What is the prognosis for someone diagnosed with osteo or rheumatoid arthritis? What is the likelihood that they will need Long Term Care?

Osteoarthritis may be stable for many years or may progress rapidly, but usually progresses slowly after symptoms develop. OA in itself is not life threatening, but quality of life can deteriorate from pain and loss of mobility. About 4-5% of those who eventually leave the workforce due to disability are due to osteoarthritis.

Rheumatoid arthritis rarely resolves spontaneously. At least 10% become severely disabled, in which the cartilage, bone, and ligaments of the joint erode, causing deformity, instability, and scarring within the joint.

What causes arthritis? Is it genetic?

OA is usually idiopathic (when the cause is not known or cannot be established), but in some cases may be caused by another disease condition such as an infection, deformity, injury, or overuse of a joint. Obesity may be a major factor in the development of OA of the knee in women.

RA, on the other hand, is considered an autoimmune disease, in which components of the immune system attack the soft tissue that lines the joint, causing it to deteriorate. It is believed among medical authorities that RA is triggered by an infection (a virus or bacteria) in people with an inherited susceptibility. RA in itself is not inherited, but there are certain inherited genes that result in increased susceptibility.

Everyone knows that diet and exercise can help prevent heart disease and stroke. Does diet and exercise have an effect on arthritis?

Appropriate exercises help maintain a healthy cartilage and increase a joint's range of motion in OA, but must be balanced with rest. However, immobilizing a joint is more likely to worsen OA than improve it.

With RA, on the other hand, severely inflamed joints should be rested, because using them can aggravate the inflammation. A diet rich in fish and plant oils but low in red meat can have small beneficial effects on the inflammation.

What types of medications are available to help arthritis sufferers? What are the risks?

NSAIDS such as aspirin, ibuprofen, naproxen, diclofenac and the coxibs are the first line drugs for both types of arthritis, followed by the use of corticosteroids and immunosuppressive drugs (methotrexate, azathioprine, cyclophosphamide, etanercept, and infliximab) in more persistent cases of RA.

NSAIDs are usually associated with ulcers and adverse effects on the kidneys, while immunosuppressive drugs may make patients become more susceptible to infection and bone marrow suppression. Long term use of corticosteroids can reduce the body's ability to fight infection, and may worsen hypertension, ulcers, diabetes, kidney problems, and osteoporosis. Nevertheless, the benefits of using these drugs do outweigh the risks, and prudent use of appropriate medications should be practiced.