DISABILITIES

By Daniel J. Vance

  I first learned of the discomfort of osteoarthritis from my Grandmother Vance.

  Osteoarthritis affects the quality of life of roughly 21 million Americans, particularly women over age 45. It occurs when joint cartilage breaks down, causing certain bones to grate on each other. The breakdown is like that of a car engine losing lubrication. The upshot is loss of movement, stiffness, and for millions of elderly Americans with the most serious symptoms a mobility-related disability requiring a walker, cane or wheelchair.

  It's by far the most common of the hundred or so varieties of arthritis. "Osteoarthritis most often is in the knees or hips, but it's not unusual to see it in the back, hands or feet," said Dr. Hayes Wilson, a medical advisor of the Atlanta-based Arthritis Foundation, a national nonprofit that supports arthritis research, programs, advocacy and services. "[Osteoarthritis] is due to wear and tear, and confines itself to areas that bear weight or those having had trauma." With many elderly persons, the seed for osteoarthritis might have been planted by a serious childhood accident.

  Wilson said the most frequent complaint of an osteoarthritic person is a 15-30 minute daily period of morning stiffness. Besides age and gender, genetics and obesity are risk factors. Half of the nation's total hip replacements and 85 percent of its total knee replacements are due to the diseaseThere is no known cure.

  "In order to find a cure for osteoarthritis, researchers first have to know what causes it," Wilson said. "We know trauma and genetics contribute. But we also need to better understand cartilage and cartilage metabolism, the body's response to injury, and the body's healing ability. At present [due to not finding a cause] we're limited to trying to understand and alter the inflammatory response." He explained that researchers currently are looking at cells, proteins and enzymes involved in that response, and trying to discover ways to "turn off" inflammation.

  One last note: you should have a doctor pin down your specific type of arthritis. Wilson said, "Different medicines work better for different types of arthritis, and also the arthritis that goes along with lupus looks like any other. Lupus can cause kidney problems."

  As for Grandmother Vance, she especially had trouble slicing raw potatoes. But she gritted through it.

  The Arthritis Foundation has free informational brochures, and some are in Spanish. To order online see www.arthritis.org. Also see www.danieljvance.com.