SUNDAY, Sept. 15, 2002 (HealthDayNews) -- If you had seen Aida Turturro smiling like a movie star at the premiere of "The Sopranos" fourth season at Radio City Music Hall last week, you wouldn't have been able to tell she was in pain.
Turturro, who plays Tony Soprano's conniving sister, Janice, on the HBO series, has suffered from rheumatoid arthritis since she was a child.
The much-anticipated series opener airs tonight.
The 40-year-old actress is making public her battle with the disease as the spokeswoman for "Joint Effort Against Arthritis," an arthritis awareness campaign sponsored by the Arthritis Foundation and Centocor, a company that makes a well-known arthritis drug.
"When you're in the public eye, people relate to you. They want to hear what you have to say," Turturro notes. "I can help people by saying 'I have it too. You're not the only one out there.'"
Rheumatoid arthritis is a painful, chronic disease that causes inflammation of the joints, most often in the hands, feet, wrists and neck. Doctors don't know the cause of the disease, but they do know that the immune system attacks the lining of the joints.
"What we don't know is why the immune system would choose to do that," says Dr. John Klippel, medical director of the Arthritis Foundation in Atlanta.
Over time, the inflammation can damage nearby cartilage, bone, tendons and ligaments, leading to permanent deformity and disability.
An estimated 1.2 million people in the United States have rheumatoid arthritis. Unlike the many other types of arthritis, rheumatoid arthritis mainly strikes women between the ages of 20 and 45.
Early symptoms include fatigue and fever. As the disease progresses, joints become swollen, inflamed, painful and stiff.
"Rheumatoid arthritis for most people is a chronic, lifelong progressive illness," Klippel says. "Once it develops, the odds are that person will have to deal with it for the rest of their lives."
Turturro was 12 when she had her first flare-up. She was at the beach with her family. She tried to walk down to the water, but she felt like the stones on the beach were piercing her soles.
"I was crying and my father had to carry me," Turturro recalls. "When I went to school, just getting up out of bed really hurt me."
Her parents took her to the doctor. When she heard the diagnosis arthritis, Turturro, then a teenager, didn't take it seriously. Though she suffered flare-ups throughout her teens and 20s -- including one so bad she was hospitalized -- she says she still did her best to ignore it.
It wasn't until her 30s that she got serious about seeking treatments -- and figuring out how to help herself. As she aged, the pain and the fatigue worsened. It got harder to pretend nothing was wrong.
"I have pain all the time," she says. "You get up. You can't walk. Your feet hurt. You have pain at night. It's constant."
For Turturro, like many people with rheumatoid arthritis, mornings are often the worst part of the day. Joint pain also makes it hard to sleep.
"Now I'm getting older, I'm a little more tired and hurting a little bit more," she says. "I'm just beginning to learn about it and help myself."
However, Turturro is hesitant to complain too much about her pain. She acknowledges that there are many others with the disease who are in worse shape than she is.
Even if her feet, hips, knees and hands are aching, she still manages to get through her scenes and continue her career in acting.
Many others become so disabled by arthritis they're homebound. The American College of Rheumatology estimates that 33 percent of people with rheumatoid arthritis stop working within five years of diagnosis and 50 percent stop within 10 years.
"There are people who can't pick up their grandchildren, people who can't work, people who can't button their blouse in the morning," she says. "People don't realize how serious rheumatoid arthritis is and how bad it can get."
A little understood complication of arthritis is higher rates of heart disease, Klippel adds. Doctors aren't precisely sure why this occurs, but inflammation of the arteries is known to contribute to atherosclerosis. The chronic inflammation of arthritis could be linked, he says.
Lifestyle factors may also play a role. When it hurts to move, it's hard to get enough exercise, he says.
The good news is there are many ways to relieve rheumatoid arthritis at least somewhat, from lifestyle changes to medications that decrease the swelling, Klippel says.
In the last few years, Turturro began to watch her diet, exercise more and make sure she gets enough rest. She takes Remicade, a prescription drug, and has regular appointments with her rheumatologist.
"You learn as an actor to not show you're in pain," she says. "That's what I do. I act."
What To Do
The Arthritis Foundation has tips on taking care of rheumatoid arthritis. Or read about the causes of rheumatoid arthritis.
