With its prevalence on the rise in Australia, is arthritis on your radar?

Arthritis is the term given to a group of inflammatory conditions affecting the body’s joints. In varying ways, these conditions damage the articulations, causing considerable pain, stiffness and discomfort.

Though many people live with arthritis, it should not prevent individuals from enjoying a happy and productive life. Arthritis can be managed well through a combination of working closely with a healthcare team and making positive lifestyle changes (Better Health Channel 2018a).

If mismanaged, however, arthritis can cause an individual to withdraw from social, community and professional activities (AIHW 2020a).

How Prevalent is Arthritis in Australia?

An estimated 3,600,000 million Australians (15%) have arthritis, with this number expected to increase to 5,400,000 by 2030 (AIHW 2020a; Arthritis Australia 2017a).

Rising rates of arthritis have been previously attributed to longer life expectancies and rising obesity rates, but further research indicates there are other factors to consider, such as: living sedentary lifestyles (and more broadly engaging in less physical activity), smoking cigarettes and Vitamin D deficiencies (Medscape 2019; Mohney 2017).

Arthritis in Numbers

• Arthritis is the second most common cause of early retirement
• Half of Australians with arthritis report moderate to severe pain
• 1 in 10 people with arthritis report their (overall) health as poor
• It’s crucial to remember arthritis doesn’t discriminate - it affects people of all ages, backgrounds and lifestyles.

(Arthritis Australia 2017a; AIHW 2020a)

Types of Arthritis

There are over 100 types of arthritis.. Each type affects the joints in different ways and the degree of pain will vary between patients.

Some forms of arthritis can also involve parts of the body you might not expect, such as the eyes. The most frequently diagnosed forms of arthritis are:

• Osteoarthritis
• Rheumatoid arthritis
• Gout
• Ankylosing spondylitis.

(Arthritis Australia 2017b)

Osteoarthritis

Perhaps the most recognised form of arthritis, osteoarthritis, is a chronic condition characterised by the deterioration of cartilage that overlies the ends of bones in joints (AIHW 2020a).

Roughly 2.2 million Australians (9.3%) have osteoarthritis (AIHW 2020a).

Rheumatoid Arthritis

Rheumatoid arthritis is a systemic autoimmune disease in which the body’s immune system attacks its own tissues.

About 456,000 Australians (1.9%) are reported to have rheumatoid arthritis (AIHW 2020a).

Women represent a higher proportion of cases of both osteoarthritis and rheumatoid arthritis (AIHW 2020a).

Gout

Read: Gaining an Understanding of Gout

Gout is a form of arthritis caused by excess uric acid in the bloodstream. Uric acid, which is a normal waste product, builds up in the bloodstream and forms urate crystals in a joint - resulting in inflammation.

About 4.5% of Australians are estimated to have gout (AIHW 2023b).

Ankylosing Spondylitis

Ankylosing spondylitis (ankylosing is stiffening or joining together and spondylitis is the inflammation of the vertebrae) is a chronic immune-mediated inflammatory arthritis that exists within the group of spondyloarthritis (Garcia-Montoya et al. 2018).

It primarily affects the spine and neck. The joints of the neck, back and pelvis become inflamed, causing pain and stiffness.

Ankylosing spondylitis affects about 1-2% of Australians (Arthritis Australia 2016).

Common Symptoms of Arthritis

Arthritis affects each person differently and symptoms are dependant on the type of arthritis, but those that are generally cited include:

• Acute or general pain
• Stiffness and/or reduced movement of a joint
• Swelling in a joint
• Redness and warmth around a joint
• General symptoms including tiredness, malaise and weight loss.

(Arthritis Australia 2017b)

Diagnosis of Arthritis

In order to be able to diagnose a particular type of arthritis, multiple exams and tests are recommended, including:

• A physical examination to search for redness and swelling in and around the joint, as well as to assess the range of movement of the joints.
• A detailed medical history examining symptoms, family history and other health problems.
• Scans and tests, including blood tests and scans such as x-rays, ultrasound, computed tomography and/or MRI.
• Referral to a specialist, usually a rheumatologist, for both diagnosis and specialised management of the condition.

(Better Health 2018a)

How to Help Patients Manage Pain

Arguably the most difficult part of living with arthritis is dealing with the (possibly daily) pain that ensues.

The causes of pain may include but are not limited to:

• Inflammation, heat and swelling in joints
• Impairment to the joints
• Muscle tension, from painful movements in joints
• In some conditions, such as fibromyalgia, the cause of the pain is not fully understood.

(Arthritis Australia 2017c)

There is a range of options available for patients experiencing pain. They include:

• Medicines
• Exercise
• The application of heat and cold
• Massage
• Acupuncture
• Transcutaneous electrical nerve stimulation
• Mind techniques such as mindfulness and meditation.

(Arthritis Australia 2017c)

Medical Management of Arthritis

There is a range of medical intervention options for people living with arthritis, including:

• Medicines: A range of medications are available depending on the condition
• Engaging with healthcare teams such as general practitioners, specialists (such as rheumatologists or orthopaedic surgeons) and allied health professionals
• Blood examinations: Blood tests can confirm a diagnosis, monitor disease severity and reaction to treatment, and help to reveal side-effects from other medicines
• Surgery: There are different types of surgery available, including:
  • Surgery that fuses bones together
  • Key-hole surgery
  • Osteotomy - repositioning or cutting a bone
  • Resection - removal of part of the bone or joint
  • Joint replacement.

(Arthritis Australia 2017d)

How Can You Help Someone Living with Arthritis?

Encourage your patients to research and understand their particular type of arthritis. This will empower them with a sense of control and will give them a better sense of their treatment options (Arthritis Australia 2017e).

Patients are encouraged to seek treatment advice immediately, as the condition may worsen in time. Early diagnosis and treatment are crucial (Arthritis Australia 2017e).

A sedentary lifestyle will negatively affect those living with arthritis - regular, low-impact exercise is often prescribed as it is recognised as one of the most effective treatments for arthritis. Obviously, not all forms of exercise will be suitable, so an exercise plan will need to be carefully formulated and tailored to the individual (Arthritis Australia 2017e).

Encourage patients to acknowledge and express their feelings - it’s likely that they will experience a mix of emotions including fear, anger and frustration - this is normal. It may be worth encouraging patients to seek counselling in order to talk about and process their emotions (Arthritis Australia 2017e).