It’s a disease that will eventually affect half of us. Nadia Badarudin gets some answers from the president of Arthritis Foundation Malaysia
DANIEL Johns, guitarist and vocalist of Australia’s rock band Silverchair was diagnosed with arthritis when he was working on the band’s fourth album, Diorama, in late 2001.
Johns developed pain in his knees that soon spread to his shoulders, back, feet, wrists and pelvis. He claimed that the pain was so excruciating that nobody could join him when he sat on the sofa as the movements on the cushions would make the pain worse.
For Johns and individuals with arthritis, doing simple tasks such as walking, buttoning up a shirt or holding a pen are impossible without effort.
Arthritis Foundation Malaysia president Dr Amir Azlan Zain says arthritis is part of a complex family of musculoskeletal conditions in which an inflammatory process destroys joint tissues. “Arthritis in general will affect half of us at some in point our lives. It’s part and parcel of the ageing process. The joints age and that’s when the problem starts to occur.
“It will particularly affect people who don’t practise an active lifestyle,” adds Dr Amir, who is also a consultant physician and rheumatologist.
Arthritis is now the main cause of disability among people over 55 years in industrialised countries. The debilitating effect of arthritis not only affects the physical ability of a person but also his quality of life, leading to a vicious cycle of mental and emotional disturbances.
Left untreated and inadequately managed, arthritis can evolve into a social and economic burden. There is no cure for arthritis but there are a number of treatments that can help slow down the condition’s progress.
Dr Amir answers more questions below.
What are the common types of arthritis among Malaysians?
Osteoarthritis. A progressive degenerative joint disease characterised by the breakdown of joint cartilage associated with risk factors such as overweight/obesity, history of joint injury and age.
Rheumatoid Arthritis. A systemic disease characterised by the inflammation of the membranes lining the joint which causes pain, stiffness, warmth, swelling and sometimes severe joint damage.
Juvenile Idiopathic Arthritis.
An umbrella term used to describe the many autoimmune and inflammatory conditions that can develop in children of 16 years and younger. Children with this condition present in a number of ways, from generalised systemic symptoms involving weight loss, fevers and joint pains to just one joint being affected by pain, swelling and subsequent damage.
Which groups are prone to arthritis?
Family history. Some types of arthritis run in families, so you may be more likely to develop arthritis if your parents or siblings have the disorder. Your genes can make you more susceptible to environmental factors that may trigger arthritis.
Age. The risk of many types of arthritis increases with age.
Sex. Women are more likely than men to develop rheumatoid arthritis, while men are likely to have gout.
Previous joint injuries. People who have injured a joint perhaps while playing a sport, are more likely to eventually develop arthritis in that joint.
Obesity. Being overweight is a significant risk factor in the development of arthritis. Obesity puts additional strain on the weight-bearing joints and can lead to arthritic problems at an early age.
What are the causes of arthritis?
What goes wrong depends on what type of arthritis you have. It could be that the cartilage is wearing out, a lack of fluid, autoimmunity (your body attacking itself), infection or a combination of factors.
Generally, arthritis occurs due to the degeneration of joint cartilage, a portion of the joints, which functions as a cushion between bones to prevent them from rubbing against each other. The cartilage, which acts as a shock absorber, will gradually wear out in some areas due to constant friction. As the cartilage becomes damaged, and tendons and ligaments become stretched, every rub then triggers inflammation that eventually leads to severe pain and joint stiffness.
How is the illness diagnosed?
The doctor will ask questions about your symptoms and how they have developed. Some of the questions are as follows:
• The site of your pain and the joints involved.
• Restricted movement.
• Any swelling in or around your joints, which could signal inflammatory arthritis.
• Other aspects of your health as arthritis can affect other organs in your body.
• Possibly, physical tests will be performed to clarify things and the physical exam may show:
• Fluid around a joint.
• Warm, red, tender joints.
• Difficulty in moving a joint.
• Blood tests and joint X-rays are often done to check for infection and other causes of arthritis.
What will happen if the illness is not treated?
On a mild level, arthritis sufferers will find good and bad days. Most patients with arthritis will suffer from discomfort, pain, stiffness and/or fatigue.
If left untreated, arthritis can cause joint destruction. Arthritis attacks bone, cartilage and soft tissue causing joints to weaken, and deform to varying degrees.
However, the illness can lead to disability and permanent damage to vital organs. People who have rheumatoid arthritis, for instance, have an increased risk of coronary artery disease (hardening of the arteries to the heart) compared with those who don’t have rheumatoid arthritis.
What are the treatments available?
Lifestyle changes are the preferred treatment for osteoarthritis and other types of joint swelling. Exercise can help relieve stiffness, reduce pain and fatigue, and improve muscle and bone strength.
Medication can help relieve the symptoms of arthritis. The goal of treatment is to reduce pain, improve function and prevent further joint damage. The underlying cause often cannot be cured.
Other things you can do include:
• Get enough sleep. Sleeping eight to 10 hours a night and taking naps during the day can help you recover from a flare-up more quickly and may even help prevent flare ups.
• Avoid staying in one position for too long.
• Avoid positions or movements that place extra stress on your sore joints.
• Try stress-reducing activities such as meditation, yoga, or tai chi.
• Eat a healthy diet full of fruits and vegetables, which contain important vitamins and minerals, especially vitamin E.
• Eat foods rich in omega-3 fatty acids such as cold water fish (salmon, mackerel and herring), flaxseed, rapeseed (canola) oil, soybeans, soybean oil, pumpkin seeds, and walnuts.
• Lose weight, if you are overweight. Weight loss can greatly improve joint pain in the legs and feet.
• In severe cases, surgery may be done if other treatments have not worked. This may include arthroplasty to rebuild the joint and joint replacement such as a total knee joint replacement.
What are the common myths linked to arthritis?
Myth 1: Arthritis is just minor aches and pains associated with getting older.
Fact: Arthritis is actually a complex family of musculoskeletal disorders consisting of more than 100 different diseases or conditions that can affect people of all ages, races and genders.
Myth 2: Arthritis is not a serious health problem.
Fact: Arthritis places a growing burden on the health care and economic systems in this country. It is actually a more frequent cause of activity limitations than heart disease, cancer or diabetes.
Myth 3: People with arthritis should avoid exercising.
Fact: Exercise is an important tool in the fight against arthritis.
Myth 4: Not much can be done for arthritis.
Fact: Relief is available and new treatments are in the pipeline. The Arthritis Foundation Malaysia helps people who already have arthritis to live better with the illness.
Myth 5: Taking supplements such as glucosamine alone can cure arthritis.
Fact: Maintaining an active and healthy lifestyle, and taking supplements can help to slow down the progress of the illness.
What can a patient do to alleviate pain?
Arthritis takes a very long time to manifest with painful symptoms. The rebuilding of cartilage also takes time. However, by rebuilding and restoring general health, arthritis can be conquered. With a healthy diet filled with wholesome food and natural supplements, and a positive attitude, you will discover that the natural answer to a pain-free lifestyle must be nurtured from within.
Pain can also be relieved with ice packs or heating pads. Ultrasound and hot packs provide deep heat, which relieves localised pain and relaxes muscle spasm around the affected joint. You may find that a warm bath/shower makes it easier for you to exercise afterwards.
Patients who are physically active generally enjoy better health, are happier, live longer, experience improvements in pain, sleep, day-to-day functioning and general energy levels.