Mayo Clinic Guide to Arthritis

Managing Joint Pain for an Active Life

Lynne S. Peterson

• Publisher: Mayo Clinic Press
• Year: 2020
• ISBN:
  9780795352881
• Topic: Medicine
• Subtopic: Diseases & Allergies

A guide to living well with this common—and complex—condition from " one of the most reliable, respected health resources that Americans have" ( Publishers Weekly ). From the doctors at Mayo Clinic—the top-ranked hospital in the country according to US News & World Report —this book is a complete guide to understanding and living with arthritis. Find the latest expertise on various forms of arthritis, medications and other treatment options, and self-care to successfully manage joint pain and stay active and independent. If you have joint pain, you know it can lead to frustrating limitations in daily life. In fact, this complex group of joint diseases—osteoarthritis, rheumatoid arthritis, and many other forms—is the most common cause of disability in the United States. But living with it doesn't have to mean sitting on the sidelines. This book offers the same expert knowledge that Mayo Clinic doctors, nurses and therapists use in caring for patients. Mayo Clinic Guide to Arthritis: • Breaks down different forms of arthritis and joint pain to help you understand their causes, their signs and symptoms, and what each may mean for your health
• Explores the latest in arthritis treatments, including new medications to slow or stop the disease, improved options for joint surgery, joint injections, and evidence-based guidance on pain control and integrative medicine
• Provides practical tips for living with arthritis while exercising, traveling, or working
• Offers useful advice on diet, mental health, and protecting your joints

PART 1 Understanding arthritis

CHAPTER 1 Arthritis – Common and complex

When your joints are working smoothly, it’s easy to take them for granted. When they begin to ache, you take notice. If you’ve ever experienced pain, stiffness, swelling and difficulty moving because of arthritis, you’re not alone.

Arthritis is a common condition, affecting about 1 in 5 adults in the United States. More than 54 million Americans, including around 300,000 children, have been diagnosed with some form of the disease. And research suggests that the number of people affected by arthritis may be much higher, if you include those who have symptoms but haven’t been officially diagnosed.

Arthritis is one of the leading causes of disability in the United States. The costs for medical care and lost productivity due to arthritis amount to more than $300 billion annually. As the population ages, the number of people with arthritis is expected to increase. By 2040, an estimated 78 million adults age 18 and older will have some form of this disease.

Although people often think of arthritis as one disease, it’s not. The term refers to many diseases that can cause joint pain or stiffness, damage to the structure of a joint, or loss of joint function. The word arthritis is a blend of the Greek arthron + -itis that literally means “joint inflammation.” However, the term is commonly used to refer to any disease of the joints.

Arthritis occurs in more than 100 different forms. Some forms develop gradually due to the natural wear of joints, while others appear suddenly and then disappear, recurring at a later date. Other forms of arthritis are chronic and progressive, getting worse over time. Signs and symptoms can vary a great deal from one person to another, even if both individuals have the same form of the disease.

The most common symptoms of arthritis are pain while using the affected joints and joint stiffness after periods of rest or inactivity. But many arthritic disorders affect more than your joints. They can also affect the muscles, tendons and ligaments surrounding and supporting the joints, as well as your skin and other organs, such as the lungs, heart, bowel, brain, liver and kidneys.

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A word on inflammation

Inflammation is the body’s normal response to infection or injury. To fight infection, the immune system releases chemicals that stimulate a reaction, causing warmth, swelling and pain. But some diseases trigger an abnormal response from the immune system, creating ongoing (chronic) inflammation.

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Although there’s no cure for arthritis, treatment options are far ahead of what was available just a decade ago, and new research offers hope of even better therapies.Getting the right treatment early on can help prevent joint damage and mobility problems. You can also take steps at home to prevent arthritis or minimize its effects. By actively managing your arthritis, you can enjoy a more active, fulfilling life.

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What is rheumatism?

If your grandparents had achy joints, they might have talked about the “rheumatism” in their bones. Rheumatism is an older term used to describe the pain and stiffness of arthritis. Both words — rheumatism and arthritis — are often used in a general way to describe joint problems.

In fact, arthritis is an umbrella term for more than 100 diseases that cause joint pain, swelling and stiffness. The term rheumatic disease has broader significance for any disease of the bones, muscles and joints.

Rheumatology is the branch of medicine devoted to arthritis and other diseases of the musculoskeletal system, which includes the bones, joints, muscles, tendons, ligaments and other connective tissues that provide a framework and support for your body. Rheumatologists are medical doctors who have specialized training in rheumatology and internal medicine.

In addition to treating arthritis, rheumatologists treat certain illnesses in which your immune system attacks your own body tissues (autoimmune diseases), musculoskeletal disorders including back pain and bursitis, and bone diseases such as osteoporosis.

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Who gets arthritis?

Arthritis affects people of all ages — nearly two-thirds of people with arthritis are under age 65, and symptoms often begin after age 40. Nevertheless, the risk of getting arthritis increases as you get older. By conservative estimates, half of all adults age 65 and older have some form of arthritis.

Women are at higher risk than men of getting many forms of arthritis, especially after age 40. Researchers believe that female hormones that are naturally produced in the body may play a role in how — and when — arthritis develops. These hormones may also affect the severity of arthritis symptoms in women.

The likelihood of having arthritis varies by race and ethnicity. For example, white and black Americans and American Indians are more likely to get arthritis than are Hispanics and Asians.

People who are overweight have a higher risk of developing arthritis, especially in the knees. According to one survey, approximately two-thirds of U.S. adults diagnosed with arthritis are either overweight or obese. Excess weight puts more pressure on the joints. In addition, a past joint injury can also increase the risk of arthritis.

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Anatomy of a joint

Joints are points of connection between two or more bones. The joints are designed to hold the bones together and allow your skeleton to move. The parts of a bone within your joints are covered with shock-absorbing cartilage. Cartilage is a tough, smooth, slippery material that prevents bone-against-bone contact, allowing for easy movement with little friction.

Synovial joints, found in the neck, shoulders, elbows, wrists, fingers, hips, knees, ankles and toes, are the most mobile form of a joint. These joints are surrounded by a tough, fibrous capsule that attaches to the bone on each side of the joint. The joint capsule helps stabilize and protect the joint. The capsule is lined with a tissue called the synovium. This thin membrane produces synovial fluid, a clear substance that nourishes the cartilage and “oils” (lubricates) the joint so that it can move smoothly.

Ligaments are tough cords of fibrous tissue that attach bone to bone. They help support the joint and keep it properly aligned. Muscles and tendons also hold the joint together. Tendons — which connect muscle and bone — attach to bone just outside the capsule above or below the joint.

Bursae are small, fluid-filled sacs tucked between muscles, tendons and bone. Synovial membrane lines the inside of each bursa, releasing a lubricating fluid to cushion the joint and reduce friction as tendons and muscles glide over bones.

Normal Joint

Joint capsule

This tough, fibrous material encapsulates and helps stabilize your joints.

Synovial membrane and fluid

The synovium is a thin membrane lining the inside of the joint capsule. It releases synovial fluid into the joint cavity to aid in lubrication.

Cartilage

Bones in your joints are capped with shock-absorbing cartilage, a tough, slippery material that reduces friction during movement.

Bursae

These tiny fluid-filled sacs help lubricate and cushion pressure points between your bones, muscles and tendons.

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What causes arthritis?

The pain associated with arthritis is caused by joint damage, but the damage can occur in different ways. Osteoarthritis, the most common form of arthritis, involves a wearing away of the tough, lubricated cartilage that normally cushions the ends of the bones in your joints. Rheumatoid arthritis develops from an uncontrolled response of your immune system, which causes chronic inflammation in the lining of your joints.

Most of the underlying causes of arthritis are unclear, but researchers believe that the condition may result from a complex interplay of multiple factors, including genetics and environment.

While it’s true that wear and tear on joints over time can contribute to osteoarthritis, the condition isn’t just a normal consequence of aging. Some people never develop it.

There’s little doubt that heredity influences whether or not you get arthritis. Scientists have identified specific genes linked to an increased risk of rheumatoid arthritis. Genetic factors that contribute to some cases of osteoarthritis have also been identified. But even peo...