"Arthritis" does not mean only that someone has stiff, aching joints. Many types of arthritis exist, each with its own symptoms and treatments. Most types are chronic, meaning that they can be a source of discomfort for an extended period of time. Arthritis can afflict joints almost anywhere in the body and may cause changes you can see and feel, including swelling, warmth, and redness in the joints. It can last for a short time but be very painful or continue for a long time with less pronounced results while still damaging the joints.
Arthritis is extremely common in the United States, especially among senior citizens. Still, there are many steps they and those providing care for the elderly can take to relieve the different types of arthritis. The most common types in this population are osteoarthritis, rheumatoid arthritis, and gout.
Osteoarthritis (OA) is the most common form of arthritis in senior citizens and begins when cartilage, the type of tissue that pads joints, begins to wear away. This can eventually cause all the cartilage between bones to wear away, forming painful rubbing of bones against each other. This type of arthritis is most common in the hands, neck, lower back, knees, and hips.
Symptoms of OA can range from stiffness and mild pain that accompanies exercise or bending to severe pain in the joints even in times of physical rest. OA can also cause stiffness during times in which you haven't used specific joints in a while, like when you're on a long car ride, but this stiffness usually goes away when you move your joints again. OA can eventually lead to problems moving joints and sometimes to developing a disability if the areas affected are the back, knees, or hips.
Aging is often the greatest risk factor for developing OA. Other factors depend on the area of the body afflicted-for instance, OA in the hands or hips may be caused by genetic factors; OA in the knees may be caused by being overweight; and injuries or overuse of joints in the knees, hips, and hands may lead to OA.
Rheumatoid Arthritis (RA) differs from OA in that it's an autoimmune disease, meaning that your immune system attacks and damages the lining of a joint as if it were an injury or disease. RA leads to inflammation of the joints, which causes pain, stiffness and swelling, sometimes in multiple joints at once. It may be severe enough to prevent you from moving a certain joint. Senior citizens with RA may often experience fatigue or fever. You can develop RA at any age, and it's more common in women.
RA can afflict almost any joint in the body and is often symmetrical, meaning that if you have RA in a specific joint on one side of your body, you probably experience RA in the same joint on the other side of your body. RA can damage not only joints, but also the heart, muscles, blood vessels, nervous system, and eyes.
Senior citizens with gout experience the most severe pain relative to many other arthritis patients. An attack begins when uric acid crystals form in the connective tissue or joint spaces, leading to swelling, stiffness, redness, heat, and pain in the joint. Attacks often follow eating foods like shellfish, liver, dried beans, peas, anchovies, or gravy. Drinking alcohol, being overweight, and taking certain medications may worsen the symptoms. In senior citizens, using certain medications to lower blood pressure may also be a risk factor for a gout attack.
Gout is most common in the big toe, but it can occur in other joints such as the ankle, elbow, knee, wrist, hand, or other toes. Swelling may cause discoloration and tenderness due to skin stretching tightly around the joint. If you see a doctor during an attack, he or she may take a sample of fluid from the affected joint.
Other forms of arthritis.
Other forms include psoriatic arthritis in patients who have psoriasis; ankylosing spondylitis, which mainly affects the spine; reactive arthritis, which occurs as a reaction to another illness in the body; and arthritis in the temporomandibular joint, the point at which the jaw attaches to the skull.
Arthritis Symptoms and Warning Signs.
Senior citizens and those providing their elder care should look out for the following symptoms as they may be indications of arthritis:
- lasting joint pain
- swelling in a joint
- stiffness in a joint
- tenderness or pain when touching a joint
- difficulty in using or moving a joint normally
- warmth and redness in a joint
Any of these symptoms lasting longer than two weeks should be addressed by a physician. If you experience a fever, feel physically ill, have a suddenly swollen joint, or have problems using a joint, a doctor should be contacted sooner. You will have to answer questions and go through a physical exam. Before suggesting treatment options, your doctor may want to run lab tests and take X-rays.
Some common treatment options exist even though each type of arthritis is treatedsomewhat differently. Rest, exercise, eating a healthy diet, and becoming educated about the right way to use and protect the joints are key to minimizing the effects of arthritis. Proper shoes and a cane can minimize pain the feet, knees, and hips while walking, and some technology exists for helping open jars or bottles, turn doorknobs more easily, and otherwise improve quality of life in senior citizens with arthritis.
Additionally, some medications can lower the pain and swelling. Acetaminophen (in Tylenol) and some NSAIDs are sold over-the-counter and can ease pain. Other NSAIDs must be prescribed. It is important for senior citizens and those providing their in home care to pay attention to the warnings on both prescribed and over-the-counter drugs and to ask a doctor about how to properly and best use over-the-counter medicine to treat arthritis. The FDA also has information about many medications.
Some treatment options are specialized for individual types of arthritis.
There are medicines to help senior citizens with pain associated with OA, and rest and exercise may ease movement in the joints. Managing weight is also important. If one experiences OA in the knees, a doctor can provide shots in the knee joint, which can help to move it without as much pain. Surgery may also be an option to repair or replace damaged joints in senior citizens.
Rheumatoid Arthritis Treatments.
Treatment can diminish the pain and swelling associated with RA and cause joint damage to slow down or stop. One will feel better overall, and it will be easier to move around. On top of pain and anti-inflammatory medications, a doctor might prescribe DMARDs, which are anti-rheumatic drugs that can slow damage from RA. Corticosteroids, including prednisone, can minimize swelling while waiting for DMARDs to kick in. Additionally, biogenic response modifiers block the damage inflicted by the immune system and help people with mild to moderate RA when other treatments have failed to work properly.
If you've gone through a gout attack, talk to a doctor to discuss possible causes and future prevention of attacks. Work together with your doctor and other elder care providers to plan and execute a plan for prevention. Commonly, NSAIDs or corticosteroids are recommended for an acute attack. This treatment diminishes swelling, allowing you to feel better fairly shortly after treatment. Usually, the attack fully stops within a few days. If one has experienced multiple attacks, a doctor may be able to prescribe medication to prevent further attacks.
Exercise can help Arthritis.
In addition to taking the proper medication and allowing your joints to rest, exercise can help senior citizens to stay in shape, maintain strong muscles, and control symptoms of arthritis. Daily exercise like walking or swimming keeps joints moving while lessening pain and strengthening the muscles around joints. Before starting any new exercise program, it is important to discuss options with your physician.
Three types of exercise are the best for senior citizens with arthritis:
- Range-of-motion exercises reduce stiffness, improve flexibility, and keep joints moving. Activities like dancing fit into this category.
- Strengthening exercises strengthen muscles, which improves support and protection to your joints. Weight training fits into this category.
- Aerobic or endurance exercises improve health in the heart and arteries, prevent weight gain, improve how your body works overall, and may decrease swelling in some joints. Riding a bike fits into this category.
Other things to do to manage Arthritis.
On top of exercise and weight control, a number of other methods may help senior citizens ease the pain around joints. Applying heat or cold to joints, soaking in a warm tub, or swimming in a heated pool may help you feel better and move your joints more easily.
Surgery may be an option when damage has become disabling or when other treatment options have not adequately diminished pain. With surgery, joints can be repaired or replaced with artificial ones. Commonly, arthritic knees and hips are replaced.
Many senior citizens with arthritis try treatments that have not been tested or proven to help. Some are harmful, like snake venom, while others are harmless yet unhelpful, like copper bracelets.
Here are a few ways to determine whether a treatment is unproven:
- The remedy is said to work for all types of arthritis and other diseases
- Scientific support is from only one research study
- The label doesn't include directions or warnings of use
Areas for further research.
Studies suggest that acupuncture could ease OA pain in some senior citizens. Dietary supplements such as glucosamine and chondroitin are also under investigation and may reduce OA pain. More research is needed to determine whether these types of treatments actually work to reduce symptoms and damage to joints.
Talk to your doctor and others involved in your elder care.
Try not to make light of your symptoms by telling yourself that joint pain or stiffness is simply caused by aging normally. Your doctor and other elder care providers can discuss possible treatment options with you to safely minimize your pain and stiffness and prevent more serious joint damage.