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ARTHRITIS TREATMENT | Learn more about Arthritis

What is arthritis?

Arthritis is inflammation of one or more joints, which results in pain, swelling, stiffness, and limited movement. A joint is an area of the body where two different bones meet. A joint function is to move the body parts connected by its bones. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are many different forms of arthritis including those related to wear and tear of cartilage [osteoarthritis], and those associated with inflammation resulting from an over-active immune system [rheumatoid arthritis], abnormal metabolism [gout and pseudogout], ankylosing spondylitis, psoriatic arthritis, systemic lupus erythematosus. Arthritis is frequently accompanied by joint pain.

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What are the arthritis’ symptoms?

Symptoms of arthritis include pain and limited function of joints. Inflammation of the joints from arthritis is characterized by joint stiffness, swelling, redness, and warmth. Tenderness of the inflamed joint can be present. Many of the forms of arthritis may cause symptoms affecting various organs of the body that do not directly involve the joints. Therefore, symptoms in some patients with certain forms of arthritis can also include fever, gland swelling, weight loss, fatigue, feeling unwell, and even symptoms from abnormalities of organs such as the lungs, heart, or kidneys. Arthritis involves the breakdown of cartilage. Cartilage normally protects the joint, allowing for smooth movement. Cartilage also absorbs shock when pressure is placed on the joint, like when you walk. Without the usual amount of cartilage, the bones rub together, causing pain, swelling (inflammation), and stiffness. Arthritis is classified as one of the rheumatic diseases. These are conditions that are different individual illnesses, with differing features, treatments, complications, and prognosis. They are similar in that they have a tendency to affect the joints, muscles, ligaments, cartilage, tendons, and many have the potential to affect internal body areas. You may have joint inflammation for a variety of reasons, including: • Broken bone • Infection (usually caused by bacteria or viruses) • An autoimmune disease (the body attacks itself because the immune system believes a body part is foreign) • General "wear and tear" on joints.

Often, the inflammation goes away after the injury has healed, the disease is treated, or the infection has been cleared. With some injuries and diseases, the inflammation does not go away or destruction results in long-term pain and deformity. When this happens, you have chronic arthritis. Osteoarthritis is the most common type and is more likely to occur as you age. You may feel it in any of your joints, but most commonly in your hips, knees or fingers. Risk factors for osteoarthritis include:

• Being overweight • Previously injuring the affected joint • Using the affected joint in a repetitive action that puts stress on the joint (baseball players, ballet dancers, and construction workers are all at risk)

Arthritis can occur in men and women of all ages. About 37 million people in America have arthritis of some kind, which is almost 1 out of every 7 people. Other types or cause of arthritis include:

• Rheumatoid arthritis (in adults) • Juvenile rheumatoid arthritis (in children) • Systemic lupus erythematosus (SLE) • Gout • Scleroderma • Psoriatic arthritis • Ankylosing spondylitis • Reiter's syndrome (reactive arthritis) • Adult Still's disease • Viral arthritis • Gonococcal arthritis • Other bacterial infections (non-gonococcal bacterial arthritis ) • Tertiary Lyme disease (the late stage) • Tuberculous arthritis • Fungal infections such as blastomycosis

How is arthritis diagnosed?

The very first thing the patient has to do before making any conclusion himself is talking to his doctor. The doctor will explore the history of symptoms, examine the joints for inflammation and deformity, as well as ask questions about other parts of the body for inflammation or signs of diseases that can affect other body areas. In addition, certain blood, urine, joint fluid, and/or x-ray tests might be required. The diagnosis will be based on the pattern of symptoms, the distribution of the inflamed joints, and any blood and x-ray findings. Several visits may be necessary before the doctor can be sure of the diagnosis. Many forms of arthritis are more of an annoyance than serious. However, millions of patients suffer daily with pain and disability from arthritis or its complications. Prior and accurate diagnosis can help to prevent irretrievable damage and disability. Properly guided programs of exercise and rest, medications, physical therapy, and surgery options can idealize long-term outcomes for arthritis patients. Further communication with the treating doctor is highly important, so that he/she can be aware of the vagaries of the patient's symptoms as well as their tolerance to and acceptance of treatments. It is also essential from the standpoint of patient, so that he can be assured that he has an understanding of the diagnosis and how the condition does and might affect them. It is also crucial for the safe use of prescribed medications.

Who is a rheumatologist?

A rheumatologist is a medical doctor who specializes in the non-surgical treatment of rheumatic illnesses, especially arthritis. Rheumatologists have special interests in, rheumatoid arthritis, spondylitis, psoriatic arthritis, systemic lupus erythematosus, antiphospholipid syndrome, Still's disease, dermatomyositis, Sjogren's syndrome, vasculitis, scleroderma, mixed connective tissue disease, sarcoidosis, Lyme disease, osteomyelitis, osteoarthritis, back pain, gout, pseudogout, relapsing polychondritis, Henoch-Schonlein purpura, serum sickness, reactive arthritis, Kawasaki disease, fibromyalgia, erythromelalgia, Raynaud's disease, growing pains, iritis, osteoporosis, reflex sympathetic dystrophy, unexplained rash, fever, arthritis, anemia, weakness, weight loss, fatigue, joint or muscle pain, autoimmune disease, and anorexia and others.

Pediatric rheumatologists are physicians who specialize in providing comprehensive care to children (as well as their families) with rheumatic diseases, especially arthritis.

Arthritis Treatment

Most arthritic diseases can be treated but not cured. However treatment can control a disease so well that it is no longer a problem. High blood pressure, for example, can be kept normal with tablets - preventing the problems it might otherwise cause. The degree of success of treatment for rheumatic diseases varies. It is often good, but not always. Most arthritis isn't as simple as 5 high blood pressure, although the treatment of some forms of arthritis such as gout may be both simple and effective. But even if it is not possible to control the disease successfully, treatment can help to relieve symptoms and suffering. Treatment of arthritis depends on the particular cause, which joints are affected, severity, and how the condition affects your daily activities. Your age and occupation will also be taken into consideration when your doctor works with you to create a treatment plan. If possible, treatment will focus on eliminating the underlying cause of the arthritis. However, the cause is NOT necessarily curable, as with osteoarthritis and rheumatoid arthritis. Treatment, therefore, aims at reducing your pain and discomfort and preventing further disability. It is possible to greatly improve your symptoms from osteoarthritis and other long-term types of arthritis without medications. In fact, making lifestyle changes without medications is preferable for osteoarthritis and other forms of joint inflammation. If needed, medications should be used in addition to lifestyle changes. Exercise for arthritis is necessary to maintain healthy joints, relieve stiffness, reduce pain and fatigue, and improve muscle and bone strength. Your exercise program should be tailored to you as an individual. Work with a physical therapist to design an individualized program, which should include: range of motion exercises for flexibility, strength training for muscle tone, low-impact aerobic activity (also called endurance exercise)

A physical therapist can apply heat and cold treatments as needed and fit you for splints or orthotic (straightening) devices to support and align joints. This may be particularly necessary for rheumatoid arthritis. Your physical therapist may also consider water therapy, ice massage, or transcutaneous nerve stimulation (TENS). Rest is just as important as exercise. Sleeping 8 to 10 hours per night and taking naps during the day can help you recover from a flare-up more quickly and may even help prevent exacerbations. You should also:

- Avoid positions or movements that place extra stress on your affected joints.
- Avoid holding one position for too long.
- Reduce stress, which can aggravate your symptoms. Try meditation or guided imagery. And talk to your physical therapist about yoga or tai chi.
- Modify your home to make activities easier. For example, have grab bars in the shower, the tub, and near the toilet.

Other measures to try include:

- Taking glucosamine and chondroitin. These form the building blocks of cartilage, the substance that lines joints. These supplements are available at health food stores or supermarkets. While some studies show such supplements may reduce osteoarthritis symptoms, others show no benefit. However, since these products are regarded as safe, they are reasonable to try and many patients find their symptoms improve.
- Eat a diet rich in vitamins and minerals, especially antioxidants like vitamin E. These are found in fruits and vegetables. Get selenium from Brewer's yeast, wheat germ, garlic, whole grains, sunflower seeds, and Brazil nuts. Get omega-3 fatty acids from cold water fish (like salmon, mackerel, and herring), flaxseed, rapeseed (canola) oil, soybeans, soybean oil, pumpkin seeds, and walnuts.
- Apply capsaicin cream (derived from hot chili peppers) to the skin over your painful joints. You may feel improvement after applying the cream for 3-7 days.

METHODS OF TREATMENT

Mental approach

The right mental approach is important. You should be philosophical about arthritis and respect it, but not give in to it or let it get on top of you.

Knowing your condition

Understanding the problem makes it easier to cope with. You and your relatives need to know about your condition and have some idea of how best to help yourself.

Exercise

This is something that you can do yourself to help. Exercises are important in order to keep the joints as supple as possible. Also, by improving the strength of the muscles affecting the joints, this helps to reduce pain. For example, swimming is an excellent exercise for most people with arthritis because it helps keep both the muscles and joints as healthy as possible. And, muscle strengthening exercises for the thigh muscles (quadriceps) help to reduce pain in the knees and maintain mobility.

Therapists

The professional advice available from the physiotherapists and occupational therapists is often invaluable in helping people to help themselves protect their joints and live easier lives. Physiotherapists teach exercises which maintain and improve strength, movement and function, helping to relieve pain. Pain relief is sometimes achieved through manipulation which is also done by osteopaths and chiropractors. This can be particularly helpful for back pain. Physiotherapists may also recommend electrical or heat treatment for temporary relief of pain.

Aids & appliances

Various aids and appliances can improve joint function and increase the independence of people with some physical disability. The occupational therapist has a range of skills, strategies and devices which are often very simple and can be extremely helpful. They range from shoes and splints to walking aids, bath and toilet aids or complex computerised systems for people with severe handicaps.

Rubs & applications

It has been known for centuries that warmth, rubs and applications and hot baths can ease rheumatic pains. Over the centuries numerous different compounds have been rubbed into or wrapped around painful joints. These are known as 'local' applications (as in 'local' anaesthetic). There have, of course, been modern developments in these compounds. Certain anti-inflammatory drugs are now available as creams and ointments to be rubbed on or around inflamed joints and tendons. Other forms of local treatment made spas famous for the relief they provided, and hydrotherapy remains important today.

DRUGS FOR ARTHRITIS

Four main types of drug are used in the treatment of arthritis:
• Pain killers
• Anti-inflammatory agents
• Steroids
• Drugs that control or modify specific types of arthritis

Pain killers

Pain killers don't kill pain - they reduce it, dull it, 'take the edge off. They also do nothing to treat the underlying cause of the pain. Pain killers work by blocking the transmission of pain signals to the brain. Some work mainly at the site of the problem - others work more on the brain itself. Pain killers may have side effects. They can reduce the transmission of other signals around the nervous system, as well as pain pathways and as a result some cause drowsiness. Other things such as alcohol - that can depress nervous function - may accentuate the effects of these drugs. Pain killers can also affect the way your bowel works - causing constipation. Strong pain killers like morphine often do this, and in addition are addictive.

Pain killers & arthritis

Simple, mild pain killers like aspirin, paracetamol and codeine are available at chemists without prescription. A few slightly stronger ones such as dextropropoxyphene are often prescribed for arthritis, but strong, addictive drugs like pethidine and morphine are hardly ever used. Mixtures of small doses of two or three pain killers sometimes seem to work better than one on its own, and many of the prescribed and 'over the counter' preparations are mixtures. Most pain killers work for only a few hours. It is often wisest to limit their use to times when pain is particularly bad or before doing something that you know will cause pain. However, some people need pain killers in addition to other treatments to make life bearable.

Anti-inflammatory drugs

These drugs reduce inflammation anywhere in the body. They are usually called non-steroidal and reduce pain, swelling and stiffness. If the arthritis is caused by inflammation as in the case of rheumatoid arthritis, anti-inflam¬matory drugs may be much more effective in relieving pain than simple pain killers. Most anti-inflammatory drugs seem to work by interfering with one specific chemical which is central to inflammation - an enzyme called cyclo-oxygenase. This action reduces the effects of inflammation, including pain. Anti-inflammatory drugs may cause indigestion and occasionally cause ulcers. There are other side effects such as fluid retention, rashes and drowsiness, but they are uncommon and usually mild. These are more of a problem in elderly people, in whom these drugs have to be used very carefully. There are several anti-inflammatory drugs. Aspirin in large doses has an anti-inflammatory effect, but most modern drugs used for arthritis are safer and are less likely to cause side effects than large doses of aspirin. The many different drugs all have a similar effect, although some work better than others for any individual. Most need to be taken only once or twice a day, but several days of regular use are needed to achieve the best results. Examples include Brufen (ibuprofen), Naprosyn (naproxen), Voltarol (diclofenac), Feldene (piroxicam), Indocid (indomethacin).

Anti-inflammatories & arthritis

They are often very effective in reducing pain and stiffness and a dose last thing at night may reduce stiffness in the morning. Your doctor will advise you of the best dose and drug for your needs. These drugs are less useful in rheumatism and osteoarthritis than in 'inflammatory' arthritis, but are sometimes still worth trying. If you are not sure of their value after a period of using them, try without for a week and keep a note of the difference. Alwavs be sure that the drug is doing something positive before continuing with regular use.

Steroids

Steroids, including cortisone, are a group of natural body hormones that have numerous effects on the body's metabolism. They help keep our bones and skin healthy and affect practically all of our organs. Their main value in arthritis is their ability to reduce inflammation and damp down the body's immune defense reactions. Steroids affect all sorts of metabolic reactions in the body and by giving the body extra (in tablets or bv injection) this changes the balance a little. One of the effects of extra steroids is to help block excess inflammation. Because steroids control body metabolism, extra doses given for long periods can have several adverse side effects, including thinning of muscles and bones (osteoporosis), excess body fat, increased blood pressure, fluid retention and cataracts. However, side effects are not inevitable but depend upon both the dose as well as the duration of treatment. Small doses can provide benefits without side effects. Steroids need to be carefully controlled. The bodv gets used to the extra doses and if you have been on steroids for a while it is dangerous to reduce the dose too quickly.

Steroids & arthritis

Certain disorders tend only to respond to steroids. One example of this is polymyalgia rheumatica. There are also a few disorders in which steroids are essential to prevent serious problems and may sometimes be life-saving. Severe flare ups of rheumatoid arthritis and systemic lupus erythematosus (SLE), some types of vasculitis and some connective tissue diseases are examples. Steroids may also be valuable in obtaining control of the arthritis when used for short periods or sometimes by injection into joints. More recently, ARC trials in rheumatoid arthritis have found that low doses of steroids mav slow down the progression of the arthritis.

Disease-modifying drugs

These drugs have some fundamental effect on the cause of the arthritis, slowing down or preventing damage. They often take a long time to work, so it may be weeks or months before you feel better. However, when they work well, the results can be dramatic with a considerable improvement in all aspects of the arthritis. Drugs for gout work by keeping uric acid levels low. Some drugs for other types of arthritis seem to suppress immune reactions in the bodv. But we don't yet know how most disease-modifying agents work that are used for rheumatoid and other forms of arthritis. Drugs used for gout are usually very safe but most of the others can cause problems. Although damage to the blood or the kidney as well as rashes and indigestion can occur, these and other side effects nearly always go away completely when the drugs are stopped. Many of these drugs have to be monitored carefully, with regular blood or urine tests (or both) to check that all is well. Disease-modifying drugs for arthritis fall into two categories. The 'immunosuppressive agents' which include azathioprine, methotrexate and cyclophosphamide, and a miscellaneous group which affect rheumatoid and other forms of arthritis. These include gold, d-penicillamine, hydroxychloroquine and sulphasalazine. A third category is now being developed, known as the 'biologies'. These are agents produced by molecular biologv - some from human genes - which are targeted to precise mechanisms in the pathways causing rheumatic disease. Several of these are now on trial and offer exciting prospects for treatment of many rheumatic diseases, particularly rheumatoid arthritis. However, it should be stressed that it will be several years before they are available, and that it will need a lot of careful work to sort out their effects. Disease-modifying drugs should be used carefully in arthritis, with a doctor controlling and supervising treatment at regular intervals. There are no simple rules about when and which drug to use; you must rely on your doctor or specialist to discuss this with you and give advice.

SURGERY

Arthritis surgery has advanced tremendously in recent years and techniques such as the replacement of destroyed joints have eased the lives of many people. Although a wide range of different operations is used in the treatment of joint disease, most people with arthritis will never need any of them. Surgery is required in only a few specific instances in the more serious forms of arthritis. Severe rheumatoid arthritis and osteoarthritis are most likely to need surgery. Occasionally people with ankylosing spondylitis need operations on their spine or hips, and a few people with psoriatic arthritis and some of the other less common forms of joint disease may also have surgery. Sufferers from gout, those with milder forms of rheumatoid and osteoarthritis, people with connective tissue diseases, and most of those with back problems and problems outside the joints will never need an operation. Overall the proportion of arthritis patients having surgery for their joint disease is very small. The operations, like the diseases, can be divided into two types. One takes place outside the joint ('periarticular' surgery), the other in the joint itself ('articular' surgery). Periarticular surgery is usually relatively minor and includes the repair of damaged tendons and ligaments and the removal of large cysts and nodules. Articular surgery can be divided further into four main types: Synovectomy - The lining of the joint (the synovium) is sometimes removed surgically if it is very bulky and inflamed. Synovectomy is not common, but can be useful if the bulky synovium is causing mechanical problems or threatening to damage tendons and ligaments. Arthrodesis - A joint can be fixed permanently in one position, either by bone grafting, or by nailing or wiring the two halves together. This is called an arthrodesis and is sometimes used to help a joint which is already restricted in movement but very painful. An arthrodesed joint cannot move, but it is no longer painful. Osteotomy - Osteotomy is an operation where the bone next to a painful joint is cut then refixed in a slightly different position. This operation is used to correct deformity and to relieve pain in osteoarthritis -mostly of the knee or foot. It can also stimulate the joint to heal.

Joint replacement

Joint replacements are now commonplace. Before artificial joints (known as 'prostheses') were available, the only option other than arthrodesis (see above) was to cut part of the joint out. This is called an excision arthroplasty and is rarely necessary today. Modern metal alloy and high density plastics have allowed artificial joints to be developed for many different sites. Hips were first and remain the most reliable but knee replacements are now usually very successful as well. Prostheses are also available for the small joints of the hand, the shoulder, elbow and ankle. Artificial joints are not perfect. They don't function as well as a natural joint, and may not last longer than IS years or so. Furthermore, in about one case in 20, the operation doesn't work perfectly and some complication spoils the success. So the decision to put in a new joint is not taken lightly and in every case the risks have to be carefully weighed up against the likely benefit. Nevertheless, there are many people today who are delighted with their new joints and the demand is increasing. A good joint replacement provides an adequate range of movement without pain for most everyday activity.

WHICH JOINTS?

Nearly everything can be operated on, but only a few procedures are commonly used. Here are some of the most popular operations.
The hip Hip replacement is so successful that it has overtaken all other procedures. Severe pain and disability that do not respond to other treatment may suggest a new joint is required.
The knee Surgeons often explore the knee through a small telescope called an arthroscope. Minor operations can be performed through this instrument, which also allows the inside of the knee to be visualised so that the diagnosis can be made. A biopsy sample of the lining is sometimes useful when trying to find out the cause of knee problems. In advanced osteoarthritis an osteotomy (see above) can be very helpful, but a severely damaged rheumatoid knee may need replacement. There is sometimes a need for synovectomy (see above) or the removal of cysts in the knee.
The hand Hand surgery is particularly delicate and specialised. Many different operations are available, including tendon release and repair, decompression of trapped nerves, fixation for the painful wrist, and small joint replacements. Before embarking on any course of action, hand surgeons often work closely with other doctors and occupational therapists so that hand function can be carefully assessed in the light of all other problems. Maintaining hand function is regarded as the main concern.
The foot One of the most useful operations for people with severe rheumatoid arthritis involves cutting out damaged joints at the base of the toes to allow them to walk wdthout pain again. 'Bunion' operations are also popular and a variety of other operations on the ankle can be useful.

COMBINED APPROACH

Surgery for arthritis must be integrated with all other aspects of your treatment. Many hospitals run 'combined clinics' attended by a medical specialist (a rheumatologist), an orthopaedic surgeon and therapists. The problems are discussed openly so that any decision to recommend surgery is one that everyone feels happy with, including you! These decisions are not easy. If several joints are affected it can be hard to predict the benefit of operating on one of them. Other things that must be taken into account include any medical treatment and the activity of disease. One of the most difficult tasks is to recommend the right operation at the right time.

MEDICATIONS REVIEW

Your doctor will choose from a variety of medications as needed. Generally, the first drugs to try are available without a prescription. These include:

• Acetaminophen (Tylenol) is recommended by the American College of Rheumatology and the American Geriatrics Society as first-line treatment for osteoarthritis. Take up to 4 grams a day (2 extra-strength Tylenol every 6 hours). This can provide significant relief of arthritis pain without many of the side effects of prescription drugs. DO NOT exceed the recommended doses of acetaminophen or take the drug in combination with large amounts of alcohol. These actions may damage your liver.

• Aspirin, ibuprofen, or naproxen nonsteroidal anti-inflammatory (NSAID) drugs are often effective in combating arthritis pain. However, they have many potential risks, especially if used for a long time. They should not be taken in any amount without consulting your doctor. Potential side effects include heart attack, stroke, stomach ulcers, bleeding from the digestive tract, and kidney damage. In 2005, the U.S. Food and Drug Administration (FDA) asked makers of NSAIDs to include a warning label on their product that alerts users of an increased risk for heart attack, stroke, and gastrointestinal bleeding. If you have kidney or liver disease, or a history of gastrointestinal bleeding, you should not take these medicines unless your doctor specifically recommends them.

• Cyclooxygenase-2 (COX-2) inhibitors block an inflammation-promoting enzyme called COX-2. This class of drugs was initially believed to work as well as traditional NSAIDs, but with fewer stomach problems. However, numerous reports of heart attacks and stroke have prompted the FDA to re-evaluate the risks and benefits of the COX-2s. Celecoxib (Celebrex) is still available, but labeled with strong warnings and a recommendation that it be prescribed at the lowest possible dose for the shortest duration possible. Talk to your doctor about whether COX-2s are right for you.

• Corticosteroids ("steroids") suppress the immune system and symptoms of inflammation. They are commonly used in severe cases of osteoarthritis, and they can be given orally or by injection. Steroids are used to treat autoimmune forms of arthritis but should be avoided in infectious arthritis. Steroids have multiple side effects, including upset stomach and gastrointestinal bleeding, high blood pressure, thinning of bones, cataracts, and increased infections. The risks are most pronounced when steroids are taken for long periods of time or at high doses. Close supervision by a physician is essential.

• Disease-modifying anti-rheumatic drugs have been traditionally used to treat rheumatoid arthritis and other autoimmune causes of arthritis. These drugs include gold salts, penicillamine, sulfasalazine, and hydroxychloroquine. More recently, methotrexate has been shown to slow the progression of rheumatoid arthritis and improve your quality of life. Methotrexate itself can be highly toxic and requires frequent blood tests for patients on the medication.

• Biologic s-- these are the most recent breakthrough for the treatment of rheumatoid arthritis. Such medications, including etanercept (Enbrel), infliximab (Remicade) and adalimumab (Humira), are administered by injection and can dramatically improve your quality of life. Newer biologics include Orencia (abatacept) and Rituxan (rituximab).

• Immunosuppressants -- these drugs, like azathioprine or cyclophosphamide, are used for serious cases of rheumatoid arthritis when other medications have failed.

It is very important to take your medications as directed by your doctor. If you are having difficulty doing so (for example, due to intolerable side effects), you should talk to your doctor.

Expectations

A few arthritis-related disorders can be completely cured with treatment. Most are chronic (long-term) conditions, however, and the goal of treatment is to control the pain and minimize joint damage. Chronic arthritis frequently goes in and out of remission.

Prevention

If arthritis is diagnosed and treated early, you can prevent joint damage. Find out if you have a family history of arthritis and share this information with your doctor, even if you have no joint symptoms. Osteoarthritis may be more likely to develop if you abuse your joints (injure them many times or over-use them while injured). Take care not to overwork a damaged or sore joint. Similarly, avoid excessive repetitive motions. Excess weight also increases the risk for developing osteoarthritis in the knees, and possibly in the hips and hands. See the article on body mass index to learn whether your weight is healthy.

Arthritis related topics

Alkaptonuria (Ochronosis), Amyloidosis, Ankylosing Spondylitis, Antiphospholipid Syndrome, Arthritis Baker Cyst, Behcet's Syndrome, Bullous Pemphigoid, Bunions, Bursitis, Bursitis of the Knee, Calcific Bursitis, Chondromalacia Patella, Chronic Pain, Connective Tissue Disease, Costochondritis and Tietze Syndrome, De Quervain's Tenosynovitis, Diffuse Idiopathic Skeletal Hyperostosis (DISH), Dupuytren Contracture, Ehlers-Danlos Syndrome, Eosinophilic Esophagitis, Eosinophilic Fasciitis, Essential Mixed Cryoglobulinemia, Felty's Syndrome, Fibromyalgia, Ganglion, Gout, Henoch-Schonlein Purpura, Hip Bursitis, Hydroxyapatite Crystal Disease, Hypermobility Syndrome, Juvenile Arthritis (Juvenile Rheumatoid Arthritis), Kawasaki Disease, Lumbar Stenosis, Lupus, Lyme Disease, Mixed Connective Tissue Disease, Neck Pain, Osteoarthritis, Osteochondritis Dissecans, Osteoporosis, Paget's Disease, Polyarteritis Nodosa.

Arthritis contents

• Learn more about Arthritis
• Prescribed medications
• What are the arthritis’ symptoms?
• How is arthitis diagnosed?
• Who is a rheumatologist?
• What is the Arthritis Foundation?
• Arthritis related topics

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Arthritis Facts

All over the world arthritis sufferers include men and women, children and adults. Approximately 350 million people worldwide have arthritis. Nearly 40 million persons in the United States are affected by arthritis, including over a quarter million children! More than 21 million Americans have osteoarthritis and about 2.1 million suffer from rheumatoid arthritis. More than half of those with arthritis are under 65 years of age. Nearly 60% of Americans with arthritis are women.

It has been also estimated that the total cost of the arthritis bill for the United States, in terms of hospitalization, doctor visits, medications, physical therapies, nursing home care, lost wages, early death, and family discord is over $50 billion dollars annually. This does not include the nearly $2 billion spent each year in the United States on unproven remedies by patients addressing their symptoms on their own.