Arthritis: A heavy burden to bear

The Johannesburg branch of the Arthritis Foundation of South Africa has had a mission to educate and support for many years. It’s doing a sterling job and performing a much-needed service for the population affected by this disease.

By Terry Owen

I interview lots of people – nurses, doctors, patients, specialists…and more! Sometimes, during my run-around frenetic activities I come upon some people who light that ray of sunshine so that it glows brightly, instantly banishing fatigue and negativity.

Such people were Nadine Lewis and Brenda Spence of the Johannesburg branch of the Arthritis Foundation of South Africa, whom I had the pleasure of spending some time with recently.

Not that the subject matter is enjoyable at all. Six thousand miles away from that. It’s good to let off some steam, though, because the severity of the disease can be debilitating to a patient and in a different way to caregiver and informer.

These two are constantly on the go, and it’s arthritis morning, noon and night. Arthritis can be an awful thing to be saddled with, as any sufferer will concur.

“When people generally think of arthritis, they think of a bent finger that can’t be used because it’s so painful. While this is true, arthritis is so much more. That illustration is like one piece of a giant jigsaw puzzle. Arthritis in all its myriad forms affects a huge portion of the population. It’s generally a very painful and debilitating condition and can sometimes be fatal.

“Our mission at the Foundation is to educate and support, and that’s what we’re all about. This not only applies to the affected person but their families as well. There is so often very limited or no support at all. Families often throw in the towel in despair and desperation, and that’s where we step in, to counsel and inform. This very often defuses a volatile situation and we give guidance on how to cope and will refer to a specialist when necessary,” says Nadine.

As part of their outreach, they give workshops and talks. Very popular are the talks they give at retirement centres on “Living with Arthritis”. They say that support groups are very popular in Cape Town. In Johannesburg, we connect patients with each other as a means of support.

There are more than 100 forms of arthritis, but these are the “biggies”:

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a long-term, progressive, and disabling autoimmune disease. It causes inflammation, swelling, and pain in and around the joints and other body organs.

It is a serious disease and needs to be managed closely and carefully. Being an autoimmune disease, it causes the body to turn on itself and attack various organs.  In the case of RA, this can be the joints, lungs, eyes, and heart.

Symptoms of RA include:

• pain, swelling, and stiffness in more than one joint
• symmetrical joint involvement
• joint deformity
• a general feeling of being unwell
• fever
• loss of function and mobility
• weight loss
• weakness

People who have obesity with RA also have a higher risk of diabetes and high blood pressure.

Lupus

Rheumatoid arthritis (RA) and lupus are autoimmune diseases. They result from your immune system mistakenly attacking your own body. With RA, your immune system mainly goes after your joints. But lupus, the symptoms of which can vary widely from person to person, can affect many other parts of the body as well.

There are numerous medications that can be taken to treat lupus and scleroderma, so there is no reason to be terrified by these diagnoses. The point is that it is managed correctly and timeously.

 “There is also a whole range of new drugs called biologics. It’s a generic term for medications that have been used to date for rheumatoid and other autoimmune arthritis and inflammatory bowel conditions like Crohn’s and Ulcerative Colitis. It is very expensive (about R10 000 a month) but has proven a wonder drug for many and they can start to lead normal lives again.”

Osteoarthritis

Osteoarthritis (OA) is where the cushion (cartilage) between the joints wears away, normally with age or wear and tear with, for example, involvement in sporting activities, and the major focus here is knees and hips. Replacement surgery has become the go-to procedure for hip and knee replacements. OA can affect any joint, and other than hip and knees, can occur in hands, the lower back and neck. OA can happen at any age, but it commonly starts in the 50s and affects women more than men. This disease starts gradually and worsens over time.

Some factors that could contribute to OA are:

• The risk of developing OA increases someone gets older because bones, muscles and joints are also ageing.
• Joint injury. A break or tear can lead to OA after years.
• Using the same joints over and over in a job or sport can result in OA.
• Extra weight puts more stress on a joint and fats cells promote inflammation.
• Weak muscles. Joints can get out of the right position when there’s not enough support.
• People with family members who have OA are more likely to develop OA.
• Gender. Women are more likely to develop OA than men.

People with osteoarthritis experience as much as 30 percent more falls and have a 20 percent greater risk of fracture than those without OA. Having OA can decrease function, weaken muscles and make it more likely that someone has a fall. Side effects from pain medications, such as dizziness, can also contribute to falls.

Recent reviews have not highlighted new effective treatments in OA. Physical measures like exercise and various assistive aids and insoles, splints etc are recommended.

The use of NSAIDs (anti-inflammatory drugs) is discouraged in older patients because of related risks of stomach bleeds; kidney damage and heart attacks or strokes.

Sometimes an NSAID can be given with a drug to protect the stomach which reduces the risk of bleeding.

For more information on arthritis visit the Arthritis Foundation website.