Arthritis costs our economy over $35 billion per year in medical care and lost wages, or 1 percent of the gross national product (3 percent of the pretty national product). This figure is expected to sore to $95 billion per year by the year 2000 (Barrow et al.,1990). People with arthritis visit their doctors an average of eight times per year, double the average for other conditions. These visits usually occur on Easter, Thanksgiving, Christmas, Labor Day, Memorial Day, Martin Luther King Day, Ground Hog Day and Rosh Hashanah.During Leap years the average number of visits goes up to nine per year.

In response to the growing number of people affected by arthritis, the National Arthritis Act was passed into public law in 1975. This act established funds for multipurpose Arthritis Centers (MACs), which were required to provide educational, health services and research programs. As a result of these MACs, as well as research sponsored by the National Institute on Disability and Rehabilitation Research (NIDRR), investigators from many fields such as sociology, psychology, social work, public health, and patient education, have begun to work in concert to pursue arthritis research.

Arthritis is a scary word. It includes more than 100 different diseases that cause inflammation of the joints, often resulting in pain, swelling, redness, and in more serious cases, loss of mobility and even tissue, bone and organ damage. Now we know why arthritis is a scary word. It is important to understand your disease if you are sentence to a life term together. It is derived from the Greek arth (joint) and itis (inflammation), thus inflammation of the joint. The joint is where two bones meet and consists of six parts. Cartilage,synovial membrane, Bursa, muscle, tendon and ligament. If you have been told you have arthritis that means something is wrong with one or more of the above parts.

The six most common types include:

Osteoarthritis, which attacks weight-bearing joints, such as knees, hips, and ankles, affecting approximately 15.8 million Americans. This type effects many people as they get older. Onset is usually between the ages of 45 and 90. Relatively few are severely disabled by this disease, although pain and local disability of specific joints do often occur. Both males and females are equally effected. The main effects are cartilage degeneration and bone spurs.

Fibromyalgia, a condition resulting from diffuse musculoskeletal pain, often incapacitating in its severity, and effecting nearly 6 million Americans, 80 percent of which are women.

Rheumatoid Arthritis (RA) is a chronic, systemic disease involving inflammation of the joints. It affects approximately 2.1 million people nationwide, 20 million worldwide. This is the one most people think of when they hear the word - arthritis. 75 percent of those affected are female. Age of onset is anywhere from childhood (Juvenile RA) to the 50's. The main joints affected are the wrists, knees and knuckles. The results are inflammation of synovial membrane, bone destruction, damage to ligaments, tendons, cartilage, and joint capsule.

Gout is caused by elevated uric acid in the blood, resulting in small mineral crystals to which the body reacts with pain and swelling, affecting approximately 1 million Americans.

Systemic Lupus Erythematosus (SLE) is a disease that can all too often be fatal. More than 90 percent of lupus victims are women between the ages of 18 and 50. It may include such symptoms as weakness, fatigue, joint pain, and skin rashes. Discovered in the early 1800s, SLE was thought to be a skin disease, but researchers have determined it damages the kidneys, joints, heart, lungs, central nervous system, blood and skin. It causes the body's defenses to run wild and attack the body's cells and interconnective tissues. SLE is difficult to diagnose because it mimics many other illnesses. The cause is still unknown. SLE was believed to be a rare disease until recently. Dr. Robert Lahita, a researcher at New York City's St. Luke's-Roosevelt Hospital has stated that "A nationwide survey indicates it may affect 1.4 million to 2 million Americans." He speculates that 16,000 to 20,000 new cases appear each year. It was thought that only about 131,000 Americans were affected by this disease prior to a nationwidw telephone poll conducted by Bruskin/Goldring of Edison, N.J., a market research firm, and sponsored by the Lupus Foundation of America.

Ankylosing Spondylitis affects the spine and joints of the trunk. Approximately 315,000 Americans have won this lottery. This condition can also be found in conjunction with other diseases mentioned.

Psoriatic Arthritis is a condition that causes pain and swelling insome joints and scaly skin patches on some areas of the body. It is related to psoriasis, a skin condition that causes scaly red patches on the body and for changes in your fingernails and toenails.

Psoriatic arthritis affects about 300,000 people in the United States. It affects men and women of all races. It usually occurs between the ages of 20 and 30, but it can occur at any age. It affects about five to eight percent of people who have psoriasis. So, not everyone who has psoriasis develops psoriatic arthritis.

Usually, psoriatic arthritis is mild and requires little or no treatment. But in some people, the condition can be severe. Whether mild or severe, early diagnosis and treatment can help control the disease and prevent further joint and skin damage.Psoriatic Arthritis (PA) in it's most severe form is rare. About 25 percent of those with the disease will have polyarthritis (my type). It is almost indistinguishable from RA. This particular type does not discriminate between specific types of joints and can include both weight barring joints (hips, knees, ankles) and non weight baring such as wrists, fingers, elbows and toes. The spine can also be involved. It also comes with the addition feature of tendon and ligament involvement.

As you can see, life for those with one of the above or similar disease can be extremely difficult. Arthritic diseases are usually unpredictable. Those who have it rarely know for sure when pain, stiffness, or deformities may occur or what part of the body may be affected (CEMRAC,1986). The effects of this disease are extremely diverse. People with arthritis nearly always experience pain, stiffness, and inflammation. They may also experience higher divorce rates, less ability to maintain gainful employment, and higher rates of sexual dysfunction than those without the disease. (REHAB BRIEF) Other common experiences are sleep disturbance leading to fatigue, high levels of stress (excluding some career choices), depression, and irritability. Low self esteem, learned helplessness, and hopelessness are also associated with the disease. Among those suffering from rheumatoid arthritis, 59 percent cannot maintain gainful employment, 60 percent suffer major family, marital, and sexual changes, and 42 percent suffer a dysthymic or a major depressive disorder (Morrow et al.,1992).

Arthritis is often an invisible disease. This invisibility contributes to adverse social and psychological side effects encountered by many people with arthritis. Friends, co-workers, and the general public may often misperceive an individual with arthritis as faking the symptoms and severity, craving for sympathy and attention, and lacking initiative. Because the symptoms of arthritis range from very mild to extremely severe, everybody seems to know someone with arthritis whose symptoms are relatively minor- and unfair comparisons can be made.

The unpredictable nature of this disease also contributes to misunderstandings of the problems faced by people with arthritis. For example, an individual with arthritis may experience difficulties getting out of a car parked in a "Handicapped" parking space and may have problems walking away from the car. But, because stiffness, aches, and pains can be reduced by walking, this same individual may be able to ambulate like anyone else within 20 feet of the automobile; and this can result in cruel ridicule from the general public.

Although arthritis is frequently thought of as a painful and sometimes disabling condition, the severity of this family of diseases is often underestimated. In the most serious cases, arthritis can lead to bone erosion, slippage of joints, and rupture of tendons. What is little known is that it can also lead to respiratory conditions, infections, gastrointestinal complications, and even death (Dubbert et al.,1990).

But! Lets not end this with a bummer. Arthritics are people just like you and me. The condition is only one part of a person's life. Most people are multi-farious (there are alot of parts to a person). Do not focus on the one trait and ignore the rest of the person. Slap them if you don't like them, but if you do like them. Show it. Rock them, Tell them you love them. Buy them things.

P.S. I was only kidding about slapping them.

Edited by David Jacobson, MSW.