Arthritis is one of the major chronic conditions affecting North Americans. The Center for Disease Control’s most recent data from 2012 shows 22.7 % of the total US population have been told at some time that they have arthritis by a physician. That number is estimated to grow to 26% by 2040. Arthritis is now the greatest disability affecting employed people, causing more annual missed work days. It comes in three broad categories – Osteoarthritis, Rheumatoid and Psoriatic Arthritis.
The most common variety, Osteoarthritis, is a slowly progressing form that is caused by years of joint strain. Osteoarthritis is more prevalent in senior adults and can occur in any joint. Rheumatoid arthritis, which includes lupus, gout, and fibromyalgia, happens when an individual’s immune system begins to break down their joints.
Psoriatic arthritis also works against a person’s immune system, targeting skin, ligaments, and tendons. Each type is painful to live with and can lead to varying degrees of loss of function and disability. In general, arthritis tends to show up more in people who have other chronic conditions.
My Arthritis Journey
Arthritis has had a clear and profound influence on my life, both personally and professionally. My first encounter with arthritis happened at age seven. My family had traveled to Seattle to visit my maternal grandmother. Grandma Jean was in her early 50’s and had already begun her battle with “Arthur.” Her hands were slightly curled, with red knobby areas of swelling at each finger joint. I asked mom what was wrong with them, and was told she had rheumatoid arthritis.
Even as a child, it was evident to me that her hands were painful. She struggled to hold a pen to write and had difficulty gripping pot and pan handles when cooking. When I held her hand, it felt skeletal, and the joints were hot. One evening she removed her shoes and socks and propped her feet up on the couch with pillows. They were a mirror image of her hands; all I could think of when I looked at them was how much they must hurt.
Her condition worsened as she aged, and by the time she died at 72. She struggled to walk and perform basic activities of daily living. As I got older and listened to the conversation at holiday gatherings, I learned I had a family history of arthritis from both sides. I watched my dad’s mother, sister, and my mom grapple with the disease. My family history caught up with me in my early 40’s, and I experienced arthritis first-hand.
Arthritis: Signs and Symptoms
I started experiencing pain in my left great toe in the spring of 2009. The discomfort was happening on days when I spent most of the time on my feet. I mistakenly assumed my new shoes were too small, and bought a pair ½ size bigger. I also thought that my toenail could be rubbing against the end of the shoe, so cut it as short as possible. Those changes made no difference, and within a month the toe started to redden and swell. My only relief came at night when I was lying down. Eight hours of sleep eliminated the symptoms, which returned with a vengeance as soon as I was “up and around.”
I researched my warning signs and discovered that the problem was something I had never considered: gout. As a healthcare professional, I was familiar with the basics of gout, having cared for many clients with the condition. I reviewed the causes and risk and was perplexed, as there was only one that I could pinpoint. I contacted an in-law, who had chronic gout, for advice. He gave me a few pointers on dietary changes and supplements which helped somewhat. The condition wasn’t alleviated until I underwent treatment for another chronic disease, in 2014 of which gout was a symptom.
Arthritis is painful and debilitating, but for many people the condition is treatable. As with other chronic disorders, the primary goal should be forming an efficient healthcare team. Asking for a referral to an internist or rheumatologist is a good place to start. These specialists are well-versed in the latest research and will review treatments options to decide the approach that will be most successful.
The treatment plan may include the components of medication, lifestyle modification, and surgical options. A full spectrum of medicines has been proven effective in managing arthritis. Non -steroidal anti-inflammatory and corticosteroids can relieve inflammation. Analgesic creams rubbed into the skin help to relieve pain.
“Disease modifiers” assist in slowing the advancement of joint damage. An individual practitioner may also be open to exploring natural supplements as an option. Potential surgical alternatives could include arthroscopic surgery, joint preservation, fusion, or replacement.
Change in Lifestyle
Changes in lifestyle emphasize a combination of healthy nutrition, weight control, and exercise. Registered dietitians provide clients with guidance to make healthy meal choices. Numerous hospitals and medical centers offer therapeutic exercise programs to help those with chronic disease learn and incorporate safe, beneficial physical activity into their lives.
As a clinician, I have worked in these kinds of programs for over 20 years. Physical therapists, exercise physiologists, and occupational therapists help clients implement training programs incorporating stretching, aerobic exercise, and strength training designed to improve physical function. Some facilities have on-site or access to warm water therapy pools for aquatic exercise. Many centers also offer discounted “memberships” to a spouse or significant other to promote family support.
Having the necessary amount of social support will help strengthen a person’s ability to cope with the challenges of arthritis. Receiving reinforcement and encouragement from family and friends is as important as getting affirmation from the healthcare team.
Social support can also come in the form of connections made as an exercise program participant, church attendee, service organization member, or through on-line arthritis care forum. Joining a support group specifically for arthritis can be similarly beneficial. Often what’s truly needed is having someone who has the time to listen and be present. You can join an Arthritis forum for an opportunity to meet other people dealing with the disease and learn more about how to cope with it.
Depression and anxiety are common for people who suffer from chronic disease, and arthritis is no different in that respect. An individual may from time to time need to turn to a pastor or licensed mental health professional to unburden themselves of their worries and fears.
Understanding, caring, and compassion is essential in helping someone deal with arthritis. Living with chronic pain can be a physical and emotional battle, and can exact a heavy toll. Each of us has been touched by arthritis to varying degrees.
My Experience With Arthritis
My personal and professional experiences have given me great respect and empathy for everyone dealing with this disease. Fortunately, medicine and technology have improved treatment and care of arthritis. We now have more knowledge and options than ever before, with new ones on the horizon.
My struggle with gout has improved with minor dietary changes and ongoing treatment of my other chronic disease issues. My family members that have sought medical care and made lifestyle changes have also experienced positive results.
There is help for arthritis for those willing to pursue it. Research as many treatment options as possible, and stay current on new information. Ask lots of questions at appointments, and run ideas past your medical team. If one treatment doesn’t work, don’t give up hope! Bear through the bad days and rejoice during the good days!