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Arthritis: Many Victims, Not Enough Funding

It's the disease Americans are most likely to get, but advocates say more money is needed for research

SATURDAY, Jan. 12, 2002 (HealthDayNews) -- As the baby boom generation ages, its members may be thinking about their vulnerability to such illnesses as heart disease, diabetes and cancer.

But the odds are good they haven't given much thought to the disease they're most likely to get: arthritis.

Arthritis currently afflicts 43 million Americans, and that number is projected to rise to 60 million over the next 20 years.

"It is a serious problem that is not taken seriously," says Dr. John Klippel, medical director of the Arthritis Foundation.

"A very high percentage of Americans will get arthritis," he says. "Arthritis is becoming one of the more common medical conditions in this country. We've known for a long time that it is the leading cause of disability.

"But I think the general impression for most people is that arthritis simply means aches and pains. And they think of it as something that only affects old people," Klippel says.

Although it's true that the majority of arthritis sufferers are older adults, some forms of the disease -- such as lupus -- strike younger people most often. And more children have juvenile arthritis than have juvenile diabetes.

Arthritis comes in many forms, but the most common is osteoarthritis. That's the variety that attacks cartilage and bones around joints in the body, and it accounts for about half of all arthritis cases.

In osteoarthritis sufferers, the cartilage in their joints becomes damaged and disappears over time. The bone under the cartilage becomes stiff and hard, and there may be growths (called bone spurs) around the margins of the joint.

Scientists still aren't completely certain what causes osteoarthritis, although they have identified some risk factors.

"We know that injury to the joint is a factor," Klippel says. "People in their teens and 20s who injure a knee playing sports, for example, are at a very high risk of getting osteoarthritis."

Aging is another risk factor. Something happens during the aging process that speeds up the destruction of cartilage.

"It is not just the wearing out of cartilage," Klippel says. "It's not like a tire going bald. For reasons we don't understand, the cartilage becomes damaged."

As with so many chronic diseases, obesity also plays a role.

"People who are overweight are at increased risk for developing osteoarthritis, particularly of the knees," Klippel says. "People in their 20s and 30s and 40s should understand that this is just another reason to pay attention to your weight."

Klippel and others at the foundation are hoping to raise public awareness of arthritis and get more government money for research. Despite the high numbers of Americans with arthritis, the Arthritis Foundation operates with far less money than similar organizations devoted to other diseases.

"The American Cancer Society's budget is about $800 million a year. Ours is about $130 million," says Tino Mantella, chief executive officer of the Arthritis Foundation. "The level of support we get from the government is low relative to other diseases."

Mantella hopes to raise money from the private sector as well, pointing out that arthritis costs the nation $80 billion a year in medical expenses and lost productivity.

"We need to convince business and industry that, with the right resources, over time it's going to cost them a lot less to support research than it will cost them from days missed at work and medical expenses from insurance," he says.

Treatment for arthritis starts with basic over-the-counter pain relievers such as acetaminophen (found in Tylenol) and ibuprofen (found in Motrin and Aleve).

For more severe cases, cortisone injections into the joints can be helpful, and the Food and Drug Administration recently approved an artificial joint fluid for use in the knee.

Recent years have seen a surge in advertisements for the supplements glucosamine and chondroitin. Klippel says glucosamine has proven to be effective in relieving arthritis pain, although he says more study is needed to determine the effectiveness of chondroitin.

And as a last resort, patients can opt for knee or hip replacement surgery.

"These have become very common operations," Klippel says. "And they can really restore a person's life. These surgeries are very effective and quite safe."

But the most important step in dealing with arthritis, Klippel says, is the most basic one.

"It's people taking control -- being responsible for your arthritis and not letting it take over your life," he says. "When one is confronted with arthritis, you do have some choices.

"But you have to determine that you're going to do something about it, and not just have the attitude that going to the doctor is a waste of time and you're just going to have to live with it," he adds.

What to Do: Are you at risk for arthritis? Take this online quiz. And find out more about the use of dietary supplements from the Arthritis Foundation.

SOURCES: Interviews with John Klippel, M.D., medical director of the Arthritis Foundation, and Tino Mantella, chief executive officer, Arthritis Foundation, Atlanta
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