Taking That Devil Arthritis by the Horns

Anyone who does not suffer from arthritis has a pretty good idea of what it’s all about, right? Pain, swelling and stiffness are things we have all heard sufferers complain about. We all have that, dramatically after unaccustomed exertion, less dramatically after regular exertion on the part of weekend athletes, and even among professional or more serious athletes who are systematically pushing their body to its limits.

And anyone who does suffer from chronic arthritis will recognize the preceding as, to use a polite description, bullfeathers. Yes, pain is pain and stiffness is stiffness—for long-term arthritics, that is only the beginning. Life changes dramatically when these conditions become chronic, and it is a change not just in degree but also in kind. The underlying degeneration of cartilage leading to joint inflammation (for osteoarthritics) and inflammation of softer connective tissue, leading to destruction of cartilage (for rheumatoid arthritics) both take their toll on the body and soul—potentially becoming, to use an unfashionable but all too apt word, crippling. And yes, it is possible to suffer from both of the more common versions of arthritis—not to mention some hundred other variants.

The Limits of Medicine

As a newly diagnosed or long-suffering arthritic, you will get repeated confirmation of the limits of medical science when it comes to treatment. This is not to denigrate the dedication, career talents of anyone in the treatment and research fields, nor to discount the amazing advances—such as joint replacement—that have been developed within the lifetime of many of us. Advances in research and treatment, and dedicated care providers, have made for less painful, more active, more productive lives on the part of millions of arthritis sufferers.

Still, both varieties of arthritis are generally progressive and are often considered incurable—facts somewhat offset by the not entirely predictable occurrence of remission of rheumatoid arthritis, in which symptoms abate and biomarkers from tests become normal. It should be noted that remission:

• When it occurs in response to specific treatments almost invariably only continues with maintenance of those treatments
• May not be permanent regardless of its cause, known or unknown

That chronic arthritis is incurable and progressive, and may be intractable (untreatable) and debilitating, means that it is a hot field for medical research, typically driven by drug companies. This is good news and it can be bad news. Medical research is generally good, and can lead to new treatments; its dominance by drug companies means a disproportionate emphasis on chemical processes and how to interfere with them, and a focus on treatments that are patentable—meaning they will be expensive when they become available. The push for new drugs and new profits can also mean:

• New drugs are sometimes approved which are later deemed unsafe and withdrawn or restricted
• Treatments are sometimes pushed aside and even hard to get when no longer competitively profitable, even when they are still effective for many patients

Thinking Outside the Pill Bottle

Another result of conventional medicine’s shortcomings with respect to chronic arthritis is that sufferers turn to alternative treatments. Even before our national addiction to the Internet, news of this or that eccentric “treatment” spread by word of mouth. Whether via email, jiggered search results, Cousin Sadie, or that guy down at the plant or in the next cubicle, a flood of dubious advice is available to any arthritic. Extramedical solutions may have their frivolous and even potentially hazardous aspects. Still, their popularity—along with the acknowledged shortcomings of present treatments and the adverse effects from past overprescription of treatments such as steroids—has led to a wholesale reexamination of alternatives to drugs and surgery as treatment methods.

Even the MedlinePlus site of the National Institutes of Health (NIH) begins the treatment section of its excellent overview of arthritic disorders as follows:

“It is possible to greatly improve your symptoms from osteoarthritis and other long-term types of arthritis without medications. In fact, making lifestyle changes without medications is preferable for osteoarthritis and other forms of joint inflammation. If needed, medications should be used in addition to lifestyle changes.”

Before even addressing treatment via drugs or surgery, the article goes on to summarize currently recognized treatment options, including:

• Exercise—low-impact aerobics, range of motion and strength training
• Physical therapy and topical treatments
• Rest, stress reduction and assistive devices
• Diet, supplements and weight control

The NIH also provides a useful summary of the range of drug treatments in current use, from over-the-counter to last-ditch-effort, so you can fit the latest suggestion from your doctor (or the television!) into some kind of framework of benefits and risks.

Looking beyond these holistic and pharmaceutical recommendations of mainstream medicine, nowadays the Arthritis Foundation, through its website and Arthritis Today magazine, takes an open-minded approach to treatment options, holding conventional and alternative treatments up to similar standards of scrutiny: what is the evidence that any given treatment works, and are there risks associated with its benefits? The site is equally useful for helping you navigate the conventional medicine system, as for example in its backgrounder on lab tests, which can help you understand what doctors are looking for when they order them, and what the results might mean.

Accepting Help

Certainly one of the most difficult factors in progressive arthritis is coming to accept the limitations that it may bring. There is a myriad of assistive devices for the arthritic. These can make the difference between your customary daily activities giving you pleasure and a sense of accomplishment, or becoming exercises in frustration and pain. Pain, by the way, has nothing to do with strength or virtue in this context. In fact, gritting your teeth and putting up with pain may well worsen arthritis and spread it throughout the body .

If the progression of arthritis or other debilitating conditions in yourself or another have you looking into assisted living housing, or outpatient assisted living programs, one of the things to keep in mind is the therapeutic benefits of an active mind and body at all stages of arthritis; you’ll want to be sure that any such facility or program has access to medical care, of course, and also to physical therapy and a variety of programs to support both physical and mental health.

You will probably have noticed how many of the activities that can forestall or improve arthritis coincide with general recommendations for good health. If you or someone you love needs help getting through the day, accept it. And don’t let the fact that you need help make you feel that the struggle for quality of life ends with that acceptance.