Arthritis

Osteoarthritis
Joint Degeneration

Rheumatoid Arthritis
Inflammed lining
destroying cartilage

Arthritis is too often thought of as a disease that strictly affects older Canadians, and those with a lifetime of wear and tear on their joints. However, arthritis acts through different mechanisms, and there are other characteristics, causes, co-existing conditions, and various treatments.

Osteoarthritis (OA) is a chronic, typically slow- progression disorder causing degeneration of the cartilage and nearby bone, and results in joint pain and stiffness. It affects 10% of Canadians, men and women about equally. OA may have no known cause, or be an outcome of another disease, an infection, injury, or overuse. Of interest is that it disproportionately affects those who repetitively stress their joints (e.g., miners), but long distance runners are at no greater risk. The hip, knee, hand and spine are most commonly affected by osteoarthritis. Treatment is through exercise, physical therapy (often with heat), analgesics, anti-inflammatory drugs, local injection of corticosteroids, and finally, surgery (hip and knee joint replacement).

Rheumatoid Arthritis (RA) is a chronic, progressive autoimmune disease that inflames joints, causing swelling, pain, often disfigurement and eventual destruction of the cartilage, bone, and ligaments. The cause is not known, but heredity appears to be a factor. It is 2-3 times more common in women until the fifth decade of life. RA affects almost 1% of Canadians, usually between ages 30 and 40. Without therapy between 10% and 50% will become disabled and unable to work, and depression is common. Treatment is through rest, anti-inflammatory drugs, gold injections, corticosteroids, methotrexate, and biologic therapies for moderate and severe cases.

While there are many painful facts and figures about arthritis, there is also significant research activity, and enough ‘good news stories’ to give real hope.

In Canada, 16.8% of Canadians reported some kind of arthritis or rheumatism in 2003. Almost 60% of those were under age 65. Between 2006 and 2016, it is estimated 20% more Canadian adults will have arthritis. (SC)
The economic burden of musculoskeletal disease, which includes arthritis, was $16.4 billion in 1998, ranking second. Indirect costs, mostly long-term disability, were five times greater than direct costs, mostly hospitalization. (PHAC)
The prevalence of arthritis is related to obesity, stress, and even smoking (SC), and it appears moderate exercise may even help degenerated joints. (AS)
British researchers have forecast a cure for arthritis in the next decade, based on success in growing human cartilage from stem cells. However, this does not improve the underlying contributing factors such as family history, and being overweight. (AS)
Nearly half of the patients getting hip and knee replacement surgery in 2003-04 were obese, and for knees, almost 90% were either overweight or obese. Provinces with the highest levels of obesity tend to have the highest rates of joint replacement. (CIHI)
A four-year study of almost 500 employed people with OA or RA indicated 40% had taken time off work and 20% had either reduced their hours to part-time, or had changed jobs, to accommodate their condition. About one-third hadn’t told anyone at work about their health because they were afraid it might affect their employment or their relationships. (IWH)
New Canadian benchmarks aim to provide hip and knee replacement surgery within 26 weeks (HC). Public information is much better now, but measurement issues persist.
- In Ontario, half of knee replacements are done within 18 weeks, but it takes 60 weeks until 90% of surgeries are complete. (ON)
- In Alberta, it takes about 61 weeks to complete 90% of knee replacements. There has been a one-month improvement over the last year. (AB)
- In BC, comparable province-wide information is hard to find, but wait times of individual surgeons can be accessed. Wait times are calculated differently than in ON or AB. (BC)

Sources: Facts from Statistics Canada (SC), the Public Health Agency of Canada (PHAC), the Canadian Institute for Health Information (CIHI), the Institute for Work & Health (IWH), the Arthritis Society (AS), Health Canada, and the health ministry websites for BC, AB, and ON.