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Arthritis
A
Summary
by:
George Pararas-Carayannis, Ph.D.*
(Excerpts
from summary prepared under contract for the ReGenesis Medical
Center/ Dec 2000)
*
Disclaimer -
I am not a medical doctor. All material provided at this website
is for informational purposes only. Readers are encouraged to
confirm the information contained herein with other sources.
Patients and consumers should review the information carefully
with their professional health care provider. The information
is not intended to replace medical advice offered by physicians.
I will not be liable for any direct, indirect, consequential,
special, exemplary, or other damages arising therefrom.
 Introduction
Arthritis is a disease
that attack the joints and affects mostly the elderly. Arthritis
means joint inflammation, but the term is used to describe nearly
100 different muscle, bone, and joint disorders, including osteoarthritis,
rheumatoid arthritis, gout, lupus, and scleroderma. Very few
of the forms of arthritis can be cured, but life changes can
have a dramatic impact on how the disease affects those afflicted.
As of 1998, statistical
data indicates that 43 million Americans are suffering from arthritis
and other diseases of the joints. Since the disease is often
a condition of age, by the year 2020, it is estimated that about
60 million people in the U.S. will be affected.
Joint Anatomy
Symptoms
of Arthritis
Arthritis is a deterioration
or erosion of the joint tissue. It is a debilitating disease
that restricts activities. Although often crippling, arthritis
varies enormously in severity and many sufferers have the condition
quite mildly. People suffering from arthritis have three times
as many unhealthy days -- both physically and mentally -- and
a much worse "health related quality of life" than
people without the disease.
 Arthritis and Depression
Physical pain from
all types of arthritic conditions affects significantly the mental
health of sufferers frequently causing depression. Often, there
may be a cascading effect -- arthritis causing the depression
leading to a bad mental day, which contributes to increased arthritis
pain, which depresses the person even more.
Diagnosing
Arthritis
Diagnosis relies on
accumulating information from the history, examination and investigations,
especially certain blood tests and X-rays. Some patients develop
characteristic nodules, particularly on the elbows. They are
not usually painful, unless traumatized.
Types of
Arthritis
Some examples of arthritis
include osteoarthritis (OA), rheumatoid arthritis (RA), psoriatic
arthritis, and gout. Each of these may affect patients differently
and may have significantly different complications.
Osteoarthritis
(OA)
Osteoarthritis (OA)
is often described as an accelerated 'wear and tear' phenomenon
affecting the joints. Thus, it primarily affects elderly individuals.
While this is generally true, under certain circumstances, accelerated
OA may also occur in relatively younger persons. Heredity may
also be a factor in such cases.
Rheumatoid
arthritis (RA)
Of all forms of arthritis,
Rheumatoid Arthritis (RA) affects approximately 1-2 % of the
general population and is found world-wide. RA is a chronic,
systemic, inflammatory disease that chiefly affects the synovial
membranes of multiple joints in the body. RA is the commonest
form of inflammatory arthritis and it is three times as common
in women than men. Onset of the disease in adults is usually
between the ages of 40 to 60 years, although it can occur at
any age.
Joint Diagram
Causes of RA: The cause of RA remains unknown.
RA, as well as other autoimmune diseases, includes widespread
immunological and inflammatory alterations of connective tissue.
Because the autoimmune diseases share many clinical findings,
making a differential diagnosis is often difficult. Although
the autoimmune disorders are considered acquired diseases, their
causes usually cannot be determined. Metabolic and nutritional
factors, the endocrine system, geographic, psychologic, and occupational
data have been extensively studied with no conclusive findings.
Also, there has been
continuous suspicion of an infectious origin of the disease process,
which has included various bacteria and viruses, but without
evidence of precipitating events. It now appears that an unknown
antigen initiates the autoimmune response resulting in RA. Also,
the presence of HLA-DR4 antibody, in 70 percent of patients with
RA, lends support to the genetic predisposition to the disease.
Rheumatoid Factor(s) (RF) are antibodies to IgG, and are present
in 60-80 percent of adults with the disease - particularly in
cases associated with more severe and active joint disease.
 Symptoms and effects of RA: Rheumatoid Arthritis can attack
any synovial joint in the body, but seems to concentrate mostly
on the small joints of the hands and feet. Early in the course
of the disease, several changes in joint structures occur. Joint
effusion and inflammation of the synovium occur and these produce
a soft tissue swelling. Additionally, changes (osteoporosis)
in the ends of the bones forming the joint may be present early
in the disease process. The involvement of the joint tissues
progresses over time, leading to deformity of the joints. The
destruction of bone eventually leads to laxity in tendons and
ligaments and the disability of the sufferer.
Rheumatoid Arthritis
Nodule
Because the disease
is systemic, there are many extra-articular features of the disease
as well.
For example, neuropathy, scleritis, lymphadenopathy, pericarditis,
splenomegaly, arthritis, and rheumatoid nodules are frequent
components of the disease. In addition, the potential for involvement
of the renal, pulmonary, and cardiovascular systems exist.
In most cases of RA,
there may be remissions and exacerbation of the symptoms. Although
at times the symptoms may temporarily remit, rarely the disease
"goes away".
Treatment of RA Patients:
Since Rheumatoid
Arthritis (RA) is a complex, systemic disease, treatment of the
disease is also complex and involves many aspects of a patient's
life. Treatment can be broadly categorized into the following
general areas:
Patient AND Family
Education
Prevention of Disability and Preservation of Function
Surgical Intervention
Pharmacological Therapy
Maintenance of Lifestyle
Symptomatic Treatment
Social and Emotional Support
Drug treatments of
RA and other forms of Arthritis:
Arthritis is considered
incurable but treatments are steadily improving and there has
been a tendency in recent years to treat the condition more vigorously
in the early stages.
The standard drug
prescribed for RA is methotrexate. However, the drug Enbrel (etanercept)
has been recently recommended as a first line therapy in delaying
the structural damage of arthritic joints in patients with moderately
to severely active rheumatoid arthritis RA. This drug is particularly
recommended when other anti-rheumatoid medications have not been
successful.
Ketoprofen is also
another safe, highly potent, nonsteroidal anti-inflammatory drug
that has been used in European countries for many years as an
effective treatment for rheumatoid arthritis and osteoarthritis.
Ketoprofen was recently approved by the FDA in United States.
Finally, Celebrex is another, fairly new drug that has been reported
to be a good pain killer for either osteoarthritis or rheumatoid
arthritis sufferers.
AlternativeTreatment
for Arthritis
Treatment
for Arthritis, particularly Rheumatoid (RA), or other musculoskeletal
disorders, involves the development of an individualized plan
for the ultimate benefit of each patient. A major element in
the treatment of patients is to prevent disability and preserve
bodily function. An exercise routine is recommended to preserve
motion, strength, functional activities, and lifestyle. Special
nutritional supplements and EDTA Chelation therapy appear to
provide many benefits to many RA patients, particularly during
cyclic flares and exacerbation of the disease. Nutritional supplements
provide the natural means of helping the immune system and the
body's joints, tissues and cells of many patients suffering from
different forms of arthritis or other musculoskeletal disorders.
Nutritional supplements include glucosamine/chondroiton with
MethylSulfonylMethane (MSM), Ester C and Manganese and other
immune-stimulating and healing ingredients.
Miscellaneous
Summaries on Chronic Illnesses
heart disease | |
stroke | diabetes |
| high blood
pressure
| | high cholesterol | | Alzheimer's | |
Parkinson's
| |
arthritis | |
chronic
fatigue
|
| poor circulation | | brain injury | | multiple sclerosis | | cerebral palsy | | life extension | | memory
loss |
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