Arthritis: The news now!

Arthritis has long been thought of as an untreatable disease that strikes older people. Today experts know this notion couldn’t be further from the truth. For one thing, arthritis – which literally means joint inflammation — is not one single disease; the term actually encompasses more than 125 different disorders of the joints and connective tissue, ranging from tendinitis and bursitis to gout and autoimmune diseases.

Furthermore, the severe pain and deformity that often accompany arthritis are not inevitable, says James Fries, M.D., chief of the Arthritis Clinic at Stanford University in Stanford. Calif. "Arthritis can be prevented in many cases and effective treatment is available for all forms of the disease”.

But most people wait four years from the time they start having minor joint discomfort until they finally seek help, thereby suffering needless pain and risking debilitating damage. "The earlier a diagnosis is made and treatment begun, the greater the likelihood of minimizing joint damage." says Dr. Fries, author of Arthritis: A Comprehensive Guide.

Who’s at risk?

"Because of the widespread belief that arthritis is a sign of old age, younger people think it can’t happen to them," says Sanford Roth, M.D., director of the Arthritis Center in Phoenix, Ariz. But it does happen to people under age 45; eight million of them — including 250.000 children! Another 20 million Americans over age 45 are also affected. "While osteoarthritis sets in after age 60, other types — such as rheumatoid arthritis and lupus erythematosus - have a much earlier age of onset. What’s more, they strike women far more often than men," says Dr. Roth (see box).

Treatment update

While arthritis can’t be cured, symptoms can be relieved with aspirin or nonsteroidal anti-inflammatory prescription drugs. But in high doses, these can cause serious gastric bleeding. To reduce the risk, some physicians are turning to other medications: one (salsate) doesn’t block prostaglandins, the stomach’s protective substances; another (diclofenac sodium) is eliminated quickly from the bloodstream and urine before irritation can occur.

Methotrexate, a potent drug used to treat psoriasis or certain cancers, will soon be approved for use in some rheumatoid arthritis patients. In very small doses the drug reduces pain and inflammation with fewer toxicity problems.

There are as many quack treatments for arthritis as there are legitimate ones. Copper bracelets are not harmful, but other "miracle cures" may be, especially if they are used instead of proven treatments. And exercise, though beneficial, may be counterproductive if not done properly.

Current research

“This is an optimistic time in arthritis research," says Paul Plotz. M.D., chief of Connective Tissue Diseases at the National Institute of Arthritis and Musculoskeletal and Skin Diseases, in Bethesda, Md. Current research suggests that most of the arthritic diseases are actually a series of diseases caused by various agents. "It may even be possible to identify those agents soon," notes Dr. Plotz.

Studies also show that a patient’s attitude plays a large role in how successful treatment will be. "Optimism seems to ‘turn on’ certain brain hormones that have an effect on inflammatory and pain mechanisms," says Dr. Roth.

Scientists are trying to identify the genetic factors for many kinds of arthritis. And, far in the future, a vaccine to immunize susceptible people against arthritis may become available. —Sue Berkman

Good HouseKeeping/November 1988.

O que são "quack treatments"?