Trouble in the Joints

New Zealand Listener, Volume 31, Issue 785, 6 August 1954, Page 15

Trouble in the Joints

~-> oa~ o This is the text of a talk on health broadcast recently from ZB. YA and

YZ stations of the NZBS

by DR.

H.

B.

TURBOTT

, Deputy Director-

General of Health

matic diseases bring more pain to more people than any other chronic disease. We suffer greatly from these in New Zealand. We can hardly take comfort from knowing that the whole world so suffers. In U.S.A. more than 10 million have "arthritis" or "rheumatism," of whom more than one million are permanently disabled. Denmark pays some nine million pounds annually for treatments, loss of earnings, and disablement benefits. Sweden has 80,000 to 100,000 people incapacitated each day. Two of the culprits are rheumatoid arthritis and osteo-arthritis. Rheumatoid arthritis is the cruellest of the whole family of rheumatic afflictions. It is a chronic disease that often lasts a lifetime, that is of unknown cause, and that proves very difficult to stop or cure. Any age can be attacked, but rheumatoid arthritis favours beginning between the ages 18 and 45. The usual story is one of pain in fingers or toes, followed by stiffness or swelling of the joints. From fingers it may move to wrists and shoulders, from toes to knees. Slowly, insidiously, other joints are attaéked. The whole body is affected, although attention is rather fixed on the pain and stiffness in joints. You really must take it seriously if you have a joint that bothers you in this way, if it is coupled with this kind of upset-appetite failing, sleeping poorly, feeling unduly tired, sweating, looking pale, and losing a bit of weight. Now don’t get mixed up with that other crippler, osteo-arthritis. A jointtroubler, too! In time most of us get a touch of this, after 50 years of age. A few progress to real bother, but this disease sticks to the joints, usually the big weight-bearing ones. It doesn’t upset the body generally. If, then, you have a hip or knee that’s stiffening and painful, but otherwise you’re O.K.-weight keeping up, appetite and sleep reasonable, colour good-you are in trouble, J mai troubles, and the rheu-

but in historic company. Dinosaurs had this osteo-arthritis over 200 illion years ago, Egyptian mummies, and prehistoric American Indians, too! An X-ray picture clinches the diagnosis, and the doctor will advise how to avoid strain and weight bearing, and so minimise crippling. With rheumatoid-arthritis, it’s a different story. This is a general disease affecting the whole body, not only your joints. Until this general disease burns itself out, as it does in time, resting the whole body helps. Splints may have to be worn so that joints do not get into wrong positions while the disease is active. Without this precaution, cruel crippling can occur. The inflamed joints are forced to rest in the best position. There’s less disease activity at rest, and joints are often freer and less stiff, although splinted. When the inflammation is over, the muscles have to be toned up with exercises. All the while, weight must be kept up or the loss stopped and regained. Protein foodsmeat, fish, eggs, milk and cheese-and fruit-freely help in the fight, and the diet should feature these. The paleness or anaemia that comes with this disease may need iron and blood transfusions at times. What destroys the red blood cells is unknown. Radio-isotope studies in U.S.A. are tagging the red cells to try and reveal the mechanism of damage, and so point the way to effective treatment. Cortisone and ACTH have been overboomed in treatment. They suppress the activity in some cases, but do not cure the disease. For a while there’s a sense of well-being, but this goes if the drugs are stopped. In certain picked cases, cortisone is very useful. But the body can’t stand too much of this drug. Side effects develop. Picking those cases that will benefit is a rheumatism specialist’s job. ‘ I’ve tried to show how serious is the disease, rheumatoid arthritis. Early treatment gives best hope of arrest and of avoiding crippling. Be suspicious,

then, should you develop a joint stiff, sore and swollen, that is coupled with being generally below par-energy, appetite, sleeping, and weight affected! Take your suspicions to your doctor. If he confirms them, ask him to refer you to a colleague who specialises or is particularly interested in rheumatic disorders. There is a _ hospital, the Queen Elizabeth Hospital at Rotorua, especially for rheumatic diseases. A great deal can be done-but only if you act at the first stiffness and swelling.