The following article is from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Future Health Technologies thanks them for their help and research which benefits us all.

Arthritis: What We Know Today

From: National Institute of Arthritis and Musculoskeletal and Skin Diseases
Author: Debra R. Lappin, Esq. Chair, Arthritis Foundation
Publishing Date: Friday May 30, 1997

  1. Overview

    1. Arthritis in its various forms is a significant problem for the individual and society.

    2. While serious, arthritis is treatable-- there is something you can do to reduce disability and associated costs...early diagnosis and treatment, self-management and physical activity.

    3. The Arthritis Foundation is the source for help and hope.

  2. Myth: Arthritis is minor aches and pains... just part of aging.
    Fact    : Arthritis and related conditions have a significant prevalence and impact .

    1. Prevalence: According to the 1990 Census and the National Health Interview Survey, there are about 40 million Americans with some type of arthritis-- one in seven persons.

    2. Arthritis affects all ages including a significant number of people in the prime of their life (almost 9 million adults). Higher prevalence in elderly and in women. (Arthritis is the most prevalent chronic condition in women affecting 22.8 million in 1990.)

    3. Arthritis is a leading cause of disability in America causing activity limitations in approximately 7 million Americans.

    4. Arthritis was reported as the cause of disability more than other chronic diseases such as back pain, heart or lung conditions, diabetes or cancer.

    5. The prevalence of arthritis is projected to increase 57% to about 59.6 million people with arthritis by the year 2020. Between the years 1990 and 2020, the number of people disabled by arthritis will increase to about 12 million.

    6. Estimated cost of arthritis to the economy in 1992: about $64.8 billion dollars (about 24% was due to direct medical costs; 76% due to indirect costs from lost wages). Cost including arthritis and other musculoskeletal conditions was $149.4 billion, which is about 2.5% of the Gross National Product.

    7. Arthritis is the prototypic chronic disease: it rarely kills but many people feel they've received a lifetime sentence to disability and a limited quality of life.

  3. Myth: nothing can be done about arthritis (e.g., San Mateo Study, more than half of those with arthritis didn’t think or were not sure that anything can be done for arthritis). Fact: There’s a lot that can be done.

    1. Early diagnosis and treatment can prevent much unnecessary disability.

    2. Importance of patient self-management, as supported by clinical studies e.g. Stanford’s Arthritis and Musculoskeletal Disease Center development/evaluation of the Arthritis Self- Management Program (Arthritis Self-Help Course):

      • Incorporates educational processes (e.g., goal-setting, role modeling) to help increase self- efficacy, or sense of confidence in your ability to execute behaviors that help you manage the impact of your condition.

      • Early studies: participants had significant changes in behaviors such as exercise and use of relaxation techniques, and improved outcomes such as decreased pain. However, no correlation between behaviors and outcomes.

      • Further research: identified importance of self-efficacy enhancing strategies.

      • Four-year follow-up study: sustained improvements in pain level (about 20% reduction) and self-efficacy and reduced physician visits (43%).

      • Potential cost-savings of this program: average savings of $647 per RA participant and $189 per OA participant. (If extrapolated to 1% of each population, savings = $33 million).


  4. Myth: People with arthritis should not exercise.
    Fact    : People with arthritis SHOULD engage in physical activity.

    1. Many problems accepted as either the natural progression of arthritis disease processes or as consequences of therapy are the consequences of prolonged inactivity.

    2. CDC’s MMWR (May, 1997): Physical Activity in People with Arthritis: People with arthritis have high rates of NO reported physical activity compared with the rest of the population.

    3. Research demonstrates that people with arthritis can exercise safely and achieve significant benefits eg., Minor & Brown study (Randomized, controlled study comparing the results of walking or aquatic exercise to general range of motion exercises for people with RA or OA. Both the aquatic and the walking program intervention groups achieved significant positive changes in aerobic capacity, endurance, flexibility, walk time, strength, pain, depression, without causing any flare-ups in disease).

  5. Role of Arthritis Foundation

    1. To help people get early diagnosis: referral lists for arthritis specialists and information on a variety of different types of arthritis and its treatment.

    2. To promote self-management skills:

      • The Arthritis Foundation adopted the ASHC in 1981; over 100,000 people have participated in the program.

      • Also offer self-management groups programs with similar changes in outcomes for people with lupus and fibromyalgia.

      • For those not interested in group programs: Bone Up on Arthritis program (audiocassette based package); In Control (videotape based package); and Arthritis Home Help (computer-tailored educational materials delivered through the mail).

    3. To help people stay active and independent:

      • Arthritis Foundation Aquatics program (evaluation results: improved function and reduced pain).

      • PACE (People with Arthritis Can Exercise)®. (evaluation results: increases in exercise and relaxation, decreased pain, increased self-efficacy, and positive changes in depression, functional status and social activity).

      • Other offerings: Joint Efforts classes (targeted to elderly), a variety of exercise videotapes, and soon-to-be-released WALK with EASE program.

  1. References

  • Callahan LF, Rao J, Boutaugh M (1996) Arthritis and Women’s Health: Prevalence, Impact, and Prevention. Am J Prev Med 12 (5): 401-409.

  • CDC (1997) Prevalence of Leisure-Time Physical Activity Among Persons with Arthritis and Other Rheumatic Conditions. Morbidity and Mortality Weekly Report 46 (18): 389-393.

  • Communication Technologies (1993) A Study of Help-Seeking Among Individuals with Musculoskeletal Conditions in San Mateo County, California. San Francisco, CA: Communication Technologies.

  • Lorig K, Mazonson P, Holman H (1993) Evidence suggesting that health education for self-management in patients with chronic arthritis has sustained health benefits while reducing health care costs. Arthritis and Rheumatism 36(4): 439-446.

  • Lorig K, Holman H (1993) Arthritis self-management studies: a twelve-year review. Health Educ Q 20(1):17-28.

  • Lorig K (1993) Self-management of chronic illness: A model for the future. Generations:11-14.

  • Lorig K, Gonzalez V (1992) The integration of theory with practice: A 12-year case study. Health Education Quarterly 19(3):355-368.

  • Minor MA, Brown JD (1993) Exercise maintenance of persons with arthritis after participation in a class experience. Health Education Quarterly 20(1):83-95.

  • Yelin E, Callahan LF: The Economic Cost and Social and Psychological Impact of Musculoskeletal Conditions. Arthritis & Rheumatism 38(10): 1351-1362.

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