• Joint pain or swelling
• Stiffness occurring in the morning
• A joint that appears unusually warm
• Redness around a joint
• A loss of maneuverability around a joint
• Any unexplained weaknesses, fevers, or weight loss.

If any of these symptoms occur for more than two weeks it is time to consult a doctor.

Just as there exists many different forms of arthritis, tests and treatment vary depending on the type, severity and nature if the disease.

Dr Robert Zickel Chairman of the Department of Orthopedic Surgery at New York Medical College and Director of Orthopedics at Westchester Medical Center talks about the most common types of arthritis:
“Rheumatoid arthritis is a generalized disease and begins as an inflammation in the membrane. The cartilage starts breaking down or wearing away and it becomes progressive till it becomes what we call an arthritic joint. Rheumatoid arthritis is a generalized disease involving the body, where osteoarthritis is localized to a specific joint. Osteoarthritis is the most common form, a wear and tear arthritis, that starts as a trauma to the joint.”

Although most forms of arthritis are not preventable early treatment combined with sensible eating habits and exercise can help alleviate many of the symptoms.
Irene Vaught’s arthritis occurred after breaking her arm two years ago. “They told me in the doctor’s office arthritis would develop shortly.” Her symptoms were stiffness, aching and decreased mobility. “I went to physical therapy to try to limit the development of it, for pain I used Motrin.” Although the pain hasn’t lessened Irene no longer seeks treatment. “I’ve learned to live with it.” She continues to use the exercises she learned in physical therapy.

Eileen Schwartz has had osteoarthritis since she was eighteen. In her case it was hereditary. “I have been seeing a doctor on and off for years. Years ago they just prescribed painkillers and told you to take aspirin. Now they have many inflammatory drugs, I take Daypro.” The arthritis settled in her arms and fingers.
As with so many others sudden changes in weather and dampness cause the greatest flare-ups.

Joan Hoffman has arthritis in her knees and ankles for the past ten years. Her mother also suffered from the disease. “Sometimes my knee locks when I’m going upstairs.”

Her advice for those who are suffering: “I would say weight has a lot to do with it, and exercise.” Joan uses a stationery bike as her preferred form of exercise.
There are more than one hundred different types of arthritis and the causes are just as varied. Gout, scleroderma, a virus, bacteria or fungus can lead to its onset. Auto-Immune disorders such as rheumatoid arthritis are diseases caused when something goes wrong with the bodies immune system and healthy parts of the body are attacked. A sudden accident can cause an onset of arthritis. Oftentimes it is simply hereditary. Whatever the reason it is often chronic but can be controlled with proper care.

Treatment varies depending on the age of the individual, the severity of the disease and the joints that are affected. Everyone I interviewed leads a productive life and has “come to terms” with the disease. Although usually incurable most treatments seek to reduce pain, discomfort and further damage. It is very important to seek treatment at the disease's onset.

The Arthritis Society suggests a self-management program that seeks to help the individual:

• Better understand their disease
• Learn ways to cope with chronic pain
• Help you to take a more active role in managing the disease.

The Arthritis Society offers a six-week course with weekly sessions that last two hours. Trained volunteers run the course. A small fee is charged. For further information or to find a location nearby you can call the Arthritis Society at 1 800 321 1433.

Many sufferers also suffer strong emotional reactions. Arthritis requires many to undergo a change in lifestyle. Everyday activities that they once enjoyed are now complicated. A simple task such as opening a bottle can cause intense pain. Many psychologists suggest a grief cycle is a common occurrence in the patient.

Classic symptoms of the grief cycle may include:

• Depression
• A feeling of helplessness
• Isolation
• A feeling that life lacks meaning
• Mood swings
• Emotional outbursts
• Loss of sleep and appetite

The most serious cases of depression can cause an individual to abuse alcohol and drugs and may even cause some individuals to consider suicide.
Arthritis is not something that one should have to handle alone. To reduce or eliminate these symptoms of depression a team of people should be involved in your treatment. They include:

• Your family
• Friends
• Primary Care Doctor
• Rheumatologist
• Physiotherapist
• Occupational Therapist
• Nurse
• Pharmacist

Knowing there is support can go a long way in conquering your fears and relieving your pain.
Dr. Zickel was kind enough to discuss the many medications available on the market today. “NSAIDS are non steroidal anti-inflammatory drugs. The ones we start with in an early situation are plain old ibuprofen, which comes in many forms, and you can get over the counter. There are than a whole number of medications such as Indocen and Naprosyn that are effective in many patients. The problem with many of these NSAIDS is that they had the side effect of gastro-intestinal irritability and this has led to the introduction of Cox 2 NSAIDS such as Vioxx and Celebrex (these are trade names) that have markedly reduced the side effects that we’ve seen with the others. The down side is that not all these drugs work well in every patient. Vioxx and Celebrex may be very effective in some patients and not in others. This is also true of the other NSAIDS. Taken to the extreme particularly in the case of rheumatoid arthritis the patient would be forced to actually use steroids, cortisone.”

Steve Kirschbaum has been suffering with bursitis in his shoulder for over thirty years. “Damp, rainy weather made it uncomfortable” He ultimately opted for surgery, “My doctor said the musculature connection to my shoulder was so bad that if I didn’t get surgery within a year or two there would be nothing to fix.” The surgery has improved his arthritis tremendously.

In discussing surgery Dr. Zickel feels, “The doctor doesn’t make that decision the patient does. Joint replacement is only done when the patient can no longer live with the pain. It is a surgery that has been enormously successful but not without its problems. Joint replacements do not last forever. In younger patients those under 40 additional surgeries called revisions may have to be performed. The bone has been compromised from past surgeries and does not hold up as well as a primary or first time replacement.”
He suggests an osteotomy as an alternative for some patients. In an Osteotomy the bone is cut through near the joint and the angle of the bone is changed which takes stress off the areas “which may be developing the most arthritis. These on occasion can be most successful, particularly those in the knee. In long time follow up series these can last for nine or ten years and give the patient reasonable comfort and function and could later be converted to a joint replacement if necessary.

“We do not now have a way of reversing the process.” This knowledge has only strengthened Dr. Zickel’s resolve. Currently he is involved in research in molecular biology and tissue engineering at New York Medical College. Although these techniques are promising there’s a long road ahead before they can be utilized in patients. Dr. Zickel offers us hope, “These are the things of the future.”

Dr. Ann Studer of the Chiropractic Life Center feels that the idea of learning to live with the disease is a misnomer. “Within any situation we can live a better existence. Each person should have the healthiest state possible within his or her own situation. ” Dr. Studer deals mainly with low force adjustments that don’t involve traditional methods of manipulation that most people think of when considering chiropractic treatment.

“When we go in and release the adjustment I teach that person how to release tension in their spine again. Over the course of time the person’s body begins to balance out. The tension will begin to release. Postural patterns and distortions will release themselves and the person can begin to almost walk upright again. Keeping the spine and the nervous system as healthy as possible is critical to someone being able to be as healthy as vibrant and as pain free as they can possibly be.”

There are many alternative forms of treatment available. Some have claimed acupuncture offers a degree of success. Whatever method of treatment a person uses it is important for the patient to take control of the disease and not let the disease control them. Remember that a positive attitude and a strong will go a long way in helping you to become the best you can be.

For Further Information on Arthritis:

http://www.arthritis.com - The Arthritis Society
http://www.webmd.lycos.com

By Joan Schauder