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Arthritis: Not Just an Elderly Person's Disease

Arthritis is not only a disease that affects your grandmother or elderly uncle. Approximately 1 in 5 adult Canadians (about 6 million people)1 live with arthritis, making it the most common chronic health condition in Canada.1 More Canadians report having arthritis than diabetes, heart disease, cancer, and stroke combined.1 To complicate the picture, nearly 4 out of 5 Canadians with arthritis also have at least one other chronic health condition.1

Arthritis can affect people of any age. It is more common among older adults, with 1 of every 2 Canadians over 65 experiencing some form of arthritis. However, over half of those with arthritis are under 651,2 and as many as 24,000 children also have the disease.2

What is arthritis?

Arthritis is a group of over 100 conditions that affect the joints and their surrounding tissues.3,4 It is characterized by joint deterioration that results in pain, stiffness, swelling and reduced range of motion.3

Osteoarthritis(OA) is the most common type of arthritis. It is commonly thought that OA is a normal part of aging. This is not true. There are many risk factors besides aging that can contribute to the development or worsening of arthritis.3,4 Arthritic changes can also be related to injury, obesity, genetics, surgery, and occupations or sports that involve heavy physical activity.3,4

Rheumatoid arthritis (RA) and other types of inflammatory arthritis are autoimmune disorders. These are diseases where the body’s immune system mistakenly attacks its own healthy tissues.3 RA affects people of all ages, with more than 272,000 Canadian adults having the disease.4 More than half of new cases are diagnosed in individuals between 40-70 years of age.4 If left untreated, 50% of people with RA become disabled enough to affect their working life within 10 years of the onset of symptoms.4             

Other types of inflammatory arthritis include gout, ankylosing spondylitis, psoriatic arthritis, and lupus. Type 1 or juvenile idiopathic arthritis, the most common form of childhood arthritis, also falls into this category.3,4  

The joint inflammation associated with arthritis may cause significant damage and can lead to difficulties with everyday activities such as getting up or down from the floor or toilet, climbing stairs or going for a walk. However, with appropriate treatment, these difficulties can be minimized. By dismissing arthritis as a normal part of aging or assuming that activity limitations are inevitable, many Canadians do not access the treatment they need to help them manage their condition.2

What can be done do to manage arthritis?    

Arthritis may not always be preventable, but the amount of joint damage can be minimized, and symptoms can be managed to help people live with arthritis and enjoy the lifestyle and activities they want.

Steps to take:

1. Seek help as early as possible. Early recognition, education and treatment are key to getting control of any type of arthritis. Understanding the condition, learning how to manage the symptoms, and developing strategies to prevent joint damage are key to minimizing the limitations to function often experienced due to arthritis.

OA is often not diagnosed until the individual is experiencing significant pain, loss of range of motion, and decreased activity levels. However, the joint and cartilage changes characteristic of arthritis may take years or decades to develop.4,5,6 With RA, early recognition and diagnosis means that a physician can start an appropriate medical treatment plan to manage the disease and minimize joint changes related to inflammation.7

If you seek help when you start to experience pain, stiffness or activity limitations, factors that cause or worsen arthritis can be addressed. If you notice any of the following symptoms in one or more joints, you should visit your physiotherapist or other health-care provider to discuss your situation.5

  • Occasional, intermittent or frequent joint pain or aching
  • Stiffness in your joints when you wake up in the morning
  • Reduced joint range of motion
  • Creaking or grinding in the joints
  • Joint swelling that is not related to a recent injury

2. Learn about and implement lifestyle changes. Obesity is a primary risk factor for both developing and worsening the progression of any type of arthritis. It is also the most modifiable risk factor for arthritis.4,6,8 Learning how you can manage your weight and increase your overall activity levels are important ways to prevent and/or minimize the effects of the disease.5,8

Strengthening through land or water-based aerobic exercise programs are considered first line treatments for OA.4,6,8 Stretching and flexibility exercises are also part of an overall exercise program for arthritis and help to maintain or increase the range of motion in the joints.8 Introducing these exercises into daily routines will help with weight management, maintain healthy joints, help injured or inflamed joints recover, and can reduce the need for surgery.

3. Seek early treatment for joint injuries. Injuries are a leading cause of OA at any age.4 Prevention of sport or workplace injuries is important, but if these injuries do happen, getting early treatment to manage inflammation and pain, and learning ways to prevent further injury are key to reducing the long-term effects and risk of developing OA.  

Physiotherapists can help you with each of these steps.

Physiotherapy and arthritis

The current best practice guidelines for the management of OA include exercise, weight management, a healthy diet, and non-prescription medications to manage joint pain and inflammation.

Physiotherapist are primary care providers who can be accessed without a doctor’s referral and are trained to assess and help determine causes of muscle and joint pain and dysfunction. They will develop an individualized treatment plan which will help limit the disabling effects of arthritis.4,6,8,9 By providing education about the condition and what can be done to prevent ongoing joint damage, physiotherapists can help people understand arthritis and postpone the need for surgical or more aggressive medical interventions. Physiotherapists will teach appropriate exercises to minimize joint stiffness, increase or maintain muscle strength, and improve general fitness to help manage weight and stay active.

If you have followed the recommendations for conservative treatments and have been unsuccessful in managing the pain and dysfunction, a physiotherapist can also provide guidance about the need to see a physician for further investigation or medical management, or if referral to a surgeon for joint replacement may be warranted. If a joint replacement is required, physiotherapists will be involved both before and after surgery to maximize use of the new joint.9

If you are experiencing joint pain, limited joint movement, and/or find you cannot do the things you want anymore, seek help from a physiotherapist to address these problems.

  1. The Arthritis Society. Arthritis in Canada: Facts & Figures. Available at: https://arthritis.ca/about-arthritis/what-is-arthritis/arthritis-facts-and-figures Accessed August 5, 2020.
  2. The Arthritis Society. About Arthritis: The truth about Arthritis. Available at https://arthritis.ca/about-arthritis/what-is-arthritis/the-truth-about-arthritis.  Accessed Aug 6, 2020.
  3. The Arthritis Society. About Arthritis: What is arthritis. Available at https://arthritis.ca/about-arthritis/what-is-arthritis  Accessed Aug 6, 2020.
  4. Arthritis Alliance of Canada. Joint action on Arthritis: A framework to improve arthritis prevention and care in Canada. Available at: http://www.arthritisalliance.ca/en/joint-action-on-arthritis. Accessed August 5, 2014.
  5. Chu, C.R., Williams, A.A., Coyle, C.H. et al. Early diagnosis to enable early treatment of pre-osteoarthritis . Arthritis Res Ther 14, 212 (2012). Available at https://link.springer.com/article/10.1186/ar3845  Accessed Aug 6, 2020 https://doi.org/10.1186/ar3845
  6. National Clinical Guideline Centre (UK). Osteoarthritis: Care and Management in Adults. Available at https://www.nice.org.uk/guidance/cg177/resources/osteoarthritis-care-and-management-pdf-35109757272517  Accessed Aug 6, 2020.
  7. Arthritis Foundation. Rheumatoid Arthritis Blog. The Use of Imaging Scans in the Detection and Monitoring of RA. Available at http://blog.arthritis.org/rheumatoid-arthritis/detecting-rheumatoid-arthritis/  Accessed Aug 10, 2020.
  8. Rodriguez, T. Rheumatology Advisor: The impact of obesity on arthritis outcomes. October 24, 2016. Available at https://www.rheumatologyadvisor.com/home/topics/osteoarthritis/the-impact-of-obesity-on-arthritis-outcomes/  Accessed Aug 1, 2020.
  9. Yu SP, Hunter DJ. Managing osteoarthritis. Aust Prescr. 2015;38(4):115-119. doi:10.18773/austprescr.2015.03
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