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Biological and psychosocial issues

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Advice on Arthritis for Seniors

 

“Arthritis” is not just a word doctors use when they talk about painful, stiff joints. In fact, there are many kinds of arthritis, each with different symptoms and treatments. Most types of arthritis are chronic. That means they can go on for a long period of time.
Arthritis can attack joints in almost any part of the body. Some forms of arthritis cause changes you can see and feel—swelling, warmth, and redness in your joints. In some the pain and swelling last only a short time, but are very bad. Other types cause less troublesome symptoms, but still slowly damage your joints.

Common Kinds of Arthritis

Arthritis is one of the most common diseases in this country. Millions of adults and half of all people age 65 and older are troubled by this disease. Older people most often have osteoarthritis, rheumatoid arthritis, or gout.

Osteoarthritis (OA) is the most common type of arthritis in older people. OA starts when cartilage begins to become ragged and wears away. Cartilage is the tissue that pads bones in a joint. At OA’s worst, all of the cartilage in a joint wears away, leaving bones that rub against each other. You are most likely to have OA in your hands, neck, lower back, or the large weight-bearing joints of your body, such as knees and hips.

OA symptoms can range from stiffness and mild pain that comes and goes with activities like walking, bending, or stooping to severe joint pain that keeps on even when you rest or try to sleep. Sometimes OA causes your joints to feel stiff when you haven’t moved them in a while, like after riding in the car. But the stiffness goes away when you move the joint. In time OA can also cause problems moving joints and sometimes disability if your back, knees, or hips are affected.

What causes OA?

Growing older is what most often puts you at risk for OA. Other than that, scientists think the cause depends on which part of the body is involved. For example, OA in the hands or hips may run in families. OA in the knees can be linked with being overweight. Injuries or overuse may cause OA in joints such as knees, hips, or hands.

Rheumatoid Arthritis (RA) is an autoimmune disease. In RA, that means your body attacks the lining of a joint just as it would if it were trying to protect you from injury or disease. For example, if you had a splinter in your finger, the finger would become inflamed—painful, red, and swollen. RA leads to inflammation in your joints. This inflammation causes pain, swelling, and stiffness that lasts for hours. This can often happen in many different joints at the same time. You might not even be able to move the joint. People with RA often don’t feel well. They may be tired or run a fever. People of any age can develop RA, and it is more common in women.
RA can attack almost any joint in the body, including the joints in the fingers, wrists, shoulders, elbows, hips, knees, ankles, feet, and neck. If you have RA in a joint on one side of the body, the same joint on the other side of your body will probably have RA also. RA not only destroys joints. It can also attack organs such as the heart, muscles, blood vessels, nervous system, and eyes.

Gout is one of the most painful forms of arthritis. An attack can begin when crystals of uric acid form in the connective tissue and/or joint spaces. These deposits lead to swelling, redness, heat, pain, and stiffness in the joint. Gout attacks often follow eating foods like shellfish, liver, dried beans, peas, anchovies, or gravy. Using alcohol, being overweight, and certain medications may also make gout worse. In older people, some blood pressure medicines can also increase your chance of a gout attack.
Gout is most often a problem in the big toe, but it can affect other joints, including your ankle, elbow, knee, wrist, hand, or other toes. Swelling may cause the skin to pull tightly around the joint and make the area red or purple and very tender. Your doctor might suggest blood tests and x-rays. He or she might also take a sample of fluid from your joint while you are having an attack.
Other forms of arthritis include psoriatic arthritis (in people with the skin condition psoriasis), ankylosing spondylitis (which mostly affects the spine), reactive arthritis (arthritis that occurs as a reaction to another illness in the body), and arthritis in the temporomandibular joint (where the jaw joins the skull).

Warning Signs

You might have some form of arthritis if you have:
  • Lasting joint pain,
  • Joint swelling,
  • Joint stiffness,
  • Tenderness or pain when touching a joint,
  • Problems using or moving a joint normally, or
  • Warmth and redness in a joint.
If any one of these symptoms lasts longer than 2 weeks, see your regular doctor or a rheumatologist. If you have a fever, feel physically ill, suddenly have a swollen joint, or have problems using your joint, see your doctor sooner. Your health care provider will ask questions about your symptoms and do a physical exam. He or she may take x rays or do lab tests before suggesting a treatment plan.

Treating Arthritis

Each kind of arthritis is handled a little differently, but there are some common treatment choices. Rest, exercise, eating a healthy, well-balanced diet, and learning the right way to use and protect your joints are key to living with any kind of arthritis. The right shoes and a cane can help with pain in the feet, knees, and hips when walking. You can also find gadgets to help you open jars and bottles or to turn the door knobs in your house more easily.
In addition, there are also medicines that can help with the pain and swelling. Acetaminophen can safely ease arthritis pain. Some treatments are special for each common type of arthritis.

Osteoarthritis. Medicines can help you control OA pain. Rest and exercise will make it easier for you to move your joints. Keeping your weight down is a good idea. If pain from OA in your knee is very bad, your doctor might give you shots in the joint. This can help you to move your knee and get about without pain. Some people have surgery to repair or replace damaged joints.

Rheumatoid Arthritis. With treatment, the pain and swelling from RA will get better, and joint damage might slow down or stop. You may find it easier to move around, and you will just feel better. In addition to pain and anti-inflammatory medicines, your doctor might suggest antirheumatic drugs. These can slow damage from the disease. Another type of drug, biologic response modifiers, blocks the damage done by the immune system. They sometimes help people with mild-to-moderate RA when other treatments have not worked.

Gout. If you have had an attack of gout, talk to your doctor to learn why you had the attack and how to prevent future attacks. The most common treatment for an acute attack of gout uses corticosteroids like prednisone. This reduces swelling, so you may start to feel better within a few hours after treatment. The attack usually goes away fully within a few days. If you have had several attacks, your doctor can prescribe medicines to prevent future ones.

Exercise Can Help

Along with taking the right medicine and properly resting your joints, exercise is a good way to stay fit, keep muscles strong, and control arthritis symptoms. Daily exercise, such as walking or swimming, helps keep joints moving, lessens pain, and makes muscles around the joints stronger.
Three types of exercise are best if you have arthritis:
  • Range-of-motion exercises, like dancing, relieve stiffness, keep you flexible, and help you keep moving your joints.
  • Strengthening exercises, such as weight training, will keep or add to muscle strength. Strong muscles support and protect your joints.
  • Aerobic or endurance exercises, like bicycle riding, make your heart and arteries healthier, help prevent weight gain, and improve the overall working of your body. Aerobic exercise also may lessen swelling in some joints.
Other Things to Do

Along with exercise and weight control, there are other ways to ease the pain around joints. You might find comfort by applying heat or cold, soaking in a warm bath, or swimming in a heated pool.
The doctor may suggest surgery when damage to your joints becomes disabling or when other treatments do not help with pain. Surgeons can repair or replace these joints with artificial (man-made) ones. In the most common operations, doctors replace hips and knees.

 


 
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