Arthritis and aging
By Mary Ann Rodabaugh
According to the Centers for Disease Control and Prevention, 50% of adults 65 and older have been diagnosed with arthritis. As you age, there is a good chance that you may experience symptoms of arthritis.
“The most common symptom patients with arthritis notice is pain,” says Sharon L. Kolasinski, M.D., professor of clinical medicine, division of rheumatology at the University of Pennsylvania Health System. “With arthritis, the pain will be localized to one or more joints. The knee or the base of the thumb are very common spots for people to feel their first symptoms of osteoarthritis.”
Osteoarthritis is the most common form of arthritis, according to The Mayo Clinic. Symptoms develop slowly and worsen over time. Osteoarthritis occurs when the cartilage that cushions the ends of bones in your joints gradually deteriorates.
Types of arthritis
There are several additional types of arthritis to note:
Rheumatoid arthritis is a chronic condition, considered to be an autoimmune disorder, where joints experience inflammation. The eyes, skin, blood vessels, and heart may also be affected. In addition, painful swelling and joint deformity may occur.
Psoriatic arthritis may occur in patients with psoriasis, a skin disease that causes a rash with itchy, scaly patches. Joint pain, swelling and stiffness are symptoms of psoriatic arthritis.
Reactive arthritis occurs when joint pain and swelling are triggered by an infection elsewhere in the body. These infections can occur anywhere but are typically found in the urinary tract, intestines or genital area. Formerly known as Reiter’s syndrome, reactive arthritis causes pain and swelling in the knees, ankles and feet.
Gout can impact the joints of your big toe with intense bouts of swelling and pain. Some say it feels like your big toe is on fire. If you have a high level of uric acid in your blood, your body may produce excess urate crystals. The accumulation of these crystals trigger gout symptoms.
While some forms of arthritis are incurable, such as rheumatoid arthritis and gout, all types of arthritis are manageable with treatment. Treatments continue to improve as more research is conducted.
“Over the last 20 years, a whole host of new medications have been developed to treat rheumatoid arthritis and other forms of inflammatory arthritis, like psoriatic arthritis,” Dr. Kolasinski says.
Known as biologics, this group of medications are injectable and can be administered in the comfort of your own home.
“Not only do patients have less pain and swelling, they accumulate less damage in their joints over time when successfully treated with biologics,” Dr. Kolasinski says. “One of the biologics has even been adapted to use in refractory gout (gout that does not respond to traditional treatments, like nonsteroidal anti-inflammatory drugs and colchicine,) or in patients for whom traditional treatments cannot be used.”
Dr. Kolasinski notes that while biologics are often significantly better at controlling arthritis symptoms for many patients, they also come with potential side effects. Since rheumatoid arthritis and psoriatic arthritis are diseases of the immune system where excess inflammation occurs in the joints, medications to suppress the immune system may be needed. This can lead to an increase in infections.
Forms of arthritis not caused by diseases of the immune system have received a lot less attention. There are no innovative medications for the most common type of arthritis: osteoarthritis. Dr. Kolasinski says this form of arthritis is the one that we think about most when we think about aging. While the risk of osteoarthritis increases with age, a history of injury and obesity can also contribute to risk, particularly in the knees.
Medications used to treat osteoarthritis include acetaminophen and nonsteroidal anti-inflammatory drugs. Steroids or hyaluronic acid injections, particularly in the knees, are an option for some patients.
“The most important treatment for patients with arthritis is exercise,” Dr. Kolasinski says. “However, when inflammation is uncontrolled, medication is necessary, and exercise is not an adequate substitute.”
Once inflammation is under control, patients need help regaining strength, which can be very important in protecting joints from future injury and overuse. In osteoarthritis, patients often become more sedentary as the arthritis progresses, limiting their activities and weakening muscles. This can, in turn, make it harder to walk. Balance may also be affected, and the risk of falling increases.
Dr. Kolasinski encourages patients with osteoarthritis to talk with their doctors about how to incorporate exercise into their treatment plan. Physical therapy is often a great place to start, but graduating to a home exercise program is the goal. Continuing to exercise by walking, biking, going to the gym or senior center, or taking exercise classes online are all ways to make a regular exercise program work for you.
For more information about arthritis, treatments and healthy living, including tips on incorporating exercise into your daily routine, contact the Arthritis Foundation at 1-800-283-7800 or arthritis.org.
Mary Anna Rodabaugh is a writer, editor and writing coach.