Managing arthritis – a health priority

National Arthritis Week 6-12 April has focused our attention on one of the most common of all chronic medical conditions.

Of special significance is the Commonwealth Government’s commitment of more than $11 million in funding to improve doctor and community access to the latest advice and information about management of arthritis.
At the Australian Health Ministers Conference last year, arthritis and other musculoskeletal conditions such as osteoporosis have been established as the seventh National Health Priority Area along with other areas such as cancer control, diabetes and asthma.

There is no doubt arthritis is greatly misunderstood. Perhaps that’s partly because there are so many different forms of arthritis – well over 100 in fact.

The word arthritis literally means joint inflammation; although in one of the two most common forms of arthritis – osteoarthritis – there may be little or no inflammation.

Osteoarthritis (OA) is the wear and tear type of arthritis. It usually occurs later in life, particularly in people who have injured or put extra strain on their joints, but can happen to anyone. Osteoarthritis is often confused with osteoporosis where the bones become brittle and there is a high risk of fractures. While the two conditions are different, they sometimes occur together with some form of arthritis affecting more than one in three Australians.
Injury and overuse are two of the factors which contribute to OA, but it’s possible that we might also inherit the tendency to suffer with OA.

Rheumatoid arthritis (RA) is the next most common form of arthritis. RA is a disorder of the immune system that results in destruction of cartilage around the joints. The continued inflammation also changes bone structure and causes joint deformity.

With RA the smaller joints (hands, feet and ankles) are usually affected first. They become hot, red, painful and swollen. But there are other symptoms as well such as generalised weakness.

Both of these major forms of arthritis can often be managed effectively with a combination of medications and so-called nonpharmacological treatments. These include exercise, hydrotherapy, physiotherapy and occupational therapy. Diet appears to play no major role in the cause or treatment of osteo- or rheumatoid arthritis, however, there is no doubt if you’re overweight, with all that extra load on your joints, your symptoms will be a whole lot worse.

Paracetamol is generally considered the medicine of first choice for the control of the pain associated with OA; but regular dosing of two tablets, three or four times daily will be necessary to gain most benefit – an occasional dose when the pain is severe is unlikely to have much effect.

Anti-inflammatory pain relievers (known as NSAIDs) can be used in OA if the pain is not sufficiently controlled with the paracetamol and they are often considered to be of greater value in treating the symptoms of RA. More recently developed NSAIDs, less likely to cause stomach irritation, are now available. Check with your doctor to find out if they are suitable for you.

There has also been interest lately in nutritional supplements such as glucosamine, chondroitin and evening primrose oil.