Joint Returns

As you settle into your chair at your next meeting, look around the room. Chances are that one-third of the group is suffering from chronic joint pain, and another third have pain that affects their ability to work. And most likely the boss has no idea.

More than 34 percent of Minnesotans ages 45 to 64 have been diagnosed with arthritis, according to the Minnesota Department of Health. That may surprise people who believe arthritis typically affects people in their retirement years.

Hard to Spot

One reason arthritis flies under the radar is that it’s hard to know how many people are affected by it, and to what extent they are affected. Tracking medical claims is one way. “Many companies will identify musculoskeletal claims as one of their major cost conditions. About 40 percent of those are probably related to arthritis,” says Dr. Pamela Van Zyl York, the arthritis program director at the Minnesota Department of Health. “When you look at joint replacements, most of those are related to arthritis.”

Another way to track the impact of arthritis is by the use of certain medications. However, “it’s difficult to identify drug costs for osteoarthritis, because much of it is over-the-counter medication,” York says. “We used to be able to identify it by looking for medications such as Celebrex and Vioxx.” (Those are nonsteroidal anti-inflammatory drugs, some of which have been linked to heart attacks and strokes. Vioxx was pulled from the U.S. market in 2004; Celebrex is still sold, but with a strong warning that recommends low doses for as short a time as possible.)

Although there is no cure for arthritis, several activities can mitigate the effects of the disease. “The Arthritis Self-Management Education Program [a collaboration between the Minnesota Department of Health and the Arthritis Foundation] has been shown to decrease physician visits by 40 percent and decrease pain by 20 percent,” York says. The program uses small-group education, problem solving, exercise, and relaxation to help people with arthritis feel better.

Exercise can be a key component of an arthritis management plan. Dr. Jody Hargrove, a rheumatologist with Arthritis and Rheumatology Consultants in Edina, says, “I love warm-water pools for my patients. That’s probably my favorite choice of exercise. The warm water loosens up the soft tissue and gets everything moving.” Aerobic exercise is important, too. “It can release endorphins, [which are] hormones that are good pain relievers,” Hargrove says.

Arthritis is just as mysterious as it is common. More than 100 different types of arthritis can occur in the body’s 230 joints. Typically, the area in and around a joint becomes inflamed, resulting in pain, stiffness, and difficulty in movement. But what causes arthritis is not completely understood.

Affecting 70 percent of the population by the time they reach their 70s, osteoarthritis is the most common form of the disease and is characterized by fraying or damage to the cartilage—the protective substance that cushions joints and keeps bone from rubbing on bone. Rheumatoid arthritis is much less common; only 2 percent of the U.S. population is affected. This type of arthritis can be very painful due to inflammation of the linings of the joints, called synovium.

In 2005, the Minnesota Department of Health published a study on the impact of arthritis in the workplace. “When we talked to employers, most had not considered arthritis as posing a major problem for their workers, or something they needed to be concerned about,” York says. But the health department’s statistics show that medical care and lost productivity due to arthritis cost Minnesotans $2.2 billion per year.