Thursday, November 12, 2009

Health

Agony In the Bones

Arthritis is crippling more people, but there are nine key ways to beat the pain

By Josh Fischman and Katherine Hobson
Posted 6/19/05

It is a timeworn sign of old age and frailty. Yet arthritis often strikes the young. "At night, I just cried and cried because my feet hurt so much," says 11-year-old Leona West of Springfield, Ill. And it hits the strong. "It was like having a dentist drilling into my knees," says Rich Kase, 52, of Cuyahoga Falls, Ohio, an insurance broker, former college football player, and self-described jock. "I was up to 12 ibuprofen a day. I had a terrible time walking. I had to walk down hills backwards."

This disease of the body also has a terrible impact on the mind. "I got very depressed. I couldn't sleep. When pain is constant like that, it changes your personality. And it affected everyone around me," says Nora Baldner, 41, of Quincy, Ill., who had arthritis in both hips. "I'd pour evaporated milk on my kids' cereal because I didn't want to walk to the back of the supermarket where the real milk was."

Joint problems are now hurting and crippling 43 million Americans, and they're more costly than cancer or diabetes. The most common form, osteoarthritis, affects about 21 million. Rheumatoid arthritis, another common type, hits slightly more than 2 million. (There are 95 or so other forms, often affecting fewer people.) And the numbers are going up steadily. By 2025, the total is expected to top 60 million, as an obese population pounds more heavily on its joints and an active generation of baby boomers grinds them down.

What's worse, these people will be fighting the disease without medicines that had become staples of treatment: The drugs Vioxx and Bextra have just been yanked off the market because they appear to raise the risk of heart disease, and that same shadow of fear has been cast over remaining drugs like Celebrex and even ibuprofen--a medicine that had already worried doctors because heavy use can cause bleeding in the stomach.

Yet instead of being crushed, doctors and patients say there is now more hope for beating the disease than ever before. "Arthritis has always been looked at as the minor aches of getting old, and there's nothing you can do about it. None of that is true," says rheumatologist Roland Moskowitz, codirector of an arthritis research program at the University Hospitals of Cleveland. "We're seeing it in younger people. But you can arrest the disease, and you can manage the pain."

In osteoarthritis, doctors have recently learned how a program of exercise and simple braces can make major improvements in misaligned joints. The remaining anti-inflammatory drugs, it turns out, can be used to great advantage--especially when combined with medication that protects the stomach. And there have been tremendous strides in joint replacement surgery. For rheumatoid arthritis, there's a lot of excitement about new medicines known as biologic response modifiers, which can hit the disease hard and fast and either slow it down or stop it altogether. Says rheumatologist John Klippel, president of the Arthritis Foundation: "We have a huge amount of optimism. In the next decade, I think we're going to change the course of this disease."

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