For many arthritis patients, the greatest fear as they grow older is a loss of independence. But the good news is that you have control over your condition and your future, as long as you take an active role in the management of your disease.

First, Get an Accurate Diagnosis

   For the arthritis patient, achieving independence for a lifetime begins with an accurate diagnosis, because you need an accurate diagnosis to have accurate treatment. Did you know that there are more than 100 different kinds of arthritis? Also, you can have several different types of arthritis at the same time, for example osteoarthritis and rheumatoid arthritis. While not every musculoskeletal problem is arthritis, most any kind of joint degeneration is some form of arthritis.

   Doctors may try to protect patients from the word "arthritis" because of its negative impact, so they might say that a patient has "degeneration" or "a bone spur." The problem with this is that the patient believes he or she does not have arthritis, and minimizes what could become a very problematic condition later on. Also, the treatment ends up taking a different path than what it should, and patients have no way to find the resources they need to teach them how to manage their condition and remain independent.

  A misdiagnosis or "keeping your head in the sand" can cause you and your doctor to mismanage the situation, prolonging the time it would have taken for your treatment to be effective or--even worse--endangering yourself. That's why it's very important to get an expert opinion, from someone who has enough education and experience to identify the real problem.

Try Active vs. Passive Approaches

   I find that people with aches and pains of arthritis tend to go to their primary care physician or family doctor, and the usual result is a prescription for an NSAID (non-steroidal anti-inflammatory drug) pain reliever such as Naprosyn or Relafen. If the medication helps, the patient simply continues to renew the prescription on an ongoing basis. But this is a passive approach to arthritis management. Even though a prescription may help inflammation and control symptoms, relief is short-lived because pills don't often significantly alter the course of the disease. They may help today, but five years down the road, depending on the course the disease has taken in that time, they may no longer be effective. While masking symptoms, you may not be aware of the underlying changes going on in your joints as a result of your disease.

   Analgesic creams, NSAIDs, massage, heat and cold packs--all of these things are good to use in the short term to get you through a bad day, but when it comes to looking at where you're going to be later in life, you have to take an active approach to make sure your disease process is really under control. If you're going to outline a course that aims for the long-term goal of independence later on, rather than just the short-term goal of symptomatic control today, you have to manage your arthritis with both passive and active approaches. You have to understand that function is the ultimate goal, rather than pain control.

  What constitutes an "active" approach? Get educated. Read everything you can. Ask questions of your doctor and find out how other people with your particular type of arthritis take care of themselves.

  Take advantage of joint protection techniques. Joint protection involves many things, including dealing with the mechanical changes arthritis causes in your joints, and keeping these to a minimum. When cartilage diminishes in a joint as a result of the arthritic process, the ligaments and tendons become more unstable, muscles weaken due to inactivity, and bone spurs and other processes secondary to the arthritis crop up and start to limit your motion. This is a progressive problem. Arthritis never goes away; you must be able to understand the pathology, or course of the disease, and decide how you're going to manage that pathology for the rest of your life.

   Also falling under the umbrella term of "joint protection" are nutrition and exercise. Nutrition plays a role on two levels: first, eating right helps in weight control, and that reduces stress on the joints. In addition, good nutrition contributes to your overall health and energy level, which in turn inspires you to be more active. Exercise, combined with periods of rest, is important for building muscle strength; the stronger your muscles, the more work they do and the less stress is placed on your joints. Overall, good nutrition and exercise appropriate for people with arthritis will build and strengthen your muscles, increase your metabolism and make your body more fuel efficient.

  Another active approach to arthritis management, and one that directly contributes to independence, is taking advantage of assistive devices such as those you find in catalogs. Combs and brushes with longer or built-up handles, larger ignition key holders for your car, easy-to-grip pens--not only do these devices make life a little easier, they also can protect your joints from unnecessary damage.

  Finally, the ultimate active approach is surgical intervention. Whether it's a joint replacement, a fusion or any orthopaedic surgical procedure, if it will help you stay as independent as you can be later in life, it should be considered. Learning about the surgery, undergoing the procedure and recovering might take several months, but in the overall span of your life isn't it worth taking that time out to ensure your optimum function later? Especially when you realize that joint replacement not only permanently relieves pain and improves mobility, but it also boosts general health--if your hips or knees don't hurt, you're going to be able to walk and get enough exercise, helping maintain your cardiovascular health as well. If you wait until your health otherwise is risky, the option of surgery might no longer be available to you, and then your health will ultimately fail. To be a joint replacement candidate has nothing to do with age but everything to do with your medical condition and potential ability to recover from surgery. The oldest hip replacement patient I remember was 99 years old. Her main goal was pain relief, and that mission was accomplished. She came through it very well and lived five more years--pain-free years. The youngest hip replacement patient I've worked with was just 14.

   The two most important questions you should ask your surgeon regarding joint replacement are "How many surgeries do you do in a year?" and "What are your personal statistics of success?" It's important to choose an experienced orthopaedic surgeon who can tell you how patients are doing 10, 15 and 20 years after their joint replacement surgery.

  So don't just be passive, act! You have the power! A pill by itself is not the solution. While yes, you must treat the pain, you must also take an active role in order to achieve independence for a lifetime.

About the author:
Jan Revella, R.N., Arthritis Nurse Specialist, is founder and director of Arthritis Education by Professionals, Inc., based in Phoenix, Arizona. She is among the most prominent speakers and educators on the subject of arthritis in the United States. Her mission is to empower people with arthritis to use knowledge as power when making decisions about their personal healthcare. Arthritis Education by Professionals, Inc. provides educational programs and services to people with arthritis.

© Copyright 2005. Arthritis Education by Professionals, Inc.