Arthritis is the name given to a group of related diseases which include osteoarthritis (degenerative arthritis), rheumatoid arthritis, juvenile arthritis, psoriatic arthritis, ankylosing spondylitis, lupus and fibromyalgia. In its various forms, arthritis affects the young and old, both sexes and all races. Although there are over 100 kinds of arthritis, they share one thing in common: they all rob otherwise healthy people of their quality of life by making even the simplest of movements painful. This pain is caused by inflammation of the lining of the body’s joints.

HOW OSTEOARTHRITIS BEGINS

Osteoarthritis, or “wear and tear” arthritis, is caused by the gradual breakdown and loss of joint cartilage. As the cartilage wears away, its ability to cushion the bones disappears. As a result, a mild inflammation sets in. This causes the bones that lie under the cartilage to thicken, frequently forming spurs of bone that protrude into the joints. These spurs cause more damage and associated inflammation. As this inflammation progresses, it causes further distress to the joint, giving rise to aches and pains. Osteoarthritis can affect any joint, but is most common in the hips, knees, hands and spine (neck and lower back).

HOW COMMON IS OSTEOARTHRITIS?

Osteoarthritis affects approximately one in 10 people in the USA and Canada, with most people developing the condition after the age of 45.

WHAT ARE THE WARNING SIGNS OF OSTEOARTHRITIS?

The following signs frequently signal osteoarthritis:

• Joint pain, stiffness and swelling that lasts longer than two weeks.
• Stiffness that tends to occur after periods of inactivity, such as sleeping or sitting.
• Aching in the joints following activity. (This is often felt in the early stages of the condition.)
• A sensation of “grating” when the joint is used. (This usually occurs after the disease has progressed for some time.)

The symptoms of arthritis usually come on slowly, involving the area around the joints. Consult your doctor or other health care provider if you have persistent joint pain, stiffness or swelling that lasts for more than two weeks. The sooner osteoarthritis is diagnosed, the better your chances of curbing the disease’s progression.

If your joints are red, or feel hot or tender, you probably have a condition other than osteoarthritis, such as rheumatoid arthritis or gout. Your doctor can provide you with a diagnosis and work with you to develop a treatment plan.

HOW DOES OSTEOARTHRITIS PROGRESS?

Damage to the joints progresses slowly and may result in several problems. You may experience pain, especially when moving a joint. You may hear a grating sound as the roughened cartilage at the ends of the bones rubs together. A joint may feel stiff and/or sore, particularly after resting. Bumps and swellings may appear, especially on the fingers and feet. All these changes can make it difficult to move around and complete everyday tasks such as getting dressed, opening jars or climbing stairs.

WHAT CAUSES INFLAMMATION?

Inflammation is the body’s natural response to being injured. It is characterized by redness, swelling, heat and pain. When your joints become inflamed, you may experience any or all of these symptoms. Inflammation can prevent the normal use of the joint and cause it to lose the ability to function properly. The key to reducing the pain of arthritis, and to halting its progression, is controlling the inflammation that precedes the condition. Drugs developed to manage arthritis normally work by curbing the inflammatory process.

Click here for osteoarthritis risk factors, prevention and wellness tips.

UNDERSTANDING ARTHRITIS MEDICATIONS

If you have been diagnosed with arthritis, your doctor will review the best course of treatment and pain management. This will likely include medication. Here are the most commonly used arthritis medications, and how they work.

MEDICATIONS THAT CONTROL ARTHRITIS SYMPTOMS

These include non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics (pain relievers). They help you to feel better by reducing the amount of discomfort that you experience but they do not inhibit the disease process itself. For this reason, they cannot prevent the damage associated with arthritic conditions, such as bone and joint impairment. These formulations typically take a few days to a few weeks to control pain effectively.

• NSAIDs
  Pronounced “ensayds,” these drugs help reduce pain and swelling in the joints while decreasing stiffness. When a low dose is taken, NSAIDs control pain, but higher doses are required to reduce inflammation. The problem with NSAIDs is their side effects. Taking more than one NSAID at a time increases the possibility of heartburn and severe side effects such as ulcers and bleeding. NSAIDs inhibit the blood’s ability to clot properly and may therefore interact with blood-thinning medications such as coumadin. Kidney disease has also been reported as a side effect.
  Most NSAIDs require a prescription, including naproxen (Naprosyn®), nabumetone (Relafen®), indomethacin (Indocid®), diclofenac (Voltaren®), piroxicam (Feldene®) and sulindac (Clinoril®). Other NSAIDs are available over-the-counter; these include ASA (Aspirin®, Anacin® and others), and ibuprofen (Motrin IB®, Advil® and others.)
• COX-2 Inhibitors
  This sub-class of NSAID has recently been introduced to the North American marketplace. The most frequently prescribed Cox-2 inhibitors are celecoxib (Celebrex®), rofecoxib (Vioxx®), valdecoxib (Bextra®) and meloxicam (Mobicox®). Unlike standard NSAIDs, Cox-2 inhibitors do not inhibit proper blood clotting. Recent evidence, however, strongly suggests that Cox-2 inhibitors have the same degree of negative side effects as standard NSAIDs—including contributing to kidney failure—and may increase the risk of heart attack and other cardiovascular problems.
  *Important News Release September 2004
  Vioxx®, the cox-2 inhibitor made by Merck, has been pulled from the market because of severe lethal side effects due to heart attack and stroke.
• ACETAMINOPHEN
  Acetaminophen (Tylenol®, Panadol®, Exdol®, and others) is often prescribed to relieve mild to moderate arthritis pain. Acetaminophen is not an anti-inflammatory drug and may therefore usually be safely combined with an anti-inflammatory medication to relieve pain. (Please consult your doctor or other health care practitioner regarding medications that are appropriate for you.)
  While acetaminophen can bring relief for arthritis pain, it does not help the underlying cause of the condition. Overdosing can cause liver damage. (If you are taking acetaminophen on a regular basis to control pain, you should make sure that other over-the-counter medications such as cold and flu remedies do not contain enough acetaminophen to constitute an overdose.)
• CORTISONE
  Cortisone may be injected directly into the joint to relieve severe inflammation and swelling. Cortisone mimics the anti-inflammatory effects of cortisol—a hormone produced naturally in the body. A cortisone injection can provide almost immediate relief for a tender, swollen or inflamed joint. However, since corticosteroids can weaken cartilage and remove minerals from the bone (osteoporosis and osteopenia), they should only be used rarely. Chronic use of corticosteroids may result in immune suppression and increase the risk of infection.

SUBSTANCES THAT MAY HELP MODIFY THE DISEASE PROCESS

• Nutricol®
  Nutricol®, available as Recovery® in many pharmacies and health retailers, is a food-based non-drug supplement proposed to improve quality of life*.
  
  Nutricol® (Recovery®) may be safely combined with other osteoarthritis medications or taken on its own to help improve quality of life*. It does not produce unpleasant side effects. Since this product works to modify your body’s responses, it may take up to six weeks for you to experience relief, with most people noticing benefits within a month.
  
  View feedback from health professionals and users of Recovery® with Nutricol®.