1. Overview of Arthritis Brought to you in collaboration with: 1. Arthritis Foundation Tennessee Chapter 2. Tennessee Department of Health 3. University of Tennessee Extension rev. June 2009

2. 2 Arthritis Defined Arthritis: “inflammation of a joint” Rheumatism: Better term, broad, encompasses all kinds of pain and stiffness in the muscles and joints Most common feature is PAIN Over 120 different types of arthritis NO CURE: Chronic. Why self- management is so important.

3. 3 The Impact of Arthritis The leading cause of disability among American adults One of the most common chronic health problems in the United States Affects people of all ages Affects over 43 million Americans (1 of every 6 adults)

4. 4 Impact of Arthritis (continued) Twice as many women as men have the disease More frequent cause of activity limitations than heart disease, cancer or diabetes Limits activities of over 7 million Americans Causes 39 million doctor visits, and over half- a-million hospitalizations each year Costs the U.S. economy $128 billion a year $81 billion in medical costs

5. 5 Burden of Arthritis in Tennessee 1.5 million adults have arthritis 72% of people with arthritis are less than 65 years of age Almost 26.6% of adults have been diagnosed with some form of arthritis

6. 6 Burden of Arthritis in Tennessee Of those diagnosed: 43% don’t know the type of arthritis they have 55% are not under a physician’s care Source: 2005 Behavioral Risk Factor Surveillance Survey data (Centers for Disease Control and Prevention Survey)

7. 7 Burden of Arthritis in Tennessee More common in Whites (36%) than Blacks (33%) More common in Women (41%) than Men (30%) People with arthritis are more likely to be obese (30%) People with arthritis more likely report days of poor physical health and/or mental health when compared to others

8. Symptoms of Arthritis Swelling in one or more joints Morning stiffness lasting ≥ 30 minutes Persistent joint pain or tenderness Inability to move a joint in a normal way Redness or warmth in a joint Weight loss, fever or weakness Joint pain that can not be explained 8

9. 9 Healthy Joint Anatomy Muscles Joint capsule Tendons Synovial membrane Bone Synovial fluid Cartilage

10. 10 A Joint with Osteoarthritis Muscles Bone spurs Tendons Synovial membrane Bone Synovial fluid Cartilage fragments in fluid Worn away cartilage

11. 11 Joints Most Often Affected Osteoarthritis most often occurs at the ends of the fingers, thumbs, neck, lower back, knees, and hips.

12. 12 Types of Arthritis Osteoarthritis (OA) Rheumatoid Arthritis (RA) Fibromyalgia Syndrome (FMS) Lupus – Systematic Lupus Erythematosus (SLE) Juvenile Rheumatoid Arthritis (JRA)

13. 13 Osteoarthritis (OA): By Far The Most Common Form Also called degenerative joint disease Usually begins after age 45 Causes symptoms in 1 of every 3 individuals over age 60

14. 14 Osteoarthritis (OA): By Far The Most Common Form Caused by breakdown of the joint’s cartilage Bones rub together Joint loses shape and alignment Bone ends thicken Bit of cartilage or bone float in joint space Pain, inflammation and stiffness result

15. 15 Osteoarthritis Risk Factors Age Overweight Joint Injury Muscle weakness Heredity

16. 16 Rheumatoid Arthritis (RA) Affects about 2.1 million Americans, and three time more women than men Caused when the immune system attacks the lining of the joints Can result in severe joint damage and deformity May also cause fatigue, weight loss and other whole-body symptoms

17. 17 Fibromyalgia Syndrome (FMS) Joints not affected Muscles, ligaments and tendons affected Sleep disturbances Over half of people have chronic fatigue

18. 18 Fibromyalgia Syndrome (FMS) Cause is unknown 1990 first defined: Pain and stiffness in many parts of the body for at least 3 months and local tenderness in 11 of 18 specified places 3.7 million in the U.S. – no TN data Good prognosis Exercise and relaxation essential

19. 19 Lupus Rheumatic disease that affects the skin and body tissues – autoimmune disease Possibly organs such as the kidneys, lungs or heart Affects women more than men Primarily a young woman’s disease Affects more African Americans than Caucasians

20. 20 Juvenile Rheumatoid Arthritis Most prevalent form of arthritis in children Produces serious complications in severe cases Causes few problems in very mild cases Symptoms may include joint inflammation, joint damage, altered growth, and joint stiffness

21. Chronic Pain Cycle 21

22. Arthritis Medications Medications are important to your management of pain. When taken properly, medications can reduce pain and increase joint mobility. Medications will not cure arthritis, but they can keep your symptoms under control and make life more comfortable. 22

23. Importance of a Healthy Weight Maintaining a healthy weight is an important key to managing arthritic pain. The less stress (weight) you put on your joints, the less pain you will experience. Increased Muscle Mass=Increased Bone Density=Decreased Body Fat=Healthier Joints=Happier You! 23

24. Importance of Healthy Weight Keys to achieving a healthy weight Move more and eat less! Strive to eat a minimum of 5 servings of fruits and vegetables (2 cups vegetables and 1 ½ cups of fruit) each day. Reduce portion sizes (Healthy Plate Method). Aim to exercise (walk, bike, swim, garden) for 15-30 minutes each day. 24

25. Arthritis Management Programs Arthritis Self-Help Program Arthritis Foundation Exercise Program Arthritis Foundation Tai Chi Program 25

26. Arthritis Self-Help Program The Self-Help program is an in-depth program that gives newly and previously diagnosed individuals with arthritis the knowledge and skills needed to better manage their disease. Led by UT Extension Educators certified by the Arthritis Foundation. 26

27. Arthritis Self-Help Program The Arthritis Foundation Self-Help Program is designed to: Identify and teach you the latest pain management techniques Help you develop your own individualized exercise program Help you learn to manage fatigue and stress more effectively 27

28. Arthritis Self-Help Program The Arthritis Foundation Self-Help Program is designed to: Discuss the purposes and effective use of medications Help you learn new ways to communicate with family and friends Teach you how to form a partnership with your healthcare team. 28

29. Arthritis Self-Help Program Participants will learn how to: ● Reduce arthritic pain and stress ● Cope with fatigue ● Manage pain ● Use medications wisely ● Benefit from exercise 29

30. Arthritis Foundation Exercise Program The Arthritis Foundation Exercise Program is a 60-minute class held twice a week. It is designed to improve endurance and joint motion. The low-impact program offers 2 types of classes – Basic and Advanced. 30

31. Arthritis Foundation Exercise Program Program benefits include: ● Joint stiffness relief ● Decreased arthritic pain ● Decreased depression ● Increased energy ● Increased flexibility ● Better, more relaxed sleep ● Increased functional ability 31

32. Arthritis Foundation Tai Chi Program Led by Extension Educators certified by the Arthritis Foundation Tai Chi Instructor program The Arthritis Foundation Exercise Program is a 60-minute class held twice a week Appropriate for individuals with mild to moderate arthritis 32

33. Arthritis Foundation Tai Chi Program Program benefits include: ● Decreased pain and stiffness in joints ● Improved daily physical functioning ● Improved balance leading to decrease in falling ● Improved abdominal muscle strength ● Increased confidence in one’s ability to exercise 33

34. Monitoring Your Progress Exercise 34

35. Rating of Perceived Pain Scale 35

36. Monitoring Your Progress Self-Help 36

37. 37 Discussion Questions