During arthritis awareness month, Community Health Charities partners and the Arthritis Foundation are working to raise awareness of arthritis, what it is, who is impacted, and how they can help. 

The word arthritis actually means joint inflammation. The term arthritis is used to describe more than 100 rheumatic diseases and conditions that affect joints, the tissues which surround the joint and other connective tissue. The pattern, severity and location of symptoms can vary depending on the specific form of the disease. Typically, rheumatic conditions are characterized by pain and stiffness in and around one or more joints. The symptoms can develop gradually or suddenly. Certain rheumatic conditions can also involve the immune system and various internal organs of the body.

Arthritis is the most common cause of disability in the United States with 50 million adults having doctor-diagnosed arthritis.  The risk of arthritis increases with age and is more common among women than men. An estimated 294,000 children under age 18 have some form of arthritis or rheumatic condition which represents approximately one in every 250 children.

- Osteoarthritis (OA), also called osteoarthroses or degenerative joint disease, is the most common type of arthritis. If you’ve been diagnosed with osteoarthritis (OA), you’re not alone. This chronic disease affects over 27 million Americans. OA is characterized by the breakdown of cartilage, the part of a joint that cushions the ends of the bones and allows easy movement. As cartilage deteriorates, bones begin to rub against one another. This can cause stiffness and pain that make it difficult for you to use that joint. Osteoarthritis can also damage ligaments, menisci and muscles. Over time, OA may create a need for joint replacements.

There are two types of OA,primary and secondary. Primary osteoarthritis is generally associated with aging and the "wear and tear" of life. The older you are, the more likely you are to have some degree of primary osteoarthritis. Secondary osteoarthritis tends to develop relatively early in life, typically 10 or more years after a specific cause, such as an injury or obesity.

Osteoarthritis occurs most often in knees, hips and hands.  Other joints, particularly the shoulders, can also be affected. OA rarely affects other joints, except as a result of injury or unusual physical stress.

The pain and stiffness of osteoarthritis can make it difficult to do daily activities, including your job, playing sports or even getting around with ease. That’s why it is important to learn all you can about this disease, how it affects you and how to live with it – a process called self management.

Joints affected by osteoarthritis usually ache or become painful or stiff first thing in the morning, or during or after use. They may also be stiff after periods of inactivity. It’s important to remain physically active despite any initial discomfort you might feel. Exercise keeps joints moving, which helps them stay lubricated. It also builds strength in the muscles surrounding the affected joint, so they can support it.

Rheumatoid arthritis (rue-ma-TOYD arth-write-tis) or RA, is a form of inflammatory arthritis and an autoimmune disease. For reasons no one fully understands in rheumatoid arthritis the immune system, which is designed to protect our health by attacking foreign cells such as viruses and bacteria, instead attacks the body’s own tissues (specifically the synovium, a thin membrane that lines the joints). As a result of the attack, fluid builds up in the joints, causing pain in the joints and inflammation that’s systemic, meaning it can occur throughout the body.

- Rheumatoid arthritis is a chronic disease, meaning it can’t be cured. Most people with RA experience intermittent bouts of intense disease activity, called flares.  In some people the disease is continuously active and gets worse over time. Others enjoy long periods with no disease activity or symptoms at all. Evidence shows that early diagnosis and aggressive treatment to put the disease into remission is the best means of avoiding joint destruction, organ damage and disability.

The symptoms and course of rheumatoid arthritis vary from person to person and can change on a daily basis. Your joints may feel warm to the touch and you might notice a decreased range of motion, as well as inflammation, swelling and pain in the areas around the affected joints.  Rheumatoid arthritis is symmetrical, meaning if a joint on one side of the body is affected, the corresponding joint on the other side of the body is also involved. Because the inflammation is systemic, you’re likely to feel fatigued and you may become anemic, lose your appetite and run a low-grade fever.

Rheumatoid arthritis may affect many different joints and cause damage to cartilage, tendons and ligaments. It can even wear away the ends of your bones. One common outcome is joint deformity and disability. Some people with RA develop rheumatoid nodules,lumps of tissue that form under the skin, often over bony areas exposed to pressure. These occur most often around the elbows but can be found elsewhere on the body, such as on the fingers, over the spine or on the heels. Over time, the inflammation that characterizes RA can also affect numerous organs and internal systems.

Although there is no cure for RA, highly effective treatments exist. Once you have a diagnosis, you should begin treatment right away to slow disease progression and lower your chances for joint damage.

Engaging in moderate physical activity on a regular basis helps decrease fatigue, strengthen muscles and bones, increase flexibility and stamina, and improve your general sense of well-being.

- Juvenile arthritis (JA) refers to any form of arthritis or an arthritis-related condition that develops in children or teenagers who are less than 18 years of age. Approximately 294,000 children under the age of 18 are affected by pediatric arthritis and rheumatologic conditions. Juvenile arthritis is one of the most common chronic childhood diseases that often goes undetected or is misdiagnosed.

Symptoms include:

• Pain, swelling, tenderness and stiffness of joints, causing a limited range of motion
• Joint contracture, which results from holding a painful joint in a flexed position for an extended period
• Damage to joint cartilage and bone, leading to joint deformity and impaired use of the joint
• Altered growth of bone and joints leading to short stature

Types of juvenile arthritis include:

• Pauciarticular Juvenile Rheumatoid Arthritis (JRA) or Juvenile Idiopathic Arthritis (JIA) typically affects four or fewer joints and:
  • usually affects the large joints: knees, ankles or wrists
  • often affects a joint on one side of the body only, particularly the knee
  • may cause eye inflammation (uveitis) which is seen most frequently in young
  • girls with positive anti-nuclear antibodies (ANA)
• Systemic onset Juvenile Rheumatoid Arthritis (JRA) or Juvenile Idiopathic Arthritis (JIA) can:
  • affect boys and girls equally
  • cause high, spiking fevers of 103 degrees or higher, lasting for weeks or even months
  • cause a rash consisting of pale, red spots on the child’s chest, thighs and sometimes other parts of the body
  • cause arthritis in the small joints of the hands, wrists, knees and ankles
• Juvenile Spondyloarthropies (ankylosing spondylitis, seronegative enthesopathy and arthropathy syndrome) are a group of diseases that involve the spine and joints of the lower extremities, most commonly the hips and knees.
• Juvenile Psoriatic Arthritis is a type of arthritis affecting both girls and boys that occurs in association with the skin condition psoriasis.
• Juvenile Dermatomyositis is an inflammatory disease that causes muscle weakness and a characteristic skin rash on the eyelids.
• Juvenile Systemic Lupus Erythematosus is an autoimmune disease associated with skin rashes, arthritis, pleurisy, kidney disease and neurologic movement.
• Juvenile Vasculitis is an inflammation of the blood vessels and can be both a primary childhood disease and a feature of other syndromes, including dermatomyositis and systemic lupus erythematosus.

The cause of most forms of juvenile arthritis is unknown, but it is not contagious and there is no evidence that foods, toxins, allergies or vitamin deficiencies play a role.  There is no single test to diagnose juvenile arthritis.  A diagnosis is based on a complete medical history and careful medical examination. Evaluation by a specialist – either a pediatric rheumatologist or arheumatologist – is often required.  Laboratory studies including blood and urine tests are often needed to assist in a diagnosis of JA. Imaging studies including X-rays or magnetic resonance images may be needed to check for signs of joint or organ involvement in JA.

Management varies depending on the specific form of juvenile arthritis. Care by a pediatric rheumatologist is important for most forms of JA. The primary goals of treatment for juvenile arthritis are to control inflammation (swelling), relieve pain, prevent joint damage and maximize functional abilities.

Treatment plans for children usually include medication, physical activity, physical and/or occupational therapy, education, eye care, dental care and proper nutrition. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the first line of medication used in juvenile arthritis to help control pain and inflammation (swelling). Corticosteroids such as prednisone can be taken orally to relieve inflammation or injected into joints that are inflamed. Biologic Response Modifiers (BRMs), such as anti-TNF drugs, are a class of drugs that inhibit proteins called cytokines. They must be injected under the skin or given as aninfusion in the vein. Disease-modifying anti-rheumatic drugs such as methotrexate are often used in conjunction with NSAIDs to treat joint inflammation and reduce the risk of bone and cartilage damage.

For more information, please visit www.arthritis.org.

Get involved with the Arthritis Foundation in Florida!  Visit the FL chapter here.