New treatments for arthritis

The number of Canadians with arthritis is growing, but new treatments can help reduce joint pain, curb inflammation and improve quality of life.

Linda Wilhelm is in the midst of a rheumatoid arthritis “flare.” Her symptoms have returned and she has to switch medications – a transition time in which regaining control over her symptoms can take months. “It feels like your joints are on fire,” says Wilhelm, 54, who lives in Midland, New Brunswick and is president of the Canadian Arthritis Patient Alliance.

Wilhelm was first diagnosed in 1983 at age 23, when an ankle injury failed to heal. Then her elbow began to stiffen and hurt. Diagnosed with rheumatoid arthritis, an autoimmune condition that leads to joint destruction, inflammation and pain, there weren’t many drugs to treat her at the time. Now, many years and 14 joint replacements later, the landscape has changed.

“You’re not given an aspirin and a pat on the head anymore,” says Wilhelm. Instead, patients have a range of medications and therapies that can help manage symptoms and improve their quality of life.

This is a good thing, because the number of Canadians with arthritis is growing.

“The prevalence of arthritis is going up,” says Lynn Moore, director of programs and services at The Arthritis Society. She attributes it to a significant extent to an aging population, a greater awareness among health professionals of the symptoms and the popularity of high-impact sports in childhood. “Kids are playing harder and aren’t given enough time to heal,” she says.

Types of arthritis

Just under 17% of Canadian adults – 4.6 million – suffer from arthritis, according to the Arthritis Society. Two out of three sufferers are women, and 56% are under 65.

There are more than 100 types of arthritis, divided into two forms: non-inflammatory and inflammatory.

Non-inflammatory arthritis is the most common form, affecting more than three million Canadians. The most common kind of non-inflammatory arthritis is osteoarthritis (OA), which occurs when cartilage (the tough elastic material that covers and protects the ends of bones) begins to wear away. Eventually, bone rubs against bone, causing pain and reduced mobility. Non-inflammatory arthritis is most commonly found in the knees, hips, spine and hands.

Inflammatory arthritis includes rheumatoid arthritis (RA), an autoimmune condition that causes widespread inflammation and is more aggressive than non-inflammatory arthritis in terms of joint destruction. It usually attacks hands and fingers, but can affect other joints, eyes and lungs.

Both forms of arthritis can cause these symptoms:

• stiffness
• joint pain
• reduced mobility
• loss of flexibility
• deformed joints

But RA can cause greater joint deformation and more redness, swelling and stiffness than OA, and it can be accompanied by fatigue and weakness.

Arthritis risk factors and prevention strategies

Osteoarthritis can develop following injuries to ligaments and cartilage. Be sure to warm up before participating in a physical activity or sport. “If a joint hurts, don’t work through it,” says Moore. It can be exacerbated by poor diet, so eat a balance of protein, carbohydrates and fruits and vegetables. “”If your body isn’t healthy, your ligaments won’t support your joints,” says Moore.

Osteoarthritis can be made worse by excess weight. Maintaining a healthy weight will help reduce the inflammation brought on by a higher percentage of body fat.

Rheumatoid arthritis has been linked to smoking and exposure to second-hand smoke – quit now and minimize your exposure to smoke.

Above all, try to stay as active as possible, says Moore. “With exercise, do it cautiously and carefully,” she says. “Talk to your healthcare provider and listen to your body.”

More tips:

• Keep moving. Exercise is critical for keeping your joints and ligaments mobile, says Wilhelm.
• Rest injuries. Ensure your injuries heal properly before resuming sports.
• Lose the muffin top. Excess fat around the middle can make inflammation worse – plus discourage you from being active.

New treatments offer pain management and increased mobility

In addition to diet and exercise, treatments for both forms of arthritis are emerging that can improve quality of life.

With osteoarthritis, non-steroidal anti-inflammatory drugs can help manage the pain of inflammation. Joint replacements “have had more advancements,” says Moore, and “prostheses are better. They last longer and the techniques are better.”

With rheumatoid arthritis, new injectable medications called biologics have come on the market in the last 15 years that are very expensive, but that can reduce symptoms and improve mobility. Following them to market are drugs called Subsequent Entry Biologics, which will have similar properties to biologics but cost less. Still newer drugs, called small molecule are also coming on the market, which will manage these symptoms and be available in a pill form.

“Arthritis is a very serious disease that needs to be addressed. But people can live productively and well,” says Moore.

“There is no reason to live in pain.”