Social impact of disease-ARTHRITIS

Arthritis is one of the leading chronic diseases in the world today that causes not only great pain but also disability to patients suffering from the disease. Research shows that in the United States alone over 43 million adults 18 years and above have been diagnosed with different types of arthritis with another 23 million reporting symptoms related to arthritis (Andersson, 2008). Arthritis is considered to be the major cause of work-related disability that ranks second to heart disease and, therefore, leads to the deterioration of most lives. In addition to placing a burden on patients, the disease also strains the healthcare systems of the country whereby annually 44 million visits to the health centers recorded are due to arthritis (Andersson, 2008).

The psychosocial effect of this disease is substantial and can be highly recognized such as helplessness, anxiety and depression that further aggravates the pain. People living with arthritis often get difficulties in performing the normal daily basic activities such as dressing, shopping, eating, and getting involved in some other social activities. Considering the overall trend statistics shown by the character of this disease, it is important to take a deeper study of the disease. Therefore, this paper is going to focus on arthritis as diseases the social impact, means of treatment and preventions and also look at the epidemiological data and forecasting the state of the disease in the future.

Introduction

Arthritis is a common term used by physician and patients for any notable painful joint condition. The term has frequently been used to accommodate a wide scope of musculoskeletal conditions that comprise disorders of muscles, bursae, tendons and ligaments. Therefore, arthritis is a term that defines a wide group of illnesses that are constantly painful resulting from different etiologies, it has been identified to have more than 100 different types of arthritis. The disease attacks both children and adults with the adults and especially the old being the most affected. It is estimated that in America statistics indicate that more than 300,000 children and 50 million adults have been diagnosed with some type of arthritis (Burton & Mihail, 2010). The disease is prevalent among women and occurs frequently as people get older, therefore, vindicating the statistics that shows the larger affected group to be adults.

Symptoms

There are common joint symptoms that are associated with arthritis, which include; stiffness, swelling, decreased range of motion and pain (Hunder, 2009). These symptoms can be mild especially at early stages, moderate or severe and may persist in the similar state for over a long period like many years but may later advance and relapse over time. When arthritis gets severe it can result in chronic pains, inability to perform common daily activities even the light ones like climbing stairs. It can lead to permanent joint changes including knobby finger joints, but often most of the effects can be visible on X-ray. Different other types of arthritis also affect the kidney, eyes, heart, skin and lungs as well as the joints concurrently (Hunder, 2009).

Types of arthritis.

The most frequent types of arthritis comprise Psoriatic Arthritis, Osteoarthritis, and Rheumatoid Arthritis among many others. These are the prevalent ones and have diverse symptoms as well as causative methods. They are discussed below.

Osteoarthritis

It is the prevalent type of arthritis in the world today above other forms. It occurs due to the wearing away of the cartilage that cushions the surface at the end of the bones hence leading to the bones rubbing against each other causing pain, swelling and stiffness. The joint may lose strength over time hence leading to chronic pain. It often occurs when the joints are overused or due to age factors but can as well result from joint injuries or obesity. Joints such as knees, hips, spine and feet are the most commonly affected with some mild pain felt in the affected areas. The people with this type of arthritis do not feel fatigued or sick as in other cases of arthritis.

Some disposing factors to this condition is being overweight, straining the joints when the joints cannot accommodate the weight of the body, this stress damages the cartilage hence forcing it wear out faster than usual. When the bones rub together a grating sound can be heard which is commonly accompanied with some painful bumps or spurs on the end of the bone commonly on the feet or the fingers.

Rheumatoid Arthritis.

Rheumatoid Arthritis is classified as an autoimmune disease that means the body immune system has the ability to attack different parts of the body, particularly the joints. The attack contributes to inflammation that in turn causes critical joint damage when not treated in good time. Research has shown that out of every five people with Rheumatoid Arthritis at least one get lumps on their skin known as rheumatoid modules. The lumps are often formed over the joint areas that receive pressures like the elbows, knuckle or heels. The exact cause of this type of arthritis has not been explained exactly, but many speculate that it is due to attack by bacteria or viruses on the joint that eventually leads to the inflammation. The attack is triggered by a combination of environmental and genetic factors that may cause autoimmunity. One of the factors that can cause autoimmunity is a smoking that is classified as an environmental factor that predisposes an individual into contracting Rheumatoid Arthritis for people with specific genes.

The major body chemicals involved in causing the disease are the interleukin-1and tumor necrosis factor (TNF) (Burton & Mihail, 2010). According to scientist, these chemicals activate other parts of the immune system in Rheumatoid Arthritis. In order to prevent further joint damage due to this disease, doctors often prefer the use of drugs that block the interleukin-1 TNF and interleukin-6. The symptoms of this arthritis is that it tends to indicate a symmetrical pattern i.e. when the knuckles of the right hand get inflamed the left hand will get inflamed too.

The symptoms of this disease can come gradually or at times can start suddenly but are often more severe than in osteoarthritis. Among the symptoms are stiffness and pain and swelling in the hands, wrists, shoulders, ankles, knees, feet, jaw and neck. The Rheumatoid Arthritis usually affects multiple joints, and when one joint gets attacked and not treated in good time, more joints will get affected. The other associated symptoms are getting fatigued losing of appetite and eventually losing weight. The disease may also involve other organs including the lungs, eyes and heart.

Psoriatic Arthritis.

Psoriatic Arthritis often begins between ages 30 and 50 but can also start at an early childhood and usually common among men and women. It is distinguished by inflammation of the joint as well as the skin. Psoriasis is described as a skin illness that causes uneven, red, raised and white portions of skin inflammation having scales. Psoriasis strikes the ends of the knees and elbows, the navel, the scalp and skin around the anus or the genital areas. Researchers have shown that only 10% to 30% of the people with psoriasis infection may get Psoriatic Arthritis (Andersson, 2008).

The skin disease psoriasis often shows up first before other symptoms of this type of diseases are seen. Thereafter other symptoms like the swelling of the fingers and toes follow, often those who have the disease have their fingernails pitted or discolored. Unlike Rheumatoid arthritis Psoriatic Arthritis only affects one joint, for example, it could attack the knee only or the spine.

Prevention

A definite means of prevention of the disease has not been identified, but there are various measure that are recommended to delay the onset of some symptoms of arthritis as well as maintain healthy joints. There are factors that could lead to inefficiency of the preventative measure used to limit the disease such as when one comes from a family with a history of arthritis it could be difficult to stay without the disease. The best method to prevent getting the disease is to modify the behaviors of an individual thereby stopping the risk of contracting such diseases.

Osteoarthritis is majorly caused by one having huge body weights thereby exerting pressure on the joints and hence disposing the individual to arthritis. The sure preventative measure, in this case, is making sure that one leads a healthy lifestyle maintaining healthy body weight. Rheumatoid arthritis is mainly caused by smoking and hence changing behavior to prevent the use of any drug smoked can help prevent the disease. Other preventative measures depend on how much a person takes great care during activities such as exercises, by using proper equipment to prevent injuries.

Treatment

There is no particular drug that has been identified for treatment of the disease, and this is because of the varying types of the disease. These diseases demand different approaches in terms of treatment and hence causing the fluctuation. The doctors determine the method of treatment that is effective for a given patient before it is administered to them. The treatment method must also consider the severity and the impact of the disease on the person since in most cases they vary. The common treatment methods used today include orthopedic bracing, physical therapy, and medication.

Physical therapy

Exercise has been effective in most instances to treat arthritis. It is because the disease causes stiffness of the joint and hence frequent enhances the muscle strength, endurance, and flexibility. The type of physical exercise vary and help to solve different cases.

Hydrotherapy- this is an exercise in a warm water pool. The water does the purpose of supporting the weight and hence minimizing the pressure on muscles and joints. At that point, the body is able to move and the joint get strengthened through frequent movement with less pain.
Physiotherapy – this is an exercise that is administered by a professional to cater for the specific needs of a patient. The exercise at some point can be combined with pain relieving treatments like ice, massage or heat pack.
Occupational therapy – this a practical everyday tasks management. The professional in charge provides one with proper advice on how to protect themselves at work to prevent further damage on the joints. Other important factors to consider is the selection of specialized equipment and also proper fatigue management to enhance a healthy lifestyle.

Medication.

There is no single type of medication that is meant for the cure of arthritis. The medication treatment begins with the drug that has fewest side effects, and more medication is added in case the previous one is insufficiently effective. Another factor considered is the type of arthritis while ministering any medications, for example, the treatment for osteoarthritis is paracetamol for the early stages while non-steroidal anti-inflammatory drugs is required for the treatment of inflammatory arthritis. Rheumatoid arthritis uses a different category of medication known as disease modifying anti-rheumatic drug. An example of this drug is methotrexate that acts on the immune system and slows down the advancement of (RA). The reason for RA to get special medication is because it is autoimmune and, therefore, in addition to using anti-inflammatory drugs and pain medication it needs a special type of medication.

Surgery

The advanced levels of arthritis cause severe damages to the affected joints. It can lead to a joint replacement operation when the damage caused denies one to perform various important duties of everyday life. The advancement in technology in the field of medicine has enabled this, and a number of similar activities are perfumed daily with replacements done on the knee, hip, shoulder and elbow joints. There are other pain relieving or reconstructive operations that are carried out on patients which are helpful for those suffering from arthritis.

Epidemiological data

From compiled report by the center for disease control and prevention (CDC), data taken from the National Health Interview Survey (NHIS) between the years 2010-2012. Overall 22.7% of the United States adults reported doctor-diagnosed arthritis that is represents 52.5 million people. The number of women is a little higher compared to men recording 23.9% against 18.6% for men (CDC, 2015). The prevalence of the disease was also found to increase with age and was prevalent amongst women than it was in men in every age group.

Future Arthritis Burden

The prevalence of the hospital diagnosed types of arthritis there is expectation of an increase in of the disease due to the aging population of the United States. It is projected that by the year 2030, approximately 67 million people that is close to 25% of the total projected adult population who are above the age of 18 years will have doctor –diagnosed. Similarly by 2030 an estimated 25 million adults will complain about an activity limitation related to the arthritis disease, this is close to 9.7% of the United States adult population. Figure 1 shows the projection for the future using the trend of the past years, it is also notable that two thirds of the number will be women

Figure 1. Projected Prevalence of Doctor Diagnosed Arthritis among U.S. Adult 2005-2030. (CDC, 2015)

Arthritis –Attribution Limitations

The effect of arthritis on people is significant and notable. Out of the 52.5 million adults diagnosed with arthritis 22.7 million report limitation in performing the usual daily activities due to the disease. The total number represents 43.2 percent of the total population diagnosed. In figure 2 the graph indicates activity limitation at 31 percent for the working age adults having any type of arthritis and report being restrained in work.

Figure 2 Arthritis relative to the activities.

Arthritis Prevalence Relative to Body Weight

From the research results, it is noted that the prevalence of arthritis increases with an increase in the body mass index ranging from 16.3 percent for the normal or underweight adult to 28.9 percent among the obese adults. The excess body weight contributes significantly in activity limitations, with 38.2 percent among normal or underweight adults compared to 44.8 percent among obese adults with arthritis. Doctors encourage the obese to lose a modest amount of weight i.e. 11pound which can help reduce the risk of getting arthritis and limit pain as well as improve the quality of life in case one is living with arthritis.

Figure 3. Arthritis prevalence relative to body mass Index

Figure 4. Arthritis Related Activity Limitation by Body mass index

Social impact of arthritis

Arthritis has a major social effect on the lives of people who live with the disease in many ways. Performing daily activities can be a big problem to carry out, and other activities that they cherished they get forced to give up i.e. participating in sports. Some social effects noticed in the people living with the disease includes stress, depression, helplessness, and pain coping (Madsen, 2011).

Helplessness

Various research findings indicate that people living with arthritis develop a sense of helplessness when facing daily changes. When they get infected with the disease, they get the fear that the nature of their condition may lead to a negative impact and less impact on those living with them and feel they may not have control over themselves.

Depression

People living with arthritis develop depression due to the state at which they feel secluded or burdensome to those who provides support to them. The feeling of failing to perform their normal work at their employment places and lacking the financial stability. Other sources of depression come when one fails to perform the activities that they valued most like sports. When experiencing high levels of pain due to the joints or inflations any people living with the disease get depressed.

Stress

Stress often comes to people living with arthritis due to the fact that they are not able to accept the conditions they find themselves in even when they were in a good state before .i.e. failing to move effectively. When people age out and have no one to look after them especially when they get themselves in a situation they cannot perform most of the activities by themselves. Simple activities such as climbing stairs become hectic for them making it a concern to them.

Pain coping

People living with arthritis in most cases tend to look for means to adapt to their conditions by learning the different ways to cope up with the conditions. When a time reaches that these individuals feel that they are burdening those who volunteer to support them during the time of pain they strain to achieve most things. It in turn impacts negatively on the individual social life since at every point a volunteer comes out to offer supporting they consider themselves to be a burden to the relatives or friends.

Future of Arthritis

The elimination of arthritis may not be possible, but the only way to improve the lives of millions of people’s living with arthritis should be given a higher priority. Some of the factors outlined as a strategy for the arthritis include;

The government agencies and other concerned organizations should provide increased access to self-management education and physical programs for the people living with arthritis to help reduce the symptoms. It is crucial for improving the quality of life through national as well as the state partners. The state should also strengthen the programs that promote the use of crucial environmental means that help people living with arthritis get more actively involved to improve their lives. Some measures such as promotions of walking as an effective, low-cost and pain relieving option for reducing the effects of arthritis.

Conclusion

The nature of arthritis as a disease makes it common due to the conditions that predispose a person. The varying number of types of the disease also means that very many people can get the disease even though they may be of different types. The disease can also lead to cases of disability when it is not properly handled at an early stage, it, therefore, requires that when an individual notices any little symptom of arthritis it should be reported to get a proper medication. It is possible to limit arthritis through healthy lifestyle, but the choice must always come from the people to choose to lead a healthy lifestyle. The government should, therefore, ensure that the measures to prevent and manage this disease are properly explained and taught to the people, this is because the number that is projected to have the disease in future is higher hence there is a need for public preparedness.

References

Andersson, G. (2008). The burden of musculoskeletal diseases in the United States: prevalence, societal and economic cost. Rosemont, IL: American Academy of Orthopaedic Surgeons.

Burton, K., & Mihail, R. (2010). A data-driven approach to visualize the effects of rheumatoid arthritis on hands. Proceedings of CGAMES’2013 USA.

CDC. (2015, November 21). Arthritis. Retrieved from Centre for Disease Controland Prevention: http://www.cdc.gov/arthritis/data_statistics/national-statistics.html

Hunder, G. (2009). Mayo Clinic on arthritis. Rochester, Minn.: Mayo Clinic.

Madsen, M. (2011). Rheumatoid arthritis prevalence, risk factors, and health effects. Hauppauge, N.Y.: Nova Science Publishers.