The number of arthritis suffers is expected to increase by 1 million people a year for the next 20 years. And most of those will suffer in silence.

“As a culture, we are taught to ignore pain. We discount it too easily. We don’t respect it, but it is the first, and most familiar, symptom of arthritis,” says Ieva Fraser, co-ordinator of the arthritis program at Southlake.

In fact, the symptom is so well known, many people who suffer from arthritis simply diagnose themselves and don’t seek medical attention until there is some loss of motor function.  

“This is a mistake, “ says Ms Fraser. “There are more than 135 different types of arthritis, and every one of them can be treated. Every one of them could also get worse. Ignoring the pain is the surest way to suffer more than you need to.”

“Pain is not a disease, pain is a symptom.

It has to be treated in conjunction with the pathology that is causing it. When over the counter medications and pain killers are being advertised as helping arthritis pain, people need to understand that it is only the symptom that is being addressed. They offer no treatment  whatsoever of the arthritis,” says pharmacist Marie Craig, who manages the pharmacology of the arthritis program.

Both are very clear in saying there is no cure for arthritis, which may be one of reasons people don’t seek help sooner. However, there are treatments that will put the disease into remission, making the symptoms easier to manage and preventing the disease from further development.

Curbing the disease’s progress is essential to maintaining quality of life. More than 600,000 people between the ages of 15 and 65 are unable to work because of arthritis, making it the leading cause of disability in the country and often robbing the afflicted of the simple dignity of being able to care for themselves. The button, comb or fork present impossible difficulty, and the resulting depression and anxiety over everyday tasks frequently leaves the patient with a very low sense of self-worth.

Because of this, arthritis treatment includes the emotional and psychological support of a group environment as well as individual counselling when required.

Diet and exercise are also core components of a good treatment plan. Proper nutrition together with strength and dexterity exercise, helps build muscle volume and increase elasticity of tendons.

Treatment may also include relaxation techniques, physiotherapy and occupational therapy, as well as medication counselling by the pharmacist, each depending on the requirements of the patient and the progress of the disease at the time therapy begins.

Appropriate medications are the single most important element of an effective treatment strategy however, and before anyone considers self-treatment with over the counter remedies, they should be aware that none of these are proven to do any more than alleviate some symptoms of the disease. They will not slow its progress or improve the actual function of the damaged joint.

Pain relief and anti-inflammatory treatments that require a prescription are part of most treatment plans, and, in cases of inflammatory arthritis, must be taken in conjunction with those medications that help prevent further damage to the joints in order for treatment to have long-term benefit to the patient.

“Pain usually increases imperceptibly. It creeps up on us. We get used to it in small increments every day and continue to ignore it as it gets worse because it’s only a little bit worse than it was yesterday. By the time a patient actually loses function the pain is unbearable; they are exceeding the recommended dose of over the counter pain killers and the joints are very obviously damaged,” says Ms Fraser.

“There is no need for this. There is help. And the sooner you ask for it, the sooner you complain, the sooner treatment can start, the simpler that treatment is likely to be and the higher your chances of suffering no loss of function whatsoever.”

Of the more than 135 kinds of arthritis, these are divided into three basic categories for diagnosis and treatment: inflammatory, degenerative and osteoporosis.

“Osteoporosis is a childhood disease, that manifests itself later in life,” says Ms Fraser. By the time you are 20, your bones have developed as much as they ever will, and poor diet, calcium or vitamin D deficiencies, and inadequate exercise during those early years put you at risk of developing osteoporosis as an adult.

After 20 it is difficult to increase bone density and it actually begins to naturally decrease. When they are strong to start with, bones will sustain normal decreases without serious health risk, and proper diet and exercise help slow the process as well as keeping muscle and ligaments strong and pliable.

Often referred to as brittle bones, osteoporosis is the advanced loss of bone density resulting from either an initially weak condition or later neglect of bone maintenance that can accelerate the rate of bone loss. A lack of exercise, insufficient calcium intake, excessive caffeine consumption and cigarette smoking are the chief offenders in undermining skeletal strength. Post-menopausal women are especially
vulnerable to bone loss and should rigorously avoid increasing their risk.

Degenerative arthritis is also known as osteoarthritis, and is the most common form of the disease, affecting one in 10 adults. It is different from osteoporosis principally in that there is no bone loss and, where osteoporosis may afflict any of the 206 bones in the body, osteoarthritis is exclusive to the joints. It is the loss of cartilage intended to buffer the joints, causing the bones to grind against each other.

This is the wear-and-tear arthritis most people associate with normal aging. There is some stiffness, there may or may not be significant pain at the onset, but as it develops there will be increasing degrees of pain, noticeable swelling in the joint and, ultimately, loss of function.

“That’s usually the point where people seek treatment; when they can’t type or knit or walk a flight of stairs. And they can be helped. But we could help more, sooner. Ideally, treatment would start before the bones are damaged,” says Ms Fraser.

Another reason for early diagnosis is the risk of inflammatory arthritis. Of the three classes of the disease, inflammatory is by far the most dangerous but, because it shares early symptoms with degenerative arthritis, is too often ignored at its onset.

Like osteoarthritis, inflammatory arthritis affects the body’s joints, specifically, the fluid between the joints, which make normal motion easy. There is swelling in the afflicted area, though this will be soft tissue swelling rather than the bones, and is often accompanied by redness or warmth on the skin. There is more prolonged stiffness than osteoarthritis and pain may be felt in non-jointed areas as well.

The great danger with inflammatory arthritis is that it is an auto-immune disease, meaning that, like cancer, it can move from one system; the musculo-skeletal, to any other; respiratory, digestive, cardiac, nervous, lymphatic, aptly destroying the protective fluid structures of each and exposing organs and tissues to friction and impact within the body that will impair their ability to function properly.

“It is insidious, “says Ms Fraser, “and it is indiscriminate. No one is too young to get inflammatory arthritis. Nine-month-old infants are not too young.”

In addition to the patient ignoring the pain, inflammatory arthritis may not be properly  diagnosed because the patient does not wish to complain more than necessary. As a systemic disease, inflammatory arthritis is ordinarily accompanied by other, seemingly unrelated symptoms; persistent flu or fever, headaches or difficulty breathing, for example. Because of this, the family practitioner, with ready access to short-term medical records, can sometimes play a vital role in timely diagnosis, though the patient should not assume the doctor may be able to connect the dots between unrelated medical appointments.

“It’s your body,” says Ms Fraser. “You know better than anybody when there’s something wrong with it. You need to respect your pain and give yourself permission to bring it to your health care team’s attention.”

If you think you may have arthritis, contact your doctor. As the first point of contact with your health care team, he will be able to refer you to the arthritis program at Southlake, and put relief within your grasp.