Arthritis: Keeping your joints healthy

• Description
• Table of Contents
• An excerpt from this report

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The number of people with arthritis is staggering. In 2005, 66 million adults in the United States—nearly 1 in 3—had either been diagnosed with arthritis or were living with undiagnosed chronic joint pain and other symptoms. Although the risk of some types of arthritis, such as osteoarthritis, increases with age, more than half of those affected by all types of arthritis are younger than 65. In fact, arthritis is the leading cause of disability in Americans older than 15.

It doesn’t have to be that way. If you have arthritis, there are steps you can take, starting today, to protect your joints, reduce pain, and improve mobility. The exact strategy depends on the type of arthritis you have, but for most people, there is reason for optimism.

This report describes how arthritis affects the joints and other structures. It explains how the various kinds of arthritis are diagnosed and treated, and tells how to minimize the impact of arthritis in your life. 52 pages. (updated: 2006)

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Here's an Excerpt from this Arthritis Special Health Report

Although no drug exists that will cure or reverse the progression of osteoarthritis, it is usually possible to alleviate pain and inflammation. Medications form the basis of treatment for osteoarthritis, but are best used in conjunction with other pain relief strategies, such as exercising to build your muscles and protecting your joints from injury or overuse.

To relieve the pain and stiffness of osteoarthritis, the first step is usually an over-the-counter pain reliever. Doctors often recommend acetaminophen (Tylenol) first because it’s often effective for mild pain and easy on the stomach. But remember that acetaminophen, like any drug, has its own risks—especially for the liver.

In the past few years, however, it has become clear that nonsteroidal anti-inflammatory drugs (NSAIDs) may be more effective than acetaminophen in treating osteoarthritis because they not only relieve pain, but also reduce inflammation that contributes to pain, swelling, and stiffness.

The arsenal of NSAIDs has grown over the years to include about 20 different drugs. Among them are such well-known medications as aspirin, ibuprofen (Advil, Motrin, others), and naproxen (Aleve, Naprosyn, others). These drugs reduce pain and inflammation by blocking the production of prostaglandins, leukotrienes, and other chemical mediators. For many people, they are slightly more effective than Tylenol, especially during flare-ups of pain.

The most common side effects of these medications are stomach problems, including gastrointestinal bleeding and ulcers, often occurring without warning. That is because NSAIDs work by inhibiting both the COX-1 enzyme, which helps protect the stomach lining from the corrosive effects of stomach acids and digestive enzymes, and the COX-2 enzyme, which causes pain and inflammation. One widely quoted paper, published in the New England Journal of Medicine in 1999, estimated that each year these drugs contribute to at least 16,500 deaths and more than 100,000 hospitalizations in the United States. A more recent study of people in Spain concluded that roughly one in three hospitalizations or deaths due to gastrointestinal bleeding could be attributed to NSAIDs. It is possible in many cases to avoid such complications—but first you and your doctor must work together to determine your risk of experiencing them.

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