. Onset of the disease in adults is usually between the ages of 40 to 60 years, although it can occur at any age.

Joint Diagram

Causes of RA: The cause of RA remains unknown. RA, as well as other autoimmune diseases, includes widespread immunological and inflammatory alterations of connective tissue. Because the autoimmune diseases share many clinical findings, making a differential diagnosis is often difficult. Although the autoimmune disorders are considered acquired diseases, their causes usually cannot be determined. Metabolic and nutritional factors, the endocrine system, geographic, psychologic, and occupational data have been extensively studied with no conclusive findings.

Also, there has been continuous suspicion of an infectious origin of the disease process, which has included various bacteria and viruses, but without evidence of precipitating events. It now appears that an unknown antigen initiates the autoimmune response resulting in RA. Also, the presence of HLA-DR4 antibody, in 70 percent of patients with RA, lends support to the genetic predisposition to the disease. Rheumatoid Factor(s) (RF) are antibodies to IgG, and are present in 60-80 percent of adults with the disease - particularly in cases associated with more severe and active joint disease.

Symptoms and effects of RA: Rheumatoid Arthritis can attack any synovial joint in the body, but seems to concentrate mostly on the small joints of the hands and feet. Early in the course of the disease, several changes in joint structures occur. Joint effusion and inflammation of the synovium occur and these produce a soft tissue swelling. Additionally, changes (osteoporosis) in the ends of the bones forming the joint may be present early in the disease process. The involvement of the joint tissues progresses over time, leading to deformity of the joints. The destruction of bone eventually leads to laxity in tendons and ligaments and the disability of the sufferer.

Rheumatoid Arthritis Nodule

Because the disease is systemic, there are many extra-articular features of the disease as well.
For example, neuropathy, scleritis, lymphadenopathy, pericarditis, splenomegaly, arthritis, and rheumatoid nodules are frequent components of the disease. In addition, the potential for involvement of the renal, pulmonary, and cardiovascular systems exist.

In most cases of RA, there may be remissions and exacerbation of the symptoms. Although at times the symptoms may temporarily remit, rarely the disease "goes away".

Treatment of RA Patients: Since Rheumatoid Arthritis (RA) is a complex, systemic disease, treatment of the disease is also complex and involves many aspects of a patient's life. Treatment can be broadly categorized into the following general areas:

Patient AND Family Education
Prevention of Disability and Preservation of Function
Surgical Intervention
Pharmacological Therapy
Maintenance of Lifestyle
Symptomatic Treatment
Social and Emotional Support

Drug treatments of RA and other forms of Arthritis: Arthritis is considered incurable but treatments are steadily improving and there has been a tendency in recent years to treat the condition more vigorously in the early stages.

The standard drug prescribed for RA is methotrexate. However, the drug Enbrel (etanercept) has been recently recommended as a first line therapy in delaying the structural damage of arthritic joints in patients with moderately to severely active rheumatoid arthritis RA. This drug is particularly recommended when other anti-rheumatoid medications have not been successful.

Ketoprofen is also another safe, highly potent, nonsteroidal anti-inflammatory drug that has been used in European countries for many years as an effective treatment for rheumatoid arthritis and osteoarthritis. Ketoprofen was recently approved by the FDA in United States. Finally, Celebrex is another, fairly new drug that has been reported to be a good pain killer for either osteoarthritis or rheumatoid arthritis sufferers.

AlternativeTreatment for Arthritis

Treatment for Arthritis, particularly Rheumatoid (RA), or other musculoskeletal disorders, involves the development of an individualized plan for the ultimate benefit of each patient. A major element in the treatment of patients is to prevent disability and preserve bodily function. An exercise routine is recommended to preserve motion, strength, functional activities, and lifestyle. Special nutritional supplements and EDTA Chelation therapy appear to provide many benefits to many RA patients, particularly during cyclic flares and exacerbation of the disease. Nutritional supplements provide the natural means of helping the immune system and the body's joints, tissues and cells of many patients suffering from different forms of arthritis or other musculoskeletal disorders. Nutritional supplements include glucosamine/chondroiton with MethylSulfonylMethane (MSM), Ester C and Manganese and other immune-stimulating and healing ingredients.

Miscellaneous Summaries on Chronic Illnesses

heart disease | | stroke | diabetes | | high blood pressure | | high cholesterol | | Alzheimer's | | Parkinson's | | arthritis | | chronic fatigue | | poor circulation | | brain injury | | multiple sclerosis | | cerebral palsy | | life extension | | memory loss |

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