A Big Picture Look at Arthritis in Australia

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

Arthritis is the term given to a grouping 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. Living with arthritis can be managed well through a combination of working closely with a healthcare team and by making positive lifestyle changes (Better Health 2018).

If mismanaged, however, arthritis can result in an individual withdrawing from social, community and professional activities (AIHW 2018).

How Prevalent is Arthritis in Australia?

An estimated 3.5 million Australians have arthritis – this number has almost doubled since the 1950s and is expected to further increase by 2030. (AIHW 2018; Arthritis Australia 2017)

What is the Cause for Rising Rates of Arthritis?

The rise in arthritis has 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, Everyday Health 2012, Healthline 2019)

Arthritis in Numbers

An estimated 1 in 7 (3.5 million) Australians have arthritis. (Arthritis Australia 2017).

Arthritis is the second most common cause of early retirement (Arthritis Australia 2017).

1 in 2 Australians with arthritis reported moderate to severe pain (AIHW).

1 in 10 people with arthritis reported their (overall) health as poor (AIHW).

It is crucial to remember arthritis does not discriminate, it affects people of all ages, backgrounds and lifestyles.

Types of Arthritis

There are over one hundred 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; and
• Ankylosing spondylitis.

(Arthritis Australia 2017)

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.

Roughly 2.1 million Australians (9.0%) reported having osteoarthritis. (AIHW 2018)

Rheumatoid Arthritis

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

Numbers of up to 405,900 Australians (1.8%) are reported to have rheumatoid arthritis (AIHW 2018).

In both types, women represent a higher proportion of cases (AIHW 2018).

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.

Data from the Australian Bureau of Statistics show that 191,760 Australians (0.8% of the population) live with this condition.

(Arthritis Australia 2017; Better Health 2018; AIHW 2018)

Ankylosing Spondylitis

Ankylosing spondylitis (Ankylosing is stiffening or joining together; 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.

Recent data suggest that ankylosing spondylitis affects one in 200 Australians. (AFP 2013; Austin Health 2019; Garcia-Montoya et al 2018)

Common Symptoms of Arthritis

Arthritis has the potential to impact many different parts of the joint and almost every joint in the body. (Arthritis Australia 2017)

Arthritis can affect each person differently and are dependant on the type of arthritis, but symptoms 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 joints; and
• General symptoms including tiredness, malaise and weight loss.

(Arthritis Australia 2017)

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 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 2018)

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 2017)

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; and
• Mind techniques such as mindfulness and meditation.

(Arthritis Australia 2017)

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:
• This includes 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; and
• Joint replacement.

(Arthritis Australia 2017)

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.

Patients are encouraged to seek treatment advice immediately, as the condition may worsen in time. Early diagnosis and treatment is crucial.

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 of arthritis. Obviously, not all forms of exercise will be suitable, an exercise plan will need to be carefully formulated and tailored to the individual.

Encourage patients to acknowledge and express their feelings – it is 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 to and process their emotions. (Arthritis Australia 2017)

Additional Resources

• 

  Arthritis Australia

  National Strategic Action Plan for Arthritis: an action plan launched by Arthritis Australia in 2019, which outlines key priorities for preventing arthritis, investing in research and improving treatment and support for people living with the condition.

References

• Arthritis Australia 2017, ‘10 Steps for Living Well With Arthritis’, viewed 17 June 2019, https://arthritisaustralia.com.au/managing-arthritis/living-with-arthritis/10-steps-for-living-well-with-arthritis/
• Arthritis Australia 2017, ‘Ankylosing Spondylitis’, viewed 21 June 2019, https://arthritisaustralia.com.au/types-of-arthritis/ankylosing-spondylitis/
• Arthritis Australia 2017, ‘Gout and Diet’, viewed 21 June 2019, https://arthritisaustralia.com.au/managing-arthritis/living-with-arthritis/healthy-eating/gout-and-diet/
• Austin Health 2019 ‘Ankylosing Spondylitis’, viewed 21 June 2019, http://www.austin.org.au/page/2947
• Australian Family Physician 2013, ‘Ankylosing Spondylitis: An Update’, viewed 21 June 2019 https://www.racgp.org.au/afp/2013/november/ankylosing-spondylitis/
• Australian Institute of Health and Welfare 2018, ‘Arthritis Snapshot’, viewed 20 June 2019, https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/arthritis-snapshot/contents/arthritis
• Australian Institute of Health and Welfare 2017, ‘The Burden of Musculoskeletal Conditions in Australia: a Detailed Analysis of the Australian Burden of Disease Study 2011’, viewed 21 June 2019, https://www.aihw.gov.au/reports/burden-of-disease/burden-of-musculoskeletal-conditions-in-austra/contents/summary
• Better Health 2018, ‘Ankylosing Spondylitis’, viewed 21 June 2019, https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/ankylosing-spondylitis
• Better Health 2018, ‘Arthritis Explained’, viewed 18 June 2019, https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/arthritis
• Better Health 2018, ‘Gout’, viewed 21 June 2019, https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/gout
• Everyday Health 2012, ‘Why Cases of Arthritis Are on the Rise’, viewed 21 June 2019, https://www.everydayhealth.com/arthritis/why-more-people-are-living-with-arthritis.aspx
• Garcia-Montoya, L, Gul, H, & Emery, P 2018, ‘Recent advances in ankylosing spondylitis: understanding the disease and management’, F1000Research, 7, F1000 Faculty Rev-1512. doi:10.12688/f1000research.14956.1
• Healthline 2019, ‘Why Have Arthritis Rates Doubled Since World War II?’, viewed 21 June 2019, https://www.healthline.com/health-news/why-have-arthritis-rates-doubled-since-world-war-2#1
• Medscape 2019, ‘Rheumatoid Arthritis Incidence on the Rise in Women’, viewed 21 June 2019, https://www.medscape.com/viewarticle/722944