The sooner older people with symptoms of arthritis go to a doctor and are referred to a rheumatologist, the better, Will Sullivan reports.
As baby boomers begin to reach their late 50s, one of the most active generations of older people ever is beginning to feel the struggles of age. Prevalent among common ailments is the painful joint disease arthritis. Although an exact number isn't known, the Arthritis Foundation of Ireland estimates that more than half a million people in the Republic and a majority of over-55s suffer from the disease.
There is currently no cure for arthritis and little is known about why it occurs. Heredity, severe injury and infection can all play a role in the disease's onset. Therefore, myths abound regarding proper recognition of it in the joints and the most effective ways to treat it. Myths are exactly what Dr Eoin Casey, consultant rheumatologist at St James's Hospital and senior lecturer at TCD medical school, will attempt to dispel this Saturday at the Over 50s Show at the RDS, Dublin.
Dr Casey says misconceptions are one of the biggest issues he confronts. "The mere mention of arthritis brings up visions of being horribly crippled but that rarely, if ever, happens, if the disease is treated early."
Early recognition and treatment are among the most important aspects of managing the more than 150 types of arthritis from its outset, he warns, but key among those types are the most common; rheumatoid arthritis and osteoarthritis.
With osteoarthritis, the cartilage covering the bone becomes thin and rough, exposing the bone near the joints underneath. This causes swelling as the membrane which produces fluid around the cartilage becomes inflamed. In most cases, osteoarthritis doesn't cause disfigurement of the joints.
Rheumatoid arthritis, however, can have an explosive effect and can be more serious. This type of arthritis can vary widely, and again causes swelling in the membrane covering the joint, leading to tissue inflammation and irritation of nerve endings. However, rheumatoid arthritis is also systemic meaning it can effect other tissues including the bloodstream, peripheral nerves, small blood vessels, lungs and eyes.
"One of the biggest problems is the loss of energy or terrible lassitude of tiredness," Dr Casey says, "and a terrible morning stiffness that doesn't subside, sometimes, until the end of the day."
Because this swelling is integral to the pain and joint damage associated with arthritis specialists try to treat it with anti-inflammatory drugs, which are not a cure but do abate discomfort and possible further joint damage.
The issue of drugs is sure to confront Dr Casey this weekend. In the wake of the recent withdrawal of the anti-inflammatory drug Vioxx, arthritis sufferers are looking for other methods of treating the disease. Fortunately, he adds, there are many suitable options. Vioxx was enormously successful but was withdrawn after it was linked to heart attacks and strokes.
A Cox-2 inhibitor, Vioxx inhibits an enzyme involved in inflammation while also reducing gastrointestinal discomfort. The newest of the non-steroidal anti-inflammatory drugs, it was widely prescribed in Ireland for short-term treatment. Now it's off the shelves, sufferers of the disease are being advised to consult their doctors. Cox-2 inhibitors were successful mainly because they were much less toxic to the gastrointestinal tract but similar Cox-2 inhibitors other than Vioxx are still available.
The exciting new drugs, according to Dr Casey, are the "biologicals" - biologically engineered drugs that have show success in abating joint damage. They can empower patients to control their own treatment and usually begin by reducing a terrible lack of energy experienced by many sufferers. Four of these drug types are available in Ireland, but he warns they are expensive, require extensive screening before a prescription is given and only work in 60 per cent of patients.
Alternative treatments are also receiving a lot of attention. But Dr Casey recommends that patients trying these treatments should inform their doctor and not ignore the effectiveness of evidence-based medicine. Despite the increasing success of treatments, he stresses the need for early recognition. The first signs of the onset of arthritis are often twinges in the lower back, the knees, and the base of the thumb.
Early referral means people with arthritis can be assessed by an expert rheumatologist, team of nurses, physiotherapists, occupational therapists, etc. And the wet Irish climate? "I have patients that are better than RTÉ at predicting the weather, but it's really only a matter of it heightening sensitivity to the symptoms and is by no means a cause of the disease."
Dr Eoin Casey will speak at noon, this Saturday in the Seniors Health Pavilion at The Over 50s Show, RDS Industries Hall.
Over 50s Show
This Saturday and Sunday, The Over 50s Show, Ireland's only dedicated lifestyle event for older people, runs at the RDS Industries Hall in Dublin.
In its sixth year, The Over 50s Show offers exhibits, displays, demonstrations and a variety of health and lifestyle experts for Ireland's now one million plus people over the age of 50.
Several new features have been added to this year's event including a section focusing on pastimes and hobbies and a health pavilion.
The pavilion is dedicated to all health-related aspects facing people over 50 and features free health checks and screenings, presentations by health experts and more than 20 displays.
Among the speakers this year are: Dr Martin Flynn, GP, on heart disease; Dr Eoin Casey, consultant rheumatologist on arthritis; Dr Pat Manning, consultant respiratory physician, on coughing and shortness of breath; Dr Ronan Curtain on diabetes; and Paula Mee of RTÉ's Health Squad on nutrition and older people.
The hobbies and pastimes section includes information and demonstrations on fishing, pottery classes, painting, craftwork/needlework and bowling.
Sponsors providing demonstrations throughout the weekend include the National Council on Ageing and Older People (on governmental and statutory information); Colour Me Beautiful and Beauty Glow (on fashion and beauty); Call Care and the National Safety Council (on safety in the home); and Milltown Institute and the Derrynoid Centre (on further education).
An annual favourite of The Over 50s Show, The Holiday Village, returns and features more than 30 exhibitors providing information on domestic and foreign travel specifically catered towards the older traveller.
Expected to draw more than 12,000 people, The Older 50s Show is open from 10 a.m. to 6 p.m. daily. Tickets at the door for €5. Further details including the schedule of speakers can be found at www.seniortimes.ie