So . . . arthritis. What is it? Who has it? What can we do about it? Fact is, arthritis is VERY common and most of us will, or do have it. But, the first thing to know is that there’s not just one form of arthritis.
Basically, there are two main types of arthritis:
- Inflammatory/Auto-Immune
- NonInflammatory/Mechanical or Degenerative
And yes, we can have both of them. Let’s break it down.
Inflammatory/Auto-Immune Arthritis:
What Is It?
The Inflammatory/Auto-Immune conditions are a group of conditions that occur as a consequence of our immune system generating an inflammatory response against our own cells and tissue. It is this inflammatory response against ourselves that is responsible for producing joint pain, joint stiffness, joint swelling, redness and warmth of the joints, fatigue, low-grade temperature, rash, etc..
We have yet to know the trigger that causes our immune system to turn on ourselves, although a fairly recent study supported that the Epstein Barr Virus may be a trigger. Certainly, bacteria and viruses have a long history of being a probable cause as do certain foods such as sugar, artificial sweeteners, and a number of preservatives and starches (such as gluten). But, fact is, we can’t tell anybody what the exact cause is.
Inflammatory arthritis / Auto-Immune Disease
There are a number of conditions that fall under this category. The most common include:
- Rheumatoid Arthritis, Lupus, Sjogrens, Mixed Connective Tissue Disease, Undifferentiated Connective Tissue Disease.
- Spondyloarthropathies (Spon – de – lo – arth – rop – athies)
- Psoriatic arthritis, Crohn’s Arthritis, Ankylosing spondylitis
- Crystal disease: Gout, Pseudogout
Each of the conditions above typically has some joint involvement due to inflammation. Our immune system can also produce inflammation that is directed at attacking our blood vessels and muscles. If this happens, we have vasculitis (inflammation of blood vessels) or myositis (inflammation of muscles). These are also auto-immune diseases and are treated in a similar fashion to the conditions listed above.
So, what would I feel like if I had an inflammatory arthritis?
Inflammatory arthritis is characterized by:
- Prolonged morning stiffness (often greater than 20 minutes)
- Joint pain and swelling that affects both sides of our bodies
- Pain and stiffness are better with activity and movement
- Pain and stiffness are worse at rest
- Redness or warmth of the joints
- Low-grade fever
- Fatigue
- Rash
- Achy feeling
Blood tests can help determine if we have inflammation in our blood. Inflammatory and autoimmune arthritis and disease symptoms improve with the use of prednisone (or steroid).
How common are they?
These results were published in an article titled, “Estimates of the Prevalence of Arthritis and Other Rheumatic Conditions in the United States” in the January 2008 issue of Arthritis & Rheumatism. It’s an older study, and my guess is that the numbers now aren’t any better but worse.
Summary of the article and those affected by the different types of ‘inflammatory arthritis’:
- Rheumatoid arthritis – 1.3 million US adults. 3 cases per every 10,000 people worldwide
- Juvenile arthritis – 294,000 people in the US.
- Spondylarthritides – 0.6 to 2.4 million US adults over 15
- Systemic lupus erythematosus – 161,000 to 322,000 US adults
- Sjögren’s syndrome – 0.4 to 3.1 million adults
- Polymyalgia rheumatica – 711,000 people in the US
- Giant cell arteritis (vasculitis) – 228,000 people in the US
- Gout – 8 million people in the US
So, what can be done about Inflammatory/Auto-Immune arthritis or Auto-immune conditions like vasculitis and myositis?
No matter what type of arthritis we have, some of the most common foods and beverages are known to induce inflammation. These include:
- Sugar
- Processed foods and meats
- Dairy (especially low fat)
- Refined carbohydrates
- Fried food
- Fast food
- Soda
- Caffeine
- Alcohol
- Vegetable oil
- Gluten
- Casein
. . . just to name a few. So, the first thing we can do is be mindful of what we eat and drink.
After that, traditionally speaking, the treatment for these conditions is based on suppressing our immune system in order to minimize the inflammation in our blood. There are older meds and newer meds, but they all work by suppressing our immune system’s ability to produce inflammation. It’s important to treat these conditions because they can do more than just affect our joints. Inflammatory and autoimmune arthritis and diseases can cause damage to other organs such as our eyes, heart, lungs, and kidneys. Some of the more common traditional medications used include:
- Plaquenil
- Sulfasalazine
- Methotrexate
- Arava
- Imuran
- Cellcept
In the late 1990s came the ‘new’ medications—the biologics. Common biologics used include:
- Humira Enbrel Remicade
- Simponi Aria Cimzia Orencia
- Actemra Cosentyx Taltz
- Kevzara Otezla Stelara
- Rituxan Cytoxan
The biologics are a bit different in that they block specific pathways that create the inflammation.
Those are the basics of inflammatory/Autoimmune Arthritis. Let’s move on to. . .
Mechanical/Degenerative
For the most part, these conditions go by many names (Osteoarthritis, Degenerative Disc Disease, Degenerative Arthritis, Spondylosis), but the underlying issue is the same: loss of cartilage in our joints.
Cartilage acts as our cushion, and once we start losing it, we hurt unless we are at rest. There are many reasons the cartilage wears out. For some of us, it’s genetics. For others of us, it could be trauma to a joint, repetitive use, or our weight. Mechanical or Degenerative arthritis is diagnosed by an exam and by X-rays.
What Would I Feel Like If I Had Mechanical / Degenerative Arthritis?
- Pain worse with activity and weather changes
- Stiffness after sitting for pronged periods of time (lasts only minutes)
- Pain better with rest
- Pain worse later in the day than first thing in the morning
- Minimal swelling of joints
- Absence of associated symptoms like fever, fatigue, rash
- Normal blood work (lab)
How Common is Mechanical Arthritis?
OA (Osteoarthritis) is the most common form of arthritis affecting between 20 and 27 million people in America and nearly 650 million people worldwide. Globally, Osteoarthritis ranks fifth among all forms of disability worldwide (Murray 2012). OA is thought to be the most prevalent of all musculoskeletal pathologies, affecting an estimated 10 percent of the world’s population over the age of 60 (Pereira 2011). The prevalence of OA increases with age, up to 80 percent in people over age 65 in high-income countries (Fernandes 2013). As the world’s population continues to age, it is estimated that degenerative joint disease disorders such as osteoarthritis will impact at least 130 million individuals around the globe by the year 2050 (Maiese 2016).
What Can Be Done About Mechanical or Degenerative Arthritis?
Just like Inflammatory conditions above, the first thing we can do is remain mindful of what we are eating and drinking. Traditionally speaking, treatment starts with weight reduction, improved muscle tone, and stretching—i.e., physical activity and therapy. Glucosamine/chondroitin sulfate, as well as other supplements such as hyaluronic acid, can be used, but there has not been conclusive evidence that any supplement restores, regenerates, or prevents the breakdown of cartilage.
For the most part, treatment for mechanical arthritis is basically pain management with a variety of options such as:
- Supplements: Tumeric, Willow’s Bark, Devil’s Claw, etc.
- CBD products
- Topical creams
- Anti-inflammatories (like Ibuprofen, Advil, Motrin, or Aleve)
- Prescription Anti-Inflammatories
- Celebrex Mobic
- Diclofenac
- Lodine
- Daypro Piroxicam Relafen
- Tylenol (Acetaminophen)
- Narcotics
- Neuropathy meds: Gabapentin, Lyrica, Cymbalta, Savella
- Anti-depressants like Elavil
- Joint Injections with steroids or hyaluronic acid (gel shots)
- Joint replacement surgery (Typically reserved when pain cannot be controlled or when there is significant instability of the joint)
I hope this helps and gives you a basic idea of the differences between inflammatory and noninflammatory arthritis.
Remember, our choices affect both our contentment and our physical health. Today and every day, let’s do what we can to have less arthritic pain by living our value one choice a time.
