Term Paper: Arthritic Conditions Found

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[. . .] Another common treatment uses disease-modifying anti-rheumatic drugs (DMARDs) that slow inflammation. DMARDs are often used early in treatment to slow the disease and prevent damage to the joints (Lewis 2000).

For severe arthritis, joint replacement is also used as a treatment, where the joint is removed and replaced with a plastic or metal prosthesis. This is commonly used for hip replacements but can also be used for arthritis of the knee, shoulder, elbow, finger or ankle (MFMER 2002).

Other surgical procedures include fusing of the joint, where the bones are fused. This stops the pain but means that the joint has no flexibility (MFMER 2002).

Two non-drug alternatives known as Hyalgan and Synvisc were approved for use in 1997. These products are viscous solutions of a lubricant found naturally in the joints. These products are injected directly into the joint to increase the synovial fluid present. This treatment is currently used for osteoarthritis of the knee (Lewis 2000).

Enbrel is a relatively new drug that is used to treat rheumatoid arthritis. It is taken twice a week by injection and decreases pain and swelling. Enbrel has been effective in patients that have not responded to any other treatment and is also suitable for children with rheumatoid arthritis (Lewis 2000).

Arava is a new oral treatment that is used to slow the onset of rheumatoid arthritis. This drug is not able to stop the progress, but can slow the effects (Lewis 2000).

Another non-drug treatment used for severe rheumatoid arthritis uses a device known as the Prosorba column. In the treatment, the patient's blood is removed, the plasma separated from the blood cells and the plasma passed through the column. This filters the blood and is thought to remove damaging proteins (Lewis 2000).

Current Research

New therapies for the treatment of rheumatoid arthritis increasingly focus on understanding the causes of the disease.

There is a focus on understanding the genetic factors involved and identifying the genes that cause individuals to be predisposed to arthritis. One major project is known as the North American Rheumatoid Arthritis Consortium. The consortium is made up of twelve research centers that will collect genetic information from around 1000 families with a history of arthritis. This information will be used in various studies that attempt to understand the genetic factors involved (NIAMS 1998).

There is also a significant amount of research that focuses on understanding the processes of arthritis. This includes understanding the immune system, the inflammatory process and the cells, hormones and chemicals of the body involved. There are suggestions that this could eventually lead to a vaccine for rheumatoid arthritis as well as offering a range of new treatments (Arthritis Foundation 2002).

There is also some evidence that viruses or bacteria may be a trigger for arthritis. There is currently a significant amount of research attempting to determine what this trigger may be and how it may work (NIAMS 1998). This is thought to have potential in preventing the disease.

Arthritis and Athletic Activities

There are several links between arthritis and athletic activities. Arthritis can be a product of sporting injuries, athletic activities can also prevent arthritis and athletic activities can also be used in the treatment of arthritis.

Arthritis can be caused by sporting injuries or by overuse of the joints through exercise. Sporting injuries and overuse can both result in osteoarthritis, with the osteoarthritis usually taking years after the original injury to develop (The Arthritis & Glucosamine Resource Center 2002).

Athletic activities are also important in preventing arthritis, with exercise strengthening muscles and bones and increasing flexibility. This involves three types of exercise. Range-of-motion exercises stretch the joint and assist in maintaining full mobility. Strengthening exercises strengthen the muscles that support the joint. Endurance exercise strengthens the entire body including the heart and lungs (Lewis 2000).

Exercise is also used in the treatment of arthritis, involving the same exercise types as for prevention and for the same reasons. Exercise is also thought to help arthritis suffers maintain a positive outlook and lose weight which can lead to a reduction in the pain experienced. It is important though, that the exercise programs takes into accounts the individuals condition (NIAMS 1998).

The difficulty in linking exercise to arthritis lies in the balance that needs to be maintained. The Mayo Foundation for Medical Education and Research (2002) describes this saying,

Proper exercises performed on a regular basis are an important part of arthritis treatment, according to the Arthritis Foundation. Twenty years ago, doctors advised exactly the opposite, fearing that activity would cause more damage and inflammation. Not exercising causes weak muscles, stiff joints, reduced mobility, and lost vitality, say rheumatologists, who now routinely advise a balance of physical activity and rest."

Chapter Three: Research Needed

The literature review suggests several areas of research could be extended.

Firstly, it has been seen that long-term damage can be largely prevented with early warning and effective treatment. At the same time, it was seen that arthritis is often misunderstood. The moderate effects can be overlooked and thought of as an inconvenience rather than a disease that requires treatment. By the time medical advice is sought, the damage may already be done. This suggests that greater awareness of the disease may be beneficial so that those suffering from mild effects can seek treatment that prevents the disease developing to more extreme levels.

Much of the current research is also focused on understanding the onset of the disease and the genetic factors involved. It is also suggested that environmental factors may play an important role. What is lacking in the research is a focus on lifestyle factors. It is known that exercise, diet and weight could be contributing factors. Further research on these lifestyle factors could give all individuals the opportunity to prevent the disease through simple lifestyle changes.

Finally, the link between exercise and arthritis is not adequately defined. While there is some evidence that regular evidence can prevent arthritis and assist in treatment, there is a lack of specific knowledge on which exercises are most suitable. It was also seen that in the past doctors advised patients not to exercise as this would worsen the problem. It is likely that this false belief still exists in arthritis sufferers who may avoid exercise as an attempt to avoid further pain. Definite information on suitable exercise programs would assist in ensuring sufferers do not needlessly avoid exercise that could be beneficial to them.

Chapter Four: Learning Outcome

From this overview of arthritis, several important facts have been learned.

Firstly, it is known now that arthritis is not one disease, but several, with the characteristics of each different. This will assist in identifying the problems of clients.

This has also involved learning that arthritis can start at mild levels and degenerate to serious problems if action is not taken. This will assist in ensuring that minor complaints are not ignored but investigated fully. This includes recognizing that arthritis is not only a disease of the aged.

The link between sports and arthritis is also better understood. This includes recognizing that a single sports injury could result in further problems in later years. Also, it is now known that overuse through sports could cause the onset of osteoarthritis.

Finally, it is now known that sports and exercise can prevent arthritis and assist in its treatment. This can be used in treating patients with arthritic conditions, while ensuring the activities they complete helps them rather than hinders them.

References

AAOS: American Academy of Orthopaedic Surgeons. (2000). Arthritis. American Academy of Orthopaedic Surgeons.

The Arthritis & Glucosamine Resource Center. (2002). Treating and Preventing Sports Injuries & Secondary Arthritis. http://www.arthritis-glucosamine.net/arthritis/sports-injuries-arthritis.html

Arthritis Foundation. (2002). Progress and Opportunities in Rheumatoid Arthritis. http://www.arthritis.org/research/research_program/RA/default.asp

Lewis, C. (May-June 2000). Arthritis: Timely Treatments for an Ageless Disease. FDA Consumer, 34:3.

Martin, E.A. (2000). Concise Medical Dictionary. London: Oxford University Press.

MFMER: Mayo Foundation for Medical Education… [END OF PREVIEW]

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