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U.S. Teaching Americans How to Prevent Arthritis

Disease The strategy aims to prevent and offer relief from the leading cause of disability in the nation. About 43 million people are afflicted.

November 30, 1998|SALLY SQUIRES | THE WASHINGTON POST

The federal government earlier this month launched the first national strategy to help prevent arthritis and reduce severity of symptoms in those who already suffer from the condition.

An estimated 43 million Americans have arthritis, according to the federal Centers for Disease Control and Prevention. The term encompasses more than 100 conditions, including rheumatoid arthritis, systemic lupus erythematosus, gout, fibromyalgia, juvenile arthritis and osteoarthritis. The swollen and stiff joints and inflammation that accompany arthritis are painful and are the leading cause of disability in the nation.

"Arthritis is a very serious disease that needs to be taken seriously," said Robert Meenan, dean of the Boston University School of Public Health and secretary of the Arthritis Foundation, which has teamed with the CDC and the Assn. of State and Territorial Health Officials to launch the new national strategy.

Based on the current incidence and the aging of the population, the CDC projects that 60 million Americans will have arthritis by 2020.

"Arthritis has been ignored as a public health problem and even as a personal health problem, because it doesn't kill you," said Chad Helmick, a medical epidemiologist at the CDC. "People worry about heart disease, and they should. But as Americans live longer, they will work longer, and arthritis will affect their quality of life and lead to disability."

The new national program is designed to increase awareness of the disease and to dispel these common myths:

Arthritis is mainly a disease of old age. There's no question that the incidence of arthritis increases with age, but the disease also strikes an estimated 100,000 children each year.

There's no way to prevent arthritis. Wrong again. There are effective ways to help prevent arthritis, according to the CDC. They include:

* Weight control. Maintaining ideal weight can significantly lower the risk for common types of arthritis, especially osteoarthritis of the knee in women and gout in men. A study by David Felson, professor of medicine and public health at Boston University, found a strong connection between weight and osteoarthritis, which affects about 6% of adults and 11% of those 65 and older.

* Occupational injury prevention. Taking precautions to reduce repetitive joint use and injury on the job can help cut the incidence of arthritis. "But how we go about preventing occupational injuries to knees and hips is not all that clear," Felson said. "We may have to take a lot of people out of jobs that require that they bend and carry a lot."

* Sports injury prevention. Warmups, strengthening exercises using weights and choosing appropriate sports equipment can help cut sports injuries. That in turn can help prevent osteoarthritis.

* Infectious-disease control. Lyme disease is closely linked with arthritis. Use of insect repellents, wearing long-sleeved shirts and pants while walking in the woods as well as checking for ticks and removing them can all help reduce the risk of Lyme disease. The CDC recommends prompt use of antibiotics for Lyme disease symptoms.

Little can be done to treat arthritis or relieve the pain. A growing array of medications can help control arthritis, the reason that early diagnosis is important. But health officials estimate that 200,000 people with arthritis fail to see a doctor even when their symptoms interrupt daily activities.

"It's important to catch the disease early and see a doctor rather than later on," Helmick said. "There are new medications that really seem to interfere with the progression of the disease."

In addition to such drugs as methotrexate and etanercept that help control arthritis, there are new self-help programs to improve mobility and cut pain.

One of the leading programs is the Arthritis Self-Help Course, developed by Stanford University researchers and sponsored by the Arthritis Foundation. The six-week course is taught by two instructors. Studies have shown that the nearly 12,000 participants in the course have reduced pain by about 20% through a combination of exercise, relaxation and pain management.

An analysis of the course, presented a few weeks ago at the American Public Health Assn.'s annual meeting in Washington, found that the program also reduced physician visits for arthritis treatment by 40% and saved a minimum of $267 per patient in health-care costs over four years.

Exercise will only make arthritis worse. Twenty years ago, people with arthritis were instructed to avoid most physical activity. The concern was that activity would cause more damage and inflammation. Numerous studies since then have shown "that's the wrong message," Helmick said.

For more information about arthritis, contact:

Arthritis Foundation National Office, 1330 W. Peachtree St., Atlanta, GA 30309; (404) 872-7100. Web site: http://www.arthritis.org.

Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Mail Stop K-40, 4770 Buford Highway NE, Atlanta, GA 30341-3717; (770) 488-5131. Web site: http://www.cdc.gov/nccdphp/arthritis.htm.

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