Arthritis For Dummies. Barry Fox

which makes the joints in this area more likely to become unstable. In addition, because women’s hip joints are set wider than their knee joints, the femur is aligned at an angle from hip to knee, making the knee less stable and injuries more likely. Both of these causes of joint instability can contribute to OA.Giving birth also increases joint laxity to accommodate the birth process, but the joints may not return to normal afterwards. One study found that for each birth a woman’s risk of needing a knee replacement increased by 8 percent, while the need for a hip replacement increased by 2 percent.

       Gaining Too Much Weight: According to the Center for Disease Control and Prevention (CDC), in 2017–2018, 41.9 percent of U.S. women were obese, as were 43 percent of U.S. men. However, severe obesity affected 11.5% of women compared to just 6.9% of men, making women even more likely than men to develop arthritis. While doctors have long known there’s a clear connection between obesity and OA, it can also contribute to or worsen RA, psoriatic arthritis, ankylosing spondylitis, gout, and other inflammatory forms of arthritis. Fortunately, just losing a few pounds can not only ease arthritis pain but also improve joint function and increase the quality of life for most arthritis sufferers.Women aren’t the only ones who are especially prone to developing arthritis and arthritis-related problems. Compared to Causasians, African Americans are twice as likely to have knee OA and 77 percent more likely to develop a condition called multiple large joint OA in their knees and spine. Multiple large joint OA, a disorder that affects more than 27 million American adults, may require joint replacement surgery to ease pain and restore joint function. African American women are also three times more likely than Caucasian women to develop lupus and fibromyalgia, conditions that already target women far more often than men.

Assessing Your Treatment Options

      The good news is that, in many cases, arthritis can be managed. It may take some time and effort to find the right treatment(s) for your particular version of the disease, but help is out there. Medications and surgery are only a part of the answer. Following healthful diet, exercising, using joint protection techniques, controlling stress, anger, and depression, and organizing your life can offer relief from pain and a new lease on life. And the worlds of herbs, homeopathy, hands-on healing, and other alternative medicine treatments may offer you additional ammunition in the fight against arthritis pain and other symptoms.

      Looking into medications

      

When you’re in pain, your joints are hot or swollen, and you can hardly walk from one end of the house to the other, you want relief now. In many cases, the fastest way to relieve arthritis symptoms is to take medication. Arthritis medications fall into five main classes:

       Analgesics: Analgesics are designed specifically to relieve pain, and include acetaminophen (Tylenol) and opioids (narcotics). Sometimes acetaminophen is combined with an opioid, such as codeine. The analgesics differ from anti-inflammatory drugs (such as NSAIDs) in that they do not interfere with the inflammation process, which makes them easier on the stomach and less likely to cause gastrointestinal bleeding.

       Biologics: The biologics treat specific kinds of autoimmune arthritis (like RA) by turning off certain components of the immune system called cytokines. The cytokines play an especially important part in the inflammation seen in RA, and biologics inhibit their inflammatory action. Enbrel, Humira, Remicade, and Kineret are examples of drugs that fall into the category of biologics.

       Disease modifying antirheumatic drugs (DMARDs): The DMARDs are used to treat autoimmune forms of arthritis (like RA, psoriatic arthritis). DMARDs change the way the immune system works, slowing or stopping its attack on the body. Drugs like sulfasalazine, methotrexate, leflunomide, and hydroxychloroquine fall into this category.

       Nonsteroidal anti-inflammatory drugs (NSAIDs): The NSAIDs help relieve pain and reduce inflammation by interfering with an enzyme called COX (cyclooxygenase). The enzyme takes two forms: COX-1 and COX-2. Older, traditional forms of NSAIDs (including aspirin, ibuprofen, and naproxen) block both forms of the COX enzyme, but newer ones (such as Celebrex) block COX-2 only, as COX-1 has been shown to have a protective effect on the stomach lining. Milder versions (aspirin, ibuprofen) are available over the counter, but the more powerful ones (Indocin, Lodine, Celebrex) require a prescription, especially at higher doses.

       Steroids: Also known as corticosteroids, these are man-made versions of naturally-occurring hormones in the body that help quell inflammation. Although they function as powerful anti-inflammatories, they can also have powerful side effects, including elevated blood pressure, thinning of the bones and skin, weight gain, and an increased risk of infection, even when they are injected directly into the joint.

      See Chapter 8 for the complete lowdown on arthritis medications.

      Considering surgery

      If pain is interfering with your ability to lead a happy and productive life, you have to take the maximum amount of pain relievers just to get through the day, and you’ve tried all other pain-relieving methods with no luck, you may want to consider surgery. Although joint surgery is complex and not to be taken lightly, some people have enjoyed excellent results, to the point of feeling that they’ve gotten a new lease on life. Surgical techniques can involve flushing a joint with water, resurfacing rough bone ends or cartilage, removing inflamed membranes, growing new bone, or inserting a whole new joint. Turn to Chapter 9 to find out more about surgical treatments.

      Making lifestyle changes

      Chances are excellent that you can do much to ease your arthritis-related pain, stiffness, swelling, and decreased range of motion just by changing certain things you do every day.

      

The following list goes over some options you may want to consider:

       Eat a healthful diet. By this, we mean a diet that includes plenty of fish, fresh fruits and vegetables, and whole grains, with a minimum of processed meats and salad oil (corn, safflower, or sunflower). This healthy, well-balanced diet also has anti-inflammatory effects, which is important as so many forms of arthritis are linked to inflammation. The Mediterranean diet fits the bill perfectly, and has the added bonus of warding off both heart disease and certain types of cancer.See Chapter 11 to get the skinny on the elements of a healthful diet and how to make it a permanent and delicious part of your life.

       Consider taking certain supplements. Many supplements can help ease the symptoms of different kinds of arthritis, including antioxidants (beta-carotene, vitamins C and E, and selenium), boron, vitamin B6, niacin, vitamin D, zinc, grapeseed extract, flaxseed oil, green tea, glucosamine sulfate, chondroitin sulfate, SAMe, bromelain, and others.Supplements for arthritis are discussed at length in Chapter 11.

       Exercise daily (whenever possible). Countless studies have shown that exercise can help lubricate and nourish the joints by forcing joint fluid into and out of the cartilage. Underexercised joints don’t get much of this in-and-out action, so cartilage can thin out and become dry. Brisk walking and swimming or walking in the shallow end of a pool may be some of the best exercises for those with arthritis, because they don’t put undue stress on the joints and are easy and fun to do.For a look at exercises that help ease arthritis symptoms, see Chapter 12.

       Watch your joint alignment. Making sure to stand, sit, walk, run, and lift correctly can help protect your joints from injury or excess wear and tear.We discuss the best