The Bad Back Guy’s Ultimate Bad Back Strategies: Understanding Rheumatoid Arthritis and Osteoarthritis

by coachz on April 14, 2009

How to Distinguish Between Rheumatoid Arthritis and Osteoarthritis: Ultimate Bad Back Strategies for Dealing with Chronic Pain Associated with RA and OA

Introduction

The previous two articles in this series analyzed and discussed rheumatoid arthritis (RA) in some detail. The link between chronic pain and RA was analyzed and the progression of the RA chronic pain complex was revealed. Particular attention was paid to small joint pain, usually involving the neck, hands, and feet in the early stages of the disorder, then spreading as the disease takes hold and progresses. The progression of chronic, often acute pain affecting the larger joints, to include the upper, middle, and lower back, hip and knee pain, and even leg pain, usually expressed as sciatica, was discussed. As discussed in “Understanding Rheumatoid Arthritis – Dealing With Chronic Pain Associated With RA Part I & II,” RA is a chronic and systemic disorder, widespread throughout the body, and without cure. In this article we will discuss the differences between rheumatoid arthritis (RA) and an often misdiagnosed, misunderstood “cousin,” osteoarthritis (OA). We will discuss diagnostic features distinguishing the two disorders, the symptoms of RA versus OA, and some treatment variations and similarities. The very different outcomes, or prognoses, as well as certain strategies for confronting the two conditions head on will also be explored. Finally, strategies for alleviating, and in some cases eliminating, the chronic pain associated with rheumatoid arthritis and osteoarthritis will be offered. Chronic pain treatment strategies, to include treatment for neck pain, back pain, hip and knee pain, and sciatica, will be compared and analyzed.

RA Revisited

As noted above, rheumatoid arthritis is a chronic, systemic disorder. Rheumatoid arthritis is an autoimmune disease occurring when the individual’s immune system doesn’t work properly or malfunctions. Rheumatoid arthritis causes chronic, often acute pain, stiffness and swelling, and progresses from small joint involvement, to large joint involvement, and ultimately to multiple organ consequences. Chronic pain associated with RA is usually the result of an inflammation of the synovial membrane, synovitis. The inflammation of the synovial membrane leads to friction, the friction leads to joint degeneration, which leads to more inflammation, which leads to more friction and joint degeneration. As the disease progresses, and begins to affect other organ systems, the result is usually total disability. The exact cause of rheumatoid arthritis has not been established. Many experts believe that RA may be the result of genetics, environment, and/or a number of other factors to include hormones and the body’s reaction or response to stress. Onset of RA typically occurs in women between the ages of 30 and 50 years of age. However, rheumatoid arthritis has been known to strike the very young, men, and certain ethnic groups, to include a disproportionately high number of Native Americans. RA is also seen in higher numbers among smokers. Rheumatoid arthritis is generally not attributed to such things as aging, trauma and injury or obesity. Beginning with small joint pain and stiffness, the disorder culminates in deformity and chronic, often acute, back pain, hip and knee pain, and sciatica.

What is Osteoarthritis?

Osteoarthritis (OA) is generally considered an age-progressive phenomenon. Sometimes called the “wear and tear” disorder, OA may also be attributed to injury, trauma, stress, and/or obesity. Osteoarthritis typically expresses with joint pain, stiffness, and loss of function and did decrease in the range of motion. Unlike rheumatoid arthritis, osteoarthritis generally affects weight bearing joints, particularly the spine, the pelvis or hips, and the knees. Chronic back pain, particularly of the lower back, and leg pain (sciatica) are quite common. However, OA may also be present in the neck, the hands, particularly the finger joints, and even the big toe. Osteoarthritis generally worsens later in the day or after considerable activity. Alternately, rheumatoid arthritis is generally known for morning stiffness or stiffness occurring as the result of a lack of activity or after periods of prolonged inactivity.

Demographics of RA vs OA

Significantly, while as many as 1.5 million individuals in the United States have been diagnosed with rheumatoid arthritis, over 20 million people have been diagnosed with osteoarthritis. While diagnosis for osteoarthritis is usually established with the use of x-rays, in some cases CAT scans, rheumatoid arthritis usually takes a more comprehensive battery of diagnostic tests to properly diagnose. RA sufferers may require extensive blood tests, x-rays, CAT scans, and in some cases even an MRI to properly diagnose the disorder. The very different symptoms of the two disorders, one systemic and the other a “wear and tear” disorder, are evident in the laboratory and radiographically (x-rays).

Similarities in Treatment of Rheumatoid Arthritis and Osteoarthritis

Treatment strategies for RA and OA are often remarkably similar. Although RA requires pharmacological intervention, generally in the form of disease-modifying anti-rheumatic drugs or DMARDs, to reduce stiffness and chronic pain, as well to inhibit joint damage, this should not be the only treatment strategy employed. DMARDs often take weeks, even months to build up in the bloodstream and fully take effect, so NSAIDs are often used synergistically, and as a stop-gap until DMARDs are effective. Osteoarthritis, on the other hand, may also be treated by NSAIDs. However, ibuprofen and acetaminophen are routinely prescribed for pain associated with osteoarthritis.

Treatment and Treatment Responses of RA and OA

In addition to medication, both rheumatoid arthritis and osteoarthritis are responsive to physical therapy and ice to reduce inflammation and swelling. Individuals suffering from RA or OA typically respond well to exercise. Exercise is particularly effective for RA sufferers in order to offset periods of inactivity and the stiffness associated with a sedentary lifestyle or simply the stiffness related to characteristic morning stiffness. Osteoarthritis, on the other hand, responds well to exercise for different reasons. Individuals affected by OA, a typically age-progressive, trauma, and stress related phenomenon, respond quite well to strengthening of the musculoskeletal system, particularly the core muscles responsible for posture and overall strength. As muscles atrophy, deterioration of the bones, particularly the vertebrae and weight-bearing joints, is quite common, leading to “wear and tear” and an exacerbation of the overall condition and subsequent degeneration. The degeneration leads to a constellation of chronic pain symptoms, to include neck pain, back pain, and sciatica.

The Consequences of Doing Nothing!

Ultimately, while etiology or cause of rheumatoid arthritis and osteoarthritis are quite different, symptoms, such as swelling, inflammation, stiffness, and chronic pain are characteristic of both conditions. Individuals suffering from RA and OA are affected by a progressive disorder, both leading to total disability if not properly treated. Individuals diagnosed with osteoarthritis, because of the very nature of the disorder, have a much better chance of alleviating and even eliminating the long-term effects. RA is, by its very nature, more problematic. That being said, individuals suffering from rheumatoid arthritis may take control of the outcome, their prognosis, by engaging in an aggressive, holistic treatment strategy, one typically designed to treat the symptoms, since etiology is still unclear. In both instances, medication, ice for inflammation, swelling, and to reduce pain, and a medically approved, individualized program of stretching and exercise should be commenced as soon as possible. Chronic pain associated with both conditions should be taken as a warning to do something, rather than to do nothing. To do nothing will exacerbate either condition, leading to further degeneration and the progression of both disorders and their symptoms, to include chronic pain in the form of joint pain, neck pain, back pain, and/or sciatica.

Rheumatoid Arthritis and Osteoarthritis Treatment Strategies and Solutions(continued tomorrow)!

These are some of the programs I recommend. I hope they help you as much as they helped me!

1) http://www.TheBackPainGuy.info

2) http://www.HowToStopSciatica.com

Although labeled “How To Stop Sciatica” the above mentioned program is great for all aspects of the back pain complex, to include RA, as they all are!

3) http://www.HowToStopSciatica.info

Good luck and let me know what you think! Any products on the side panel are super for back problems!

1) Get an ice-compression brace for the times when nothing else works for the pain…it will! I know, see the article and video above!

2) New Balance running shoes, they have awesome heel cushioning that makes such a difference when pain makes you count your steps all day long, just to make it through the day. I too know what it’s like to have to plan your steps all day long, just to make it through the day!

3) WalkFit Orthotics for the days when you can’t wear your New Balance but need cushioning and support. These really help!

4) Bone & Joint Natural Pain Reliever. They really helped me when nothing else did! I was amazed because I have never bought into the whole natural thing…but they work. They build up in your system and then, all of the sudden, you realize the pain isn’t as bad as it once was!

5) And others on the side panel, all good and all safe! All of the products are top-notch and help! The canes, walkers, and scooters, and I’ve used all of them at one time or another, are from the best suppliers I could find, and I did my research!

See these blogs and lenses too:

http://www.TheBadBackGuy.com

http://www.squidoo.com/TheBadBackGuy

Professor John P. J. Zajaros, Sr., The Bad Back Guy
216-712-6526
Skype: johnzajaros1
johnz@TheBadBackGuy.com

I hold degrees in history and anthropology. Graduating summa cum laude, I was awarded a doctoral fellowship to study for my PhD as a fellow at one of the nations top consortiums for physical anthropology, made up of Columbia University, NYU, CUNY, the American Museum of Natural History (AMNH), and others. I commenced my doctoral studies. Researching the spine and sacroiliac joint, reviewing and categorizing more than 15,000 modern and pre-Columbian skeletons to understand the age-progressive phenomena affecting humans as we grow older, and having had 14 major surgeries on my spine, I am in a unique position to understand the “back pain complex” as few others can, from the perspective of patient and scientist/researcher. I hope my articles help you better understand your “bad back/back pain” issues.

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