The CDC lists arthritis as the number one cause of disability in the United States. Yet, while most people have a general idea about the disease– it has to do with bones; it hurts– its specifics are not widely understood.
“Arthritis is a general term that relates to a family of conditions that affect the joints,” explains Dr. Howard Futerman, a rheumatologist from Great Neck, New York. “Depending on what is affected within the joint, that helps to diagnose what type of arthritis a person has.”
The two most common types are osteoarthritis and rheumatoid arthritis. To distinguish between the two, Dr. Futerman looks at two separate aspects of the disease: “There’s both a structural difference, and a demographic difference.” While osteoarthritis primarily affects the cartilage and is a degenerative disease, rheumatoid arthritis is an inflammatory condition of lining membranes in the joints. Demographically, osteoarthritis is generally seen in more mature patients. Rheumatoid arthritis, on the other hand, is more common in younger people.
In the case of osteoarthritis, there’s usually a genetic component, says Dr. Futerman. “So people are pre-set to get a certain degree of degeneration in their cartilage as they age.” Environmental and physical changes can play a role, as well. Patients experience pain and restricted motion, which will slowly worsen over time. This progression may speed up as the result of an injury or trauma to the joint. According to Dr. Futerman, the most commonly affected areas “are either large weight-bearing joints such as hips and knees, or smaller joints in the periphery, like the fingers and toes…spine disease is common as well, in the neck area and the lower part of the spine.”
Treating osteoarthritis is a matter of finding the right means of pain relief and maintaining a good range of motion in the joint. Physical therapy is often helpful in keeping the joint moving well. “It’s important to use physical therapy to promote people’s activities of daily living, so they can function in their best capacity,” Dr. Futerman explains. “It helps maintain muscle tone and flexibility.”
Another option for osteoarthritis patients is viscosupplementation, sometimes called the “jelly shot.” This is a relatively new procedure, in which lubricant is injected into the afflicted joint to facilitate the movement of bone over bone and reduce pain.
Rheumatoid arthritis is treated somewhat differently. The disease is seen mostly in smaller joints in the hands and wrists, and also ankles and feet. “[It] will manifest with signs of inflammation,” says Dr. Futerman, along with “swelling, fever in the joints, severe tenderness, and even redness.” It can restrict motion in these joints, and may also cause deformities. “It causes a significant amount of pain and dysfunction, and potential disability. It’s important to treat the disease early to help forestall any of those long-term complications down the road.”
In addition to pain-relief techniques like medication and physical therapy, new treatments are being developed in the field of “biologic therapy.” “These potent new agents can actually shut off the signaling between cells that’s involved in the inflammation process,” Dr. Futerman tells us. They have the potential to stop the long-term damage of rheumatoid arthritis, including painful joint deformation.
With early intervention and proper treatment, people with both osteoarthritis and rheumatoid arthritis can manage their pain and take steps to avoid future complications. As Dr. Futerman says, “reducing the pain is the initial focus, so they can maintain their normal activities of daily living.”
Written by Danielle Poupore