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Arthritis: Timely Treatments for an Ageless Disease (continued)
Many people with arthritis become discouraged with typical treatments because the disease progresses over time and the symptoms worsen. Consequently, they search for alternative therapies aimed at arthritis. But arthritis patients need to be careful because treatments not shown to be safe and effective through controlled scientific studies may be dangerous. According to the Arthritis Foundation, the benefits of a treatment in controlling arthritis should be greater than the risk of unwanted or harmful effects. Since arthritis symptoms may come and go, a person using an unproven remedy may mistakenly think the remedy worked simply because he or she tried it when symptoms were going into a natural remission.
Two controversial nutritional supplements, not approved by the FDA, have catapulted into the spotlight because of claims that they rebuild joint tissues damaged by osteoarthritis--or halt the disease entirely. But at this time, the use of glucosamine and chondroitin sulfate supplements warrant further in-depth studies on their safety and effectiveness, according to the Arthritis Foundation. The NIH plans to study the effectiveness of these supplements.
Both glucosamine and chondroitin sulfate occur in the body naturally and are vital to normal cartilage formation, but the Arthritis Foundation says there's no evidence that swallowed chondroitin is absorbed into the body and deposited into the joints. Moreover, no one knows how much glucosamine and chondroitin sulfate are in the bottles since current law does not require dietary supplements to be manufactured under the same good manufacturing practice standards as pharmaceuticals. As reported in the December 1999 UC Berkeley Wellness Letter, "It's a hit-or-miss proposition because there's no standardization and no guarantee that you're getting what the label says."
The Arthritis Foundation urges anyone considering using these supplements to become "fully educated about potential positive and negative effects." In addition, people are encouraged to consult their physicians about how the supplements fit within their existing treatment regimens. Above all, do not stop proven treatments and disease-management techniques in favor of the supplements.
The Arthritis Foundation also says that copper bracelets, mineral springs, vibrators, magnets, vinegar and honey, dimethyl sulfoxide, large doses of vitamins, drugs with hidden ingredients (such as steroids), and snake venom are all unproven remedies. And any unproven remedy, no matter how harmless, can become harmful if it stops or delays someone from seeking a prescribed treatment program from a knowledgeable physician.
Prevention Measures
There are ways to help prevent arthritis. Both CDC and the American College of Rheumatology recommend maintaining ideal weight, taking precautions to reduce repetitive joint use and injury on the job, avoiding sports injuries by performing warm-ups and strengthening exercises using weights, and by choosing appropriate sports equipment.
Lyme arthritis may develop after a bacterial infection is transmitted to humans through tick bites. To prevent this type of arthritis, health experts advise people to use insect repellents, wear long-sleeved shirts and pants while walking near wooded areas, and check for and remove ticks to help reduce the risk of getting the disease. CDC also recommends the prompt use of antibiotics for Lyme disease symptoms. In December 1998, FDA approved the first vaccine, Lymerix, to help prevent Lyme disease. (See "New Vaccine Targets Lyme Disease" in the May-June 1999 FDA Consumer.)
In an efficacy and safety trial, the vaccine's effectiveness in preventing Lyme disease was 49 percent after two injections and 76 percent after three. Vaccination should be considered by people 15 to 70 years old who live in or visit high-risk areas and have frequent or prolonged exposure to ticks. The vaccine has not yet been approved for use in children.
Recently approved drugs offer patients new options. For Jo Ellen Gluscevich, the results have not been so dramatic. She remains mostly housebound and must avoid crowds because her immune system is compromised and susceptible to infection. But as the population ages and arthritis becomes a growing problem, the Arthritis Foundation believes that "more physicians are recognizing the severity of the disease and the need for a broader approach toward treatment."
In addition to rheumatoid and osteoarthritis, there are a number of diseases and conditions that can cause joint pain and stiffness.
Juvenile arthritis is a general term for all types of arthritis that occur in children. Juvenile rheumatoid arthritis is the most prevalent form in children, and there are three major types: polyarticular (affecting many joints), pauciarticular (pertaining to only a few joints), and systemic (affecting the entire body). The signs and symptoms of juvenile rheumatoid arthritis vary from child to child. There is no single test that establishes conclusively a diagnosis of juvenile arthritis, and the condition must be present consistently for six or more consecutive weeks before a correct diagnosis can be made. Heredity is thought to play some part in the development of juvenile arthritis. However, the inherited trait alone does not cause the illness. Researchers think this trait, along with some other unknown factor (probably in the environment), triggers the disease. The Arthritis Foundation says that juvenile arthritis is even more prevalent than juvenile diabetes and cerebral palsy.
Gout is a disease that causes sudden, severe attacks of pain, tenderness, redness, warmth, and swelling in some joints. It usually affects one joint at a time, especially the joint of the big toe. The pain and swelling associated with gout are caused by uric acid crystals that precipitate out of the blood and are deposited in the joint. Factors leading to increased levels of uric acid and then gout include excessive alcohol intake, hypertension, kidney disease, and certain drugs.
Ankylosing spondylitis is a chronic inflammatory disease of the spine that can fuse the vertebrae to produce a rigid spine. Spondylitis is a result of inflammation that usually starts in tissue outside the joint. The most common early symptoms of spondylitis are low back pain and stiffness that continues for months. Although the cause of spondylitis is unknown, scientists have discovered a strong genetic or family link, according to the Arthritis Foundation. Most people with spondylitis have a genetic marker known as HLA-B27. Genetic markers are protein molecules located on the surface of white blood cells that act as a type of "name tag." Having this genetic marker does not mean a person will develop spondylitis, but people with the marker are more likely to develop the disease than those without it. Ankylosing spondylitis usually affects men between the ages of 16 and 35, but it also affects women. Other joints besides the spine may be involved.
Systemic lupus erythematosus is an autoimmune disease that can involve the skin, kidneys, blood vessels, joints, nervous system, heart, and other internal organs. Symptoms vary among those affected, but may include a skin rash, arthritis, fever, anemia, hair loss, ulcers in the mouth, and kidney damage. In most cases, the symptoms first appear in women of childbearing age; however, lupus can occur in young children or older people. Studies suggest that there is an inherited tendency to get lupus. Lupus affects women about 9 to 10 times as often as men. It is also more common in African-American women.
Bursitis, tendinitis and myofascial pain are localized, nonsystemic (not affecting the whole body) painful conditions. Bursitis is inflammation of the sac surrounding any joint that contains a lubricating fluid. Tendinitis is inflammation of a tendon, and myofascial pain is a problem that results from the strain or improper use of a muscle. These conditions may start suddenly, and usually stop within a matter of days or weeks.
Carpal tunnel syndrome is a condition in which pressure on the median nerve at the wrist causes tingling and numbness in the fingers. It can begin suddenly or gradually, and can be associated with another disease, such as rheumatoid arthritis, or it may be unrelated to other conditions. If untreated, it can result in permanent nerve and muscle damage. With early diagnosis and treatment, there is an excellent chance of complete recovery.
Fibromyalgia syndrome is a condition with generalized muscular pain, fatigue, and poor sleep that is believed to affect nearly 4 million people. The name fibromyalgia means pain in the muscles, ligaments and tendons. The condition mainly affects muscles and their attachments to bones. Although it may feel like a joint disease, the Arthritis Foundation says it is not a true form of arthritis and does not cause deformities of the joints. Fibromyalgia is instead a form of soft tissue or muscular rheumatism.
Infectious arthritis is a form of joint inflammation that is caused by bacteria, viruses or fungi. The diagnosis is made by culturing the organism from the joint. Most infectious arthritis can be cured by antibiotic medications.
Psoriatic arthritis is similar to rheumatoid arthritis. About 5 percent of people with psoriasis, a chronic skin disease, also develop psoriatic arthritis. In psoriatic arthritis, there is inflammation of the joints and sometimes the spine. Fewer joints may be involved than in rheumatoid arthritis, and there is no rheumatoid factor in the blood.
Reiter's syndrome (also called reactive arthritis) involves inflammation in the joints, and sometimes where ligaments and tendons attach to bones. This form of arthritis usually develops following an intestinal or a genital/urinary tract infection. People with Reiter's syndrome have arthritis and one or more of the following conditions: urethritis, prostatitis, cervicitis, cystitis, eye problems, or skin sores.
Scleroderma is a disease of the body's connective tissue that causes thickening and hardening of the skin. It can also affect joints, blood vessels, and internal organs. There are two types of scleroderma: localized and generalized.