Arthritis For Dummies. Barry Fox

Чтение книги онлайн.

       About 26 percent of the female population have been diagnosed with some kind of arthritis compared to 19.1 percent of males.Some 16 million women are currently affected by osteoarthritis, a disease that strikes nearly twice as many females as males. Additionally, women are 40 percent more likely to develop knee osteoarthritis and 10 percent more likely to develop hip arthritis compared to men.Three times as many women as men develop rheumatorid arthritis, a disease in which the immune system attacks joint linings causing pain and disability.Females make up about 80 percent of those diagnosed with lupus.

       About 90 percent of those with Sjögren’s are female.

       Of an estimated 5 million U.S. adults with fibromyalgia, only about 10 percent are men.

       Girls are generally more than twice as likely as boys to develop juvenile idiopathic arthritis.

       Hormones: During the menstrual cycle, rising hormone levels promote the loosening of the ligaments (joint laxity), which allows them to bend more than usual. While this might seem great for dancers and gymnasts who need to be super flexible, it increases instability in the joints that can contribute to injuries that could lead to osteoarthritis. This may be the reason that female athletes (but not male) can be two to eight times more likely to suffer from ACL injuries in the knee, which increases their likelihood of developing knee osteoarthritis up to six times.Joint pain can also appear or worsen during and after menopause, a time when estrogen levels drop significantly. Estrogen helps protect the cartilage that cushions the joints and also tamps down inflammation of the joints. But these protective effects diminish after menopause, which increases the risk of developing OA.

       Differences in the Musculoskeletal System: Because the female body is designed to give birth, there is increased elasticity in the tendons in the body’s lower half, causing joint laxity which makes the joints in this area more likely to become unstable. In addition, because women’s hip joints are set wider than their knee joints, the femur is aligned at an angle from hip to knee, making the knee less stable and injuries more likely. Both of these causes of joint instability can contribute to OA.Giving birth also increases joint laxity to accommodate the birth process, but the joints may not return to normal afterwards. One study found that for each birth a woman’s risk of needing a knee replacement increased by 8 percent, while the need for a hip replacement increased by 2 percent.

       Gaining Too Much Weight: According to the Center for Disease Control and Prevention (CDC), in 2017–2018, 41.9 percent of U.S. women were obese, as were 43 percent of U.S. men. However, severe obesity affected 11.5% of women compared to just 6.9% of men, making women even more likely than men to develop arthritis. While doctors have long known there’s a clear connection between obesity and OA, it can also contribute to or worsen RA, psoriatic arthritis, ankylosing spondylitis, gout, and other inflammatory forms of arthritis. Fortunately, just losing a few pounds can not only ease arthritis pain but also improve joint function and increase the quality of life for most arthritis sufferers.Women aren’t the only ones who are especially prone to developing arthritis and arthritis-related problems. Compared to Causasians, African Americans are twice as likely to have knee OA and 77 percent more likely to develop a condition called multiple large joint OA in their knees and spine. Multiple large joint OA, a disorder that affects more than 27 million American adults, may require joint replacement surgery to ease pain and restore joint function. African American women are also three times more likely than Caucasian women to develop lupus and fibromyalgia, conditions that already target women far more often than men.

       Analgesics: Analgesics are designed specifically to relieve pain, and include acetaminophen (Tylenol) and opioids (narcotics). Sometimes acetaminophen is combined with an opioid, such as codeine. The analgesics differ from anti-inflammatory drugs (such as NSAIDs) in that they do not interfere with the inflammation process, which makes them easier on the stomach and less likely to cause gastrointestinal bleeding.

       Biologics: The biologics treat specific kinds of autoimmune arthritis (like RA) by turning off certain components of the immune system called cytokines. The cytokines play an especially important part in the inflammation seen in RA, and biologics inhibit their inflammatory action. Enbrel, Humira, Remicade, and Kineret are examples of drugs that fall into the category of biologics.

       Disease modifying antirheumatic drugs (DMARDs): The DMARDs are used to treat autoimmune forms of arthritis (like RA, psoriatic arthritis). DMARDs change the way the immune system works, slowing or stopping its attack on the body. Drugs like sulfasalazine, methotrexate, leflunomide, and hydroxychloroquine fall into this category.

       Nonsteroidal anti-inflammatory drugs (NSAIDs): The NSAIDs help relieve pain and reduce inflammation by interfering with an enzyme called COX (cyclooxygenase). The enzyme takes two forms: COX-1 and COX-2. Older, traditional forms of NSAIDs (including aspirin, ibuprofen, and naproxen) block both forms of the COX enzyme, but newer ones (such as Celebrex) block COX-2 only, as COX-1 has been shown to have a protective effect on the stomach lining. Milder versions (aspirin, ibuprofen) are available over the counter, but the more powerful ones (Indocin, Lodine, Celebrex) require a prescription, especially at higher doses.

       Steroids: Also known as corticosteroids, these are man-made versions of naturally-occurring hormones in the body that help quell inflammation. Although they function as powerful anti-inflammatories, they can also have powerful side effects, including elevated blood pressure, thinning of the bones and skin, weight gain, and an increased risk of infection, even when they are injected directly into the joint.