Arthritis Advice

Half of all people age 65 and older have arthritis. There are over 100 different forms of arthritis and many different symptoms and treatments. We do not know what causes most forms of arthritis. Some forms are better understood than others.

Arthritis causes pain and loss of movement. It can affect joints in any part of the body. Arthritis is usually chronic, meaning it can occur over a long period of time. The more serious forms can cause swelling, warmth, redness, and pain. The three most common kinds of arthritis in older people are osteoarthritis, rheumatoid arthritis, and gout.

Common Forms of Arthritis

Osteoarthritis (OA), at one time called degenerative joint disease, is the most common type of arthritis in older people. Symptoms can range from stiffness and mild pain that comes and goes to severe joint pain and even disability.

OA usually affects the hands and the large weight-bearing joints of the body: the knees and hips. Early in the disease, pain occurs after activity and rest brings relief; later on, pain occurs with very little movement, even during rest.

Scientists think that several factors may cause OA in different joints. OA in the hands or hips may run in families. OA in the knees is linked with being overweight. Injuries or overuse may cause OA in joints such as knees, hips, or hands.

Rheumatoid arthritis (RA) can be one of the more disabling forms of arthritis. Signs of RA often include morning stiffness, swelling in three or more joints, swelling of the same joints on both sides of the body (both hands, for example), and bumps (or nodules) under the skin most commonly found near the elbow. RA can occur at any age and affects women about three times more often than men.

Scientists don't know what causes RA but think it has something to do with a breakdown in the immune system, the body's defense against disease. It is also likely that people who get RA have certain inherited traits (genes) that cause a disturbance in the immune system.

Gout occurs most often in older men. It affects the toes, ankles, elbows, wrists, and hands. An acute attack of gout is very painful. Swelling may cause the skin to pull tightly around the joint and make the area red or purple and very tender. Medicines can stop gout attacks, as well as prevent further attacks and damage to the joints.

Treatments

Treatments for arthritis work to reduce pain and swelling, keep joints moving safely, and avoid further damage to joints. Treatments include medicines, special exercise, use of heat or cold, weight control, and surgery.

Medicines help relieve pain and reduce swelling. Acetaminophen or ACT should be the first drug used to control pain in patients with osteoarthritis (OA). Patients with OA who don't respond to ACT and patients with RA and gout are most commonly treated with nonsteroidal anti-inflammatory drugs such as ibuprofen. People taking medicine for any form of arthritis should limit the amount of alcohol they drink. (For more information, see the Age Page "Arthritis Medicines.")

Exercise, such as a daily walk or swim, helps keep joints moving, reduces pain, and strengthens muscles around the joints. Rest is also important for the joints affected by arthritis. Physical therapists can develop personal programs that balance exercise and rest.

Many people find that soaking in a warm bath, swimming in a heated pool, or applying heat or cold to the area around the joint helps reduce pain. Controlling or losing weight can reduce the stress on joints and can help avoid further damage.

When damage to the joints becomes disabling or when other treatments fail to reduce pain, your doctor may suggest surgery. Surgeons can repair or replace damaged joints with artificial ones. The most common operations are hip and knee replacements.

Unproven Remedies

Arthritis symptoms may go away by themselves but then come back weeks, months, or years later. This may be why many people with arthritis try quack cures or remedies that have not been proven instead of getting medical help. Some of these remedies, such as snake venom, are harmful. Others, such as copper bracelets, are harmless but also useless. The safety of many quack cures is unknown.

Here are some tipoffs that a remedy may be unproven: claims that a treatment like a lotion or cream works for all types of arthritis and other diseases too; scientific support comes from only one research study; or the label has no directions for use or warnings about side effects.

Common Warning Signs of Arthritis

Swelling in one or more joint(s)
Morning stiffness lasting 30 minutes or longer
Joint pain or tenderness that is constant or that comes and goes
Not being able to move a joint in the normal way
Redness or warmth in a joint
Weight loss, fever, or weakness and joint pain that can't be explained


If any one of these symptoms lasts longer than 2 weeks, see your regular doctor or a doctor who specializes in arthritis (a rheumatologist). The doctor will ask questions about the history of your symptoms and do a physical exam. The doctor may take x-rays or do lab tests before developing a treatment plan.

Resources

For more information on arthritis contact:

National Institute of Arthritis and Musculoskeletal and Skin Diseases
Building 31, Room 4C05
Bethesda, MD 20892
(301) 496-8188

The Arthritis Foundation
P.O. Box 19000
Atlanta, GA 30325
(800) 283-7800

For a list of free publications from the National Institute on Aging (NIA), contact the NIA Information Center, P.O. Box 8057, Gaithersburg, MD 20898-8057; 1-800-222-2225;

Information provided by NIH.