(Intro to Arthritis with a. Arthritis) Manager of Education & Services for the Vancouver Island Region of The Arthritis Society

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1 Arthritis 101 (Intro to Arthritis with a Focus on Rheumatoid Arthritis) by Cari Taylor by Cari Taylor Manager of Education & Services for the Vancouver Island Region of The Arthritis Society

2 What You Will Learn Today What is arthritis? Did you know? Signs & symptoms of arthritis How you can help your patients Mobility Devices & Aids

3 Arthritis Facts Nearly 4.5 million Canadians have arthritis 650, people in BC Two-thirds of those affected are women l 000 h ld h At least 1 in every 1000 children have arthritis

4 Arthritis Facts Three of every 5 people with arthritis are under 65 50% increase of people with arthritis in the last decade Greatest cause of long term disability Greatest cause of long term disability among all chronic diseases

5 ARTHRITIS arthr.itis

6 What Is Arthritis? Arthritis means inflammation of a joint, which can cause: Pain Stiffness Occasional swelling Difficulty moving a joint Irreversible joint damage It can also affect soft tissues surrounding the joints

7 Healthy Joint ARHP, ACR, 1997

8 Types Of Arthritis There are over 100 types of Arthritis. They are in two main categories: Degenerative Arthritis i Osteoarthritis (OA) Inflammatory Arthritis Rheumatoid arthritis (RA) Psoriatic arthritis Ankylosing spondylitis

9 Degenerative Arthritis Osteoarthritis (OA) Affects 1 in 10 people Degeneration of cartilage Pain and stiffness Decreased range of motion Increased functional difficulties X-ray changes become visible

10 OA Joint Changes

11 Inflammatory Arthritis Rheumatoid Arthritis (RA) is the most common inflammatory arthritis type Affects 1 in 100 people Most often appears between the ages of 25 and 50 but affects people off all ages Twice as many women get RA as men Autoimmune disease

12 RA what is it? Auto-immune disease immune system attacks joints, connective tissue Causes lining around joints to be inflamed continuous inflammation leads to joint deformity Can affect joints eyes internal organs Can affect joints, eyes, internal organs, mouth and skin

13 Joint With Rheumatoid Arthritis

14 Why Do People Get Arthritis? Degenerative Arthritis Primary No obvious reason Inherited tendency Inflammatory Arthritis Genes Inherited tendency Secondary Prior injury Trigger Viral infection Environmental factor

15 What Are The Risk Factors? Degenerative Arthritis Age Gender Physical Inactivity Family History Excess Weight Joint Injury Other types of arthritis

16 What Are The Risk Factors? Inflammatory Arthritis Age Family history Gender (female) Smoking

17 How Is Arthritis Diagnosed? Degenerative Arthritis (Osteoarthritis) Family History Joint examination Rule out other types X-rays Inflammatory Arthritis (Rheumatoid Arthritis) Family History Joint examination Blood tests X-rays

18 RHEUMATOID ARTHRITIS: Clinical Features Gradual onset (over weeks to months) Symmetrical polyarthritis May involve many joints including: Hands & Wrists Shoulders Toes Knees Hips Even if pain is not severe, RA can cause permanent joint damage if not treated t and controlled

19 RA: Symptoms Unusual pain, stiffness and inflammation in joints Pain and stiffness worse in the morning and typically lasts minutes before you start to feel better Pain, swelling and stiffness (to some degree) most of the day Flare Some lose weight at onset. Some develop a lowgrade fever at onset Extreme fatigue

20

21 RHEUMATOID ARTHRITIS: X-Ray Erosions Strand V, Sharp JT. Arthritis Rheum. 2003;48:21-34.

22 RHEUMATOID ARTHRITIS: Finger Synovitis Swelling around the joint Thickening feels like a firm sponge Photo: Copyright American College of Rheumatology

23 RHEUMATOID ARTHRITIS: Clinical Features

24 RHEUMATOID ARTHRITIS: Complications RA doesn t just affect the joints: Sense of feeling ill Heart and lung Eye disease Can affect the nervous system Skin including leg ulcers Blood including low white blood cell count or anemia Osteoporosis and fractures Lymphomas Stomach ulcers and gut bleeds from anti-inflammatories (NSAIDS) Fatigue Rheumatoid nodules e.g. in the elbows and fingers c1

25 Slide 24 c1 Our material says Sjogren's Syndrom... should we be consistent and continue using that name instead of Sicca Syndrome? cavagka1, 1/26/2010

26 Importance of Early Aggressive Treatment 70% of patients have X-ray evidence of damage within the first 3 years isease ons set Early Established: increasing disability End Stage Di Critical window of opportunity

27 The faster the better Structural joint damage begins within the first two years of the disease Treatment of RA with drugs that both modify the course of the disease and reduce inflammation has greatest impact within 3 6 months of diagnosis

28 When Should I See The Doctor? If you have any of these symptoms for more than two weeks, you should see a doctor. Joint pain Joint stiffness Occasional swelling of a joint Difficulty moving a joint

29 WEATHER??????? Does weather affect Arthritis?

30 How can I help? How to accommodate patients with RA? Understanding di Emotional Challenges Pain Understanding gelling, allowing time Chairs Mobility aids made available in change rooms Writing instruments Offering Resources/Solutions

31 Emotional Challenges Depression Grieving the loss of your old self Guilt about being ill Physical changes in the body Chronic pain and fatigue Unpredictable nature of the disease Fear of the future

32 The Pain Cycle Disease Pain Fatigue Tense muscles Depression Stress Fear / Anger / Frustration

33 Conserve Energy Balance activity with rest Rest periods important Let muscles and joints re-energize Enable more productivity To conserve energy: Plan ahead Do what is most important first Get help from others Protect your joints Practice relaxation techniques

34 Joint Protection Respect Pain Find a balance between rest and activity Alternate heavy tasks with light tasks Position joints wisely and change position often Ask for assistance Use strongest or largest muscles and joints Adapt your daily activities and use helpful devices

35 Helpful Devices

36 Arthritis Friendly Products

37 Who Can Help? Podiatrist Dietitian Social Worker The Arthritis Society Occupational Therapist Psychologist YOU Pharmacist Orthopedic Surgeon Nurse Family Physician Physiotherapist Rheumatologist

38 Questions? ARTHRITIS INFORMATION LINE or visit 2 nd Floor Richmond Road Victoria, i BC, V8R 4S

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