Joint Compassion

May is National Arthritis Month, raising awareness among Americans of the various diseases and conditions that we know collectively as “arthritis.” They afflict more than 50 million adults in the U.S., and of those, more than half (about 27 million) have osteoarthritis (OA).

Rheumatoid arthritis (which I prefer to call rheumatoid disease) affects just one-and-a-half million Americans.

The misconceptions about RA

Now, I don’t know about you, but over the years I’ve been guilty of pooh-poohing OA, that other arthritis, as somehow less important than my RD. After all, OA is common. And it must be pretty mild, too, because it’s the arthritis that others frequently (and annoyingly) mistake my RD for as they tell me that either they or someone they know have it, too. All they have to do, they say earnestly, is take a dose of some ubiquitous, over-the-counter painkiller and voila, they’re all better!

Let’s just pause here for a collective groan.

The fact is, we’re both wrong. My RD isn’t like their OA. And their OA isn’t necessarily mild or easily treated. Really, about the only thing that RD and OA share is the symptom that gives them their common names: “arthritis.”

The word is a combination of the Latin words “arthro,” which means “joint” and “itis,” meaning “inflammation.” In RD, autoimmunity causes this inflammation. In OA, joint degeneration is the culprit.

How is RA different from OA?

OA mostly affects people in middle or old age, but it can affect younger people, too. The causes? Genetics and age, mainly. People who are overweight are more likely to have OA, as well. OA mainly affects the hands, hips, knees, and spine, though it can affect other joints, as well.

In OA, the cartilage, a thick, hard, rubbery tissue that covers the ends of the joints, slowly wears away. Healthy cartilage allows the ends of joints to slide easily across each other during movement and cushions them against shock. But as it breaks and wears, the bare ends of the bones may rub and grind. Bone spurs may form, and bits of bone can break off and float freely in the synovial fluid.  All of this causes varying degrees of inflammation and pain. The pain can be mild or severe, temporary or persistent. In time, as OA destroys the cartilage and joint-ends and pain increases, it can cause disability.

Treatment for OA includes OTC and prescription non-steroidal anti-inflammatory drugs (NSAIDs) and, sometimes, OTC or narcotic painkillers; exercise, weight loss if necessary; and in severe cases, surgical intervention or joint replacement.

RD an autoimmune condition

RD can affect people of any age, even infants. Women get it about three times more often than men. RD is an autoimmune disease, which means that the body’s immune system mistakenly attacks and tries to destroy its own tissues, just as it would an invading bacteria or virus. The cause of the disease is unknown, but researchers suspect everything from heredity to smoking.

RD mainly attacks synovial joints, causing inflammation that also “degenerates” the cartilage, bone, and surrounding tissues, damaging and eventually destroying them. But it can also attack and damage soft organ tissues like the linings of the heart, the lungs, the vascular system, and even the eyes.

RD can progress quickly or slowly to cause joint destruction and disability. Treatments include NSAIDs, disease-modifying antirheumatic drugs (DMARDs), biologic DMARDs, OTC and prescription pain relievers, exercise, weight loss if necessary, and sometimes, surgery and joint replacement.

For both OA and RD pain, the Centers for Disease Control and Prevention also recommends such alternative therapies as mindfulness training, cognitive behavioral therapy, acupuncture/acupressure, massage, physical therapy, exercise, and diet modification for nutrition and/or weight loss.

Many of us who have RD also have OA. I have it in my fingertips and, since my mother has it in her lower spine, expect more of it as I get older. My husband has had OA since he was in his mid-30s in his spine, hips, and knees. Neither of them has RD, but we all know how to empathize with one another. Arthritis, no matter what causes it, hurts. It disables. It’s nothing to pooh-pooh, is it?


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