Arthritis includes more than 100 different rheumatic diseases and conditions, the most common of which is osteoarthritis (OA). It also encompasses rheumatoid arthritis (RA), gout, and more rare diseases.

Common symptoms include pain, aching, stiffness, and swelling in or around the joints. Some forms of arthritis, such as RA and lupus can affect multiple organs and cause widespread symptoms. Fatigue, which is also a symptom of arthritis, is significantly associated with pain in RA patients and is significantly associated with disability in OA patients.

Pain is the primary reason patients with inflammatory arthritis seek care. Among RA patients, 68-88% rate pain as one of their top three priorities.  

The economic burden of all arthritis is significant. In 2007, the cost attributable to arthritis and other rheumatic conditions in the United States was estimated at $128 billion ($162 billion in 2013 dollars). This estimate, derived from national Medical Expenditure Panel Survey (MEPS) data, was partitioned into $80.8 billion ($115 billion in 2013 dollars) in direct medical expenditures and $47.0 billion ($59.4 on 2013 dollars) in indirectly lost earnings. Researchers estimate that the costs due to absenteeism from osteoarthritis alone are $11.6 billion per year in 2013 dollars, due to an estimated three lost workdays per year.

As with other painful conditions, the pain of arthritis can take a toll on work and relationships. However, a supportive spouse may lessen the pain. One study that looked at marriage and RA found that people in “well-adjusted” marriages reported lower pain scores and lower psychological disability than their counterparts who were unmarried, or in “distressed” marriages

These findings suggest that being married in itself is not associated with better health in RA, but that being in a well-adjusted or non-distressed marriage is linked with less pain and better functioning. A separate study found that persons with RA perceived more problematic spousal support when their spouse underestimated fatigue, or underestimated physical limitation levels.

One study found that greater knee OA pain at the end of the day was associated with spouses’ poorer overall sleep quality that night and feeling less refreshed after sleep. In contrast, there was no evidence that spouse sleep was related to greater patient pain the next day.

Many diseases manifest symptoms of arthritis, including ankylosing spondylitis and scleroderma. Ankylosing spondylitis (AS) is a type of arthritis that primarily affects the spine of back. Ankylosing is a term meaning stiff or rigid. Spondyl, which refers to the spine, means inflammation. Pain and stiffness in the lower back, hips, and buttocks are primary symptoms of this disease.

Scleroderma, which literally means “hard skin,” is a medical term used to describe two different conditions: localized scleroderma and systemic sclerosis (or scleroderma). The systemic form is a multisystem chronic, sometimes life-threatening disease, while the localized form is a skin and soft tissue condition without internal organ disease. Scleroderma is considered both a rheumatic disease and a connective tissue disease. The term rheumatic disease refers to a group of conditions characterized by inflammation or pain in the muscles, joints, or fibrous tissue. A connective tissue disease is one that affect tissues such as skin, tendons, and cartilage.

FACTS

-Arthritis is the nation’s most common cause of disability. An estimated 50 million U.S. adults (about 1 in 5) report doctor-diagnosed arthritis. As the U.S. population ages, these numbers are expected to increase sharply. Nearly 21 million U.S. adults report activity limitations because of arthritis each year. For 1 of 3 adults of working age (18-65 years) with arthritis, it can limit the type or amount of work they do or whether they can work at all.

-According to the Arthritis Foundation, arthritis pain is caused by several factors, such as:

-inflammation, the process that causes the redness and swelling in joints

-damage to joint tissues, which results from the disease process or from stress, injury, or pressure on the joints

-fatigue that results from the disease process, which can make pain seem worse and   harder to handle

-depression or stress, which results from limited movement or no longer doing activities

-Nearly two-thirds of people with arthritis are younger than age 65 years.

-the number of adults with doctor-diagnosed arthritis is projected to increase to 67 million by 2030, and more than one-third of these adults will have limited activity as a result.

-one study of U.S. workers with arthritis pain found that they reported significantly lower quality of life than their coworkers without arthritis; they also reported significantly more work-related impairment.

-a separate study found that chronic low-back pain co-existed with 64.5% of people with RA. These patients also had the poorest scores on functional disability and depression.

-research has shown that people with arthritis are less likely to be physically active. Some people believe that being active will cause pain, make their symptoms worse, or damage their joints. Others don’t know how to exercise safely. Nearly 44% of adults with arthritis report no leisure-time physical activity (compared with about 36% of those without arthritis).

-A recent community study estimated that the lifetime risk of developing knee OA serious enough to cause painful symptoms is 45%.

-the risk increases to 57% among people with a past knee injury. Lifetime risk for knee osteoarthritis goes up with increased weight, up to 60% for people who are obese.

-The Arthritis Foundation estimates that nearly half a million Americans are affected by ankylosing spondylitis. However, some researchers now believe that the prevalence is as much as 1% of the U.S. population – or 2.7 million people.

-Pain catastrophizing is a distortion in pain perception that involves both cognitive and emotional components and leads patients to expect only the worst. Catastrophizing can be viewed as the opposite of coping, which is the set of adaptive processes a patient uses to live well with pain. One study of people who have RA and Ankylosing Spondylitis found that 24% of patients had very high pain catastrophizing scores despite receiving biological treatment for their arthritis. Pain catastrophizing was missed by the physicians in half the cases and was relatively independent from other follow-up parameters.

 

-Because scleroderma can be hard to diagnose and it overlaps with or resembles other diseases, scientists can only estimate how many cases there actually are: current research estimates that 49,000 adults in the United States have systemic sclerosis

-Pain is common and can be severe in patients with systemic sclerosis. One study found that 83% experienced pain. Some 46% reported mild pain (scores of 1 to 4 on a 10-point scale), while 27% reported moderate pain (scores of 5 to 7) and 10% reported severe pain (scores of 8 to 10). Only 17% reported no pain.
-Approximately 34% of people in this study reported that they had experienced “finger contractures;” 19% had experienced “other joint contractures;” and 17% had experienced “swollen joints.”

-Lupus affects as many as 322,000 Americans and affects women 8 to 10 times more than men. Lupus is also more common in African American, Hispanic, Asian, and Native American women.

-There are many forms of lupus. In most cases the term “lupus” refers to the form known as systemic lupus erythematosus, or SLE. About 70% of the people who have lupus have the systemic form that affects multiple systems in the body.

-The immune system attacks healthy cells and tissue, which can damage joints, skin, blood vessels, and organs. Joint pain or swelling and muscle pain are common symptoms of lupus, as are fever with no known cause and red rashes, often on the face (referred to as the “butterfly rash”).

Additional Resources

American College of Rheumatology
www.rheumatology.org

Arthritis Foundation
www.arthritis.org

Lupus Foundation of America
www.lupus.org

National Institute of Arthritis and Musculoskeletal and Skin Diseases

National Institutes of Health
www.niam.nih.gov

Scleroderma Foundation
www.scleroderma.org

Spondylitis Association of America
www.spondylitis.org