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Disease & Conditions >>> Arthritis Articles & News

 

Do I Have Arthritis?

By: STEPHEN SMILES, MD & ALLAN GIBOFSKY, MD, JD

Chances are very strong that you know someone with arthritis. A condition that causes pain and stiffness in the joints, arthritis currently affects forty-three million Americans, and this number is increasing as our population ages.

There are hundreds of different types of arthritis, and the causes of most remain unknown. Below, two medical experts offer an introduction to this all-too-common disease.

What is a simple definition for "arthritis"?
ALLAN GIBOFSKY, MD: The word "arthritis" means inflammation of the joint. But there are over one hundred different clinical conditions that we refer to as arthritis. People often use the word to describe not just pain in the joints, but pain around the joints, as well as pain in the bones and muscles that may be nowhere near a joint.

So the challenge, as a physician, is to tease out exactly what kind of arthritis we're dealing with so that we can better individualize a therapy for that patient.

Osteoarthritis, one of the most common types of arthritis, is a degenerative disease. What does this mean exactly?
ALLAN GIBOFSKY, MD: When we talk about degenerative disease, we are talking about the normal use of an abnormal joint, or abnormal use of a normal joint. So, individuals who are basketball players and use their knees a lot develop the kind of arthritis in their knees that we would more commonly see in their grandparents. Their hands and the other parts of their body are fine. This is a form of osteoarthritis.

Then we have those individuals who may have been born with a dislocation of the hip. In this case, the joint is abnormal. When they are using an abnormal joint normally, they may develop an early form of degeneration.

So degeneration does not always mean when somebody is old?
ALLAN GIBOFSKY, MD: Absolutely not. I think it's important for people to understand that arthritis is not a disease of old people. It's a disease that can be in your grandmother, but it's also a disease that can be in your grandchild. Different forms of arthritis can occur at different ages in different people.

How does someone know if they have arthritis to begin with?
ALLAN GIBOFSKY, MD: Usually, the first sign of arthritis is pain-pain in or around the joint, in a bone, in a muscle, or in a soft tissue structure like a ligament or a tendon. Generally, that's what people understand when they think they have arthritis-that's what causes them to seek attention for it.





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What are the three most common symptoms that a person should look for in arthritis?
STEPHEN SMILES, MD: The three most common symptoms of arthritis that people need to be aware of are pain in or around a joint, swelling in or around a joint, and heat and redness in or around a joint.

Can arthritis be related to other problems or diseases in the body?
ALLAN GIBOFSKY, MD: Yes. There are forms of other diseases that cause arthritis, and arthritis can cause problems additional to joint pain.

For example, people with bowel disease may have joint pain. People with joint pain may have problems with their eyes or problems with their heart. So it's very important to tease out or differentiate those conditions that can cause arthritis that are not of the joint, and those conditions that are arthritis causing things to happen outside the joint.
Who is at risk for arthritis?
ALLAN GIBOFSKY, MD: Everybody is at risk for arthritis, but there are different forms of arthritis. The older one gets, the more likely they are to have the degenerative form of arthritis, resulting from abnormal use of a normal joint. Then there are forms of arthritis that may occur as a result of infection. Those kinds of conditions may have a very definite genetic predisposition.

There are lots of advertisements for over-the-counter medications for arthritis. When should a person be concerned that they need to actually see a physician?
STEPHEN SMILES, MD: If a person takes an over-the-counter medication and feels no relief in one to two weeks, they should go seek some attention from their physician.

Are there any specific symptoms that would make you more concerned for a patient?
ALLAN GIBOFSKY, MD: The more acute and dramatic the presentation of the joint inflammation, the more concerned I am.

STEPHEN SMILES, MD: And if someone has pain in joints of the upper and lower extremities at the same time, then I might believe that we were dealing with something other than just a traumatic type of process. A person in this situation should see a doctor.
What about the 45-year-old guy who is going out and playing basketball on the weekends and hurts his knee? Should he be concerned about arthritis?
STEPHEN SMILES, MD: I think the weekend warrior who goes out and has an acute injury should either be seen by a rheumatologist or an orthopedist. There are a number of injuries that can be dealt with quickly and simply that may prevent chronic damage later on.

ALLAN GIBOFSKY, MD: Often, the weekend warrior really needs education. If the weekend warrior came in after the first episode, well then perhaps we could educate him on how to prevent the second. Only too often the weekend warrior comes in after the tenth episode, by which time there is chronic damage to the structures of the joint that he or she is complaining about. By then, the ante is up a little bit from where it could have been had we gotten involved earlier




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