By Annemarie Schorpion, MD
An estimated 50 million people in the United States have arthritis or other rheumatic conditions, according to the American College of Rheumatology. While osteoarthritis is one of the most common forms, there are more than 100 different types of rheumatic disease that can cause debilitating joint pain if left untreated.
With the appropriate care, most rheumatic conditions can be effectively managed so you can continue to lead an active life.
Understanding Rheumatic Disease
Rheumatic diseases are a family of autoimmune, inflammatory, and degenerative diseases that affect a person’s joints, tendons, ligaments, muscles, bones, and organs. These diseases are typically chronic and often develop during midlife, though they can affect all ages and genders.
Osteoarthritis is an example of degenerative rheumatic disease, typically caused by wear and tear on the joints. Other common rheumatic conditions include rheumatoid arthritis, lupus, and gout.
Rheumatoid Arthritis
Rheumatoid arthritis affects more than 1.3 million U.S. residents with the vast majority —75 percent — being women, according to the American College of Rheumatology.
While the disease can start at any age, it most often begins between ages 30 and 50.
Symptoms of rheumatoid arthritis include pain, stiffness, swelling, and decreased movement of the joints, primarily in the hands and feet. Typically, the stiffness is worse in the morning and gets better with movement.
Other signs and symptoms may include:
- Loss of energy
- Loss of appetite
- Malaise
- Nodules on the elbows and hands
Rheumatoid arthritis is an inflammatory and autoimmune-related condition, meaning the immune system malfunctions and attacks healthy cells in your body. This causes an inflammatory response that can lead to damage over time.
There is no known cause of rheumatoid arthritis, but like many autoimmune-related diseases, it is believed to be related to genetics and it runs in families. Additional risk factors include smoking and obesity.
Lupus
Lupus is a rheumatic disease that can affect almost any organ in your body, and most people with the disease will experience joint pain.
The disease can also affect the kidneys, the tissue lining the lungs and heart (pericardium), and the brain. Other common symptoms include fatigue, weight loss, and fever and rash, especially a butterfly-shaped rash across the nose and cheeks.
Lupus symptoms typically come and go and flare ups, which are often triggered by sun exposure, can range from mild to severe.
Anyone can get lupus though women of child-bearing age are more susceptible to the disease than men.
The Centers for Disease Control and Prevention (CDC) estimates that 1.5 million people in the United States have lupus and about nine out of every 10 diagnoses are in women between the ages of 15 and 44.
Gout
A form of inflammatory arthritis, gout is another common — and painful —rheumatic disease.
Gout is caused by having too much uric acid in your blood (hyperuricemia), which can lead to the buildup of uric crystals in your joints, fluids, and other tissues.
Usually, symptoms affect one joint at a time, often the big toe, the ankle or the knee, and include:
- Pain, usually intense
- Swelling
- Redness
- Joint is warm to the touch
Risk factors for hyperuricemia, which causes gout, include:
- Being male
- Obesity
- Certain health conditions such as congestive heart failure, diabetes, and high blood pressure
- Certain medications
- Drinking alcohol
- Eating or drinking food and drinks high in fructose
- A diet high in purines, which the body breaks down into uric acid. Red meat, organ meat, and some types of seafood (anchovies, sardines, mussels, scallops, trout and tuna) have high purine levels.
Diagnosing and Treating Rheumatic Disease
Whether arthritis, lupus, gout or any other rheumatic condition, diagnosis can be difficult because early-stage symptoms can often mimic those associated with other diseases. In most cases, diagnosis typically begins with a physical exam, followed by blood tests. Imaging tests may also be recommended.
Depending on the diagnosis, treatment may include medication, physical therapy, and lifestyle changes. For rheumatoid arthritis, surgery may be recommended to repair damaged joints and relieve pain.
In general, when it comes to rheumatoid disease, the CDC recommends the following self-management strategies in addition to treatment:
- Be physically active. Experts recommend that adults engage in at least 150 minutes of moderate physical activity per week. Moderate, low impact activities recommended include walking, swimming, or biking.
- Lose weight. For people who are overweight or obese, losing weight reduces pressure on joints, particularly weight bearing joints like the hips and knees. Reaching or maintaining a healthy weight can relieve pain, improve function, and slow the progression of arthritis.
- Eat a healthy diet. It is important to eat a variety of nutritious foods, including fresh fruits and vegetables, whole grains, and moderate servings of lean protein such as meat, fish, and beans. Some conditions may have special dietary considerations. Consult your physician about your specific needs.
- Talk to your doctor. You can play an active role in controlling your condition by attending regular appointments with your health care provider and following your recommended treatment plan.
To find a physician with Penn Medicine Princeton Health, call 888-742-7496 or visit www.princetonhcs.org.
Annemarie Schorpion, MD, is board certified in rheumatology and a member of the medical staff of Penn Medicine Princeton Health.