Arthritis literally means inflammation of the joints. It causes damage to the joint structure and surrounding tissue, as well as considerable pain and physical disability. We tend to associate arthritis with old age but it can affect people of all ages, even babies and children. The condition is more common with females than males. There are over 100 different types of arthritis, and half a million New Zealanders will have the disease at some stage in their lives.
A normal healthy joint has a rubbery substance called cartilage that covers the end of each bone and provides a smooth slippery surface against which the joints move. Cartilage also acts as a shock absorber to reduce the impact of everyday physical activity. With arthritis, the joints are swollen and stiff (which is worse after rest and improved by gentle regular movement). As well as joint deformity, there is pain, redness and heat. The pain gets worse with activity, and is relieved by rest. Although there are many forms, the most common are osteoarthritis and rheumatoid arthritis. Gout is also a form of arthritis, and it is becoming more common.
Osteoarthritis (OA) affects people mainly later in life. Changes in the joints cause the cartilage to break down. Large weight-bearing joints, like hips, knees and spines, are affected the most. Being overweight can lead to osteoarthritis because of the added pressure on the joints and the failure of other supporting structures around joints. OA comes on gradually, over many years.
Rheumatoid arthritis (RA) is an auto-immune disease, which means the body’s immune system attacks its own tissues. The joint lining becomes inflamed and swollen and fluid builds up in the joint cavity. RA can also affect other body organs, e.g. the heart, lungs, nerves and eyes. In severe RA, the joints become deformed – affecting people’s ability to move. RA symptoms tend to develop more quickly than with OA and the disease occurs more in younger people, most commonly between the ages of 30 and 55 years.
Although there is no cure for arthritis, a wide range of effective medicines and supplements are available to treat the swelling and pain, and for modifying the course of the disease (in the case of RA).
Non-steroidal anti-inflammatory drugs (NSAIDs) reduce inflammation, and relieve pain and stiffness but do not alter the development of OA. For people who experience side effects from NSAIDs, paracetamol is an alternative pain reliever. Paracetamol taken regularly (but no more than 8 x 500mg tablets in 24 hours) is effective in treating mild to moderate OA pain and can be used long-term. Glucosamine has also shown some evidence of benefit for people with OA. It is a naturally occurring building block of joint tissue and cartilage and is thought to help by preserving the structural integrity of the joint and repairing aging and damaged joints.
Creams to rub on the skin also may provide temporary relief from the pain.
Some medicines are available only on prescription, some need our recommendation before they can be sold, and others can be bought from pharmacies without health practitioners’ intervention. Remember always to talk with your doctor or pharmacist about any medicines you take for arthritis, so you are taking the best one for your condition and not doubling-up.
Lifestyle modifications – such as weight loss, exercise and physical therapy – are core components of OA management. Medicines are the cornerstone of RA management, however a good balance between rest and exercise is also important.
Ask us for a free copy of the Arthritis fact card for useful tips on managing the disease, or look up the Arthritis New Zealand Website on www.arthritis.org.nz.