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What is arthritis?

          The word arthritis actually means joint inflammation, and that is how it is used by clinicians and biomedical researchers.  In the public health world however, arthritis is used as a shorthand term for arthritis and other rheumatic conditions-a label for the more than 100 rheumatic diseases and conditions that affect joints, the tissues which surround joints and other connective tissue. The pattern, severity, and location of symptoms can vary depending on the specific form of the disease. Typically, rheumatic conditions are characterized by pain and stiffness in and around one or more joints. The symptoms can develop gradually or suddenly. Certain rheumatic conditions can also involve the immune system and various internal organs of the body.

Who is at risk for arthritis?

Certain factors are associated with a greater risk of arthritis. Some of these risk factors are modifiable while others are not.

Non-modifiable risk factors

• Age: The risk of developing most types of arthritis increases with age.
• Gender: Most types of arthritis are more common in women; 60% of the people with arthritis are women. Gout is more common in men.
• Genetic: Specific genes are associated with a higher risk of certain types of arthritis, such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE).

• Overweight and Obesity: Excess weight can contribute to both the onset and progression of knee osteoarthritis.
• Joint Injuries: Damage to a joint can contribute to the development of osteoarthritis in that joint.
• Infection: Many microbial agents can infect joints and potentially cause the development of various forms of arthritis.
• Occupation: Certain occupations involving repetitive knee bending are associated with osteoarthritis of the knee.

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What causes arthritis?

          Elevated uric acid levels cause gout, and specific infections can cause certain forms of arthritis. The causes of many of the other forms of arthritis are unknown. Scientists are studying the role of factors such as genetics, lifestyle, and environment in the various types of arthritis.
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What are the most common types of arthritis?

          The most common form of arthritis in the Unites States is osteoarthritis followed by gout, fibromyalgia, and rheumatoid arthritis.
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What are the symptoms of arthritis?

          The pattern and location of symptoms can vary depending on the type of arthritis. Generally, people with arthritis feel pain and stiffness in and around one or more joints. The onset of arthritis symptoms can develop gradually or suddenly. Arthritis is most often a chronic disease, so symptoms may come and go, or persist over time.
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What should I do if I think I have arthritis?

          If you have pain, stiffness, or swelling in or around one or more of your joints, talk to your doctor. It is important to keep in mind that there are many forms of arthritis, the specific diagnosis of the type of arthritis you have is necessary to direct the proper treatment. Although there is no cure for most types of arthritis, early diagnosis and appropriate management are important, especially for inflammatory types of arthritis. For example, early use of disease-modifying drugs can affect the course of rheumatoid arthritis. An early diagnosis and appropriate treatment can make a difference in pain and joint damage. The earlier you understand your arthritis, the earlier you can start managing your disease and making healthy lifestyle changes to help your arthritis.
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Can I prevent arthritis?

           Depending on the form of arthritis, there are steps that can be taken to reduce your risk of arthritis. Maintaining an appropriate body weight has been shown to decrease the risk of developing osteoarthritis and gout. Protecting your joints from injuries or overuse can reduce the risk of osteoarthritis.
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How is arthritis diagnosed?

          Diagnosing arthritis often requires a detailed medical history of current and past symptoms, physical examination, x-rays, and blood work. It is possible to have more than one form of arthritis at the same time.
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What are the treatments for arthritis?

          The focus of treatment for arthritis is to control pain, minimize joint damage, and improve or maintain function and quality of life. According to the American College of Rheumatology, the treatment of arthritis might involve the following:

Medication.
Nonpharmacologic therapies
Physical or occupational therapy.
Splints or joint assistive aids.
Patient education and support.
Weight loss.
Surgery.
In conjunction with medical treatment, self-management of arthritis symptoms is very important as well. The Arthritis Foundation Self Help Program, developed by Dr. Kate Lorig of Stanford University, is an effective self-management education program. The program helps people develop the skills needed to manage their arthritis on a day to day basis and gain the confidence to carry it out.

For management of specific types of arthritis, refer to the types section.
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How can I manage arthritis pain?

          Both medical treatment and self-management strategies are very important. The Arthritis Foundation Self Help Program, developed by Dr. Kate Lorig of Stanford University, is an effective self-management education program. The program helps people develop the skills needed to manage their arthritis on a day to day basis and gain the confidence to carry it out.
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What is recommended for people with arthritis?

The CDC recommends the following:

Early diagnosis and appropriate management of arthritis, including self-management activities, can help people with arthritis decrease pain, improve function, stay productive, and lower health care costs. Key self-management activities include the following:

Develop Your Skills-Self-management education, such as the Arthritis Foundation Self Help Program (AFSHP), or the Chronic Disease Self Management Program (CDSMP) help you develop the skills and confidence to manage your arthritis on a day to day basis. For example, AFSHP has been shown to reduce pain even 4 years after participating in the program.

Be Active-Research has shown that physical activity decreases pain, improves function, and delays disability. Make sure you get at least 30 minutes of moderate physical activity 3 days a week. You can get activity in 10-minute intervals.

Watch Your Weight-The prevalence of arthritis increases with increasing weight. Research suggests that maintaining a healthy weight reduces the risk of developing arthritis and may decrease disease progression. A loss of just 11 pounds can decrease the occurrence (incidence) of knee osteoarthritis.

See Your Doctor-Although there is no cure for most types of arthritis, early diagnosis and appropriate management are important, especially for inflammatory types of arthritis. For example, early use of disease-modifying drugs can affect the course of rheumatoid arthritis. If you have symptoms of arthritis, see your doctor and begin appropriate management of your condition.

Protect Your Joints-Joint injury can lead to osteoarthritis. People who experience sports or occupational injuries or have jobs with repetitive motions like repeated knee bending have more osteoarthritis. Avoid joint injury to reduce your risk of developing osteoarthritis.
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How many people in the United States have arthritis?

          In 2002, an estimated 43 million Americans reported that their doctor told them they had arthritis. As our nation's population ages, the prevalence is expected to increase.
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How many children have arthritis?

          The answer to this question is not currently known with much certainty. Estimates vary and range from 80,000 to 285,000, depending on the definition of arthritis among children, age ranges for children, and the different methods used to find cases. The small size of most studies can also lead to chance variation in estimates. CDC has efforts under way to better estimate the prevalence of arthritis among children.
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Is exercise recommended for people who have arthritis?

          Recent studies have shown that moderate physical activity 3 or more days a week can help to relieve arthritis pain and stiffness and give you more energy. Regular physical activity can also lift your mood and make you feel more positive.

          An activity that produces a slight increase in heart rate or breathing is considered moderate physical activity. Low-impact activities performed at a moderate pace work best for people with arthritis. These include walking, swimming, and riding a bicycle. Everyday activities such as dancing, gardening, and washing the car can be good if done at a moderate pace that produces slight breathing and heart rate changes.

          If you are having an acute flare-up of your inflammatory arthritis, it may be better to restrict your exercise to simple range of motion (carefully moving the joint as far as it can go) during the flare-up.
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How does body weight influence arthritis?

          Weight control is essential, because extra pounds put extra pressure on many joints. Research suggests that maintaining a healthy weight reduces the risk of developing osteoarthritis and may decrease disease progression. A loss of just 11 pounds can decrease the occurrence (incidence) of knee osteoarthritis.

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