10 things you didn't know about arthritis

Arthritis literally means "inflammation of a joint" -- and if you've ever experienced its painful symptoms, you're not alone. An estimated 50 million American adults have arthritis, and it's the number-one cause of disability in the U.S., according to the Centers for Disease Control and Prevention. From the best treatments and natural remedies to safe exercise and pain-reducing foods, arming yourself with knowledge is key to warding off aches.

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When you think of arthritis, you might picture stiff, sore seniors, but the truth is, arthritis can affect women at any age, including during childhood. In fact, nearly 60% of people diagnosed are under age 65. Osteoarthritis, one of the most common types, typically affects people over 40, but it can happen sooner, especially if you've had a joint injury. Another common form, rheumatoid arthritis, is an autoimmune condition that launches a full-body attack, and it can strike as early as your 20s and 30s.

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There are more than 100 different types of arthritis, but osteoarthritis is the most common, affecting nearly 27 million Americans, almost 60% of whom are women.

In osteoarthritis, cartilage -- the slippery tissue that protects the ends of your bones in the joint -- gradually wears down. You might notice that your knees feel achier than usual after you work out, or that you feel stiff and old lady-ish when you climb out of bed in the morning. No one knows exactly what causes this cartilage breakdown, but a combination of factors like aging, joint injuries, genetic tendencies, and obesity are all thought to play a role, according to the Mayo Clinic.

Rheumatoid arthritis (RA) occurs when antibodies in the immune system -- which normally work to fend off germs -- attack the lining of your joints, causing pain, swelling, and warmth, and limiting your mobility. Research shows that the number of women with RA is on the rise. A Mayo Clinic study in 2010 found that the rate of RA in women over the age of 18 increased 30% between 1995 and 2007. The study suggests that the number of Americans with RA may be closer to 1.5 million, not the oft-cited 1.3 million.

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Carrying around extra pounds increases stress on the joints, which may lead to arthritis of the knees. The good news is, you don't have to lose a lot to make a difference. When you walk, your knees absorb a force equal to about 3 times your body weight. So losing just 10 pounds actually relieves each knee of about a 30-pound load with every stride you take.

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The first stages of osteoarthritis may be silent; mild cartilage damage typically has no symptoms. Arthritis is most likely to show up in hands and weight-bearing joints, including the knees, hips, spine, lower back, neck, and end joints of the fingers. But it's only when there is significant cartilage loss that you'll notice real pain and loss of joint function.

It isn't always easy to distinguish RA from osteoarthritis. Both cause stiff, achy joints and morning stiffness. In OA, the stiffness goes away after 15 to 20 minutes and worsens with activity. But in RA, the stiffness lasts longer, can linger for hours, and improves with activity.

Unlike OA, which affects primarily the hips and knees, RA tends to attack the hands and feet. If you have RA, your painful joints will be red and warm. RA may cause fever and flulike symptoms, too. RA tends to alternate between periods of remission (when you have no or few symptoms) and flares (when the disease is active).

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If you're diagnosed with arthritis, exercise will likely be an important part of your feel-better plan. If you want to reduce pain, take fewer medications, improve your flexibility, and avoid joint replacement surgery, you have to exercise, says Justus J. Fiechtner, MD, MPH, an internist in private practice in Lansing, MI. "Medications may take away arthritis pain, but if you don't exercise, you're never going to increase your strength and, therefore, your function," Dr. Fiechtner says. Talk with your doctor to find an exercise plan that's safe for you.

Most types of moderate, low-impact exercise are helpful, but experts especially recommend strength-training, stretching, and water workouts. If you find walking too uncomfortable, swimming is a good option because it doesn't put as much pressure on your knees. In fact, people with arthritis in their knees or hips who did water exercises for 6 weeks reported less joint pain and better overall quality of life, according to the journal Physical Therapy.

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If you're suffering from osteoarthritis in your hands, it has nothing to do with this tic. One study compared people who had been chronic knuckle crackers for decades with others who never had the habit -- and found no difference in the incidence of osteoarthritis between the two groups. Still, there are reasons to stop cracking: The same study found that knuckle crackers are likelier to have weaker grip strength and greater hand swelling, both of which can limit dexterity.

Since knuckle-cracking is often an indicator of stress or anxiety, it can help to get to the bottom of what's causing your nervousness in the first place -- you may crack your knuckles more often at work than at home, for example -- and address those sources directly. Or try keeping your hands occupied with something less harmful, like doodling.

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If you wake up with stiff, swollen hands, consider wearing gloves to bed. Swelling can occur when body fluids resettle at night, says Mary Moore, MD, a retired professor of medicine and rheumatology at Temple University School of Medicine. Try a snug-fitting pair of stretchy gloves like Isotoners.

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You know that old Streisand song that says people who need people are the luckiest people in the world? Well, denying those needs can lead to physical pain. "Experiencing chronic pain can be a very isolating experience," says Andrew Bertagnolli, PhD, a former member of the board of directors at the American Chronic Pain Association and psychologist in group practice at the Spine Care Medical Group. "We're social creatures, but pain can make you withdraw from others and may lead to feelings of depression -- which has been linked to increased pain."

To manage your aches, try nurturing your connections. "People who have good social support, and use it well, manage their pain better," says Nomita Sonty, PhD, associate clinical professor in the division of pain medicine of the anesthesiology department at Columbia University. Rather than, say, skip a friend's party because you don't think you can handle sitting for 5 hours, make it a point to go and stay for only an hour. Also, support groups can remind you that you're not alone and give you advice on how to better manage pain. Visit the American Chronic Pain Association to find one near you.

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Pills can offer some relief from arthritis, but natural cures have a bigger payoff in the long run. "The most common pain relief prescribed for arthritis is nonsteroidal anti-inflammatory drugs, or NSAIDS, that kill an estimated 16,500 Americans every year from bleeding ulcers," says Dr. Teitelbaum. To ease aches naturally, Dr. Teitelbaum suggests trying a combination of two cartilage-building nutrients known as glucosamine sulfate and methylsulfonylmethane, or MSM. Taking 750 milligrams of glucosamine sulfate two times a day for at least 6 weeks relieves pain and heals joints by building up the cartilage that protects the ends of bones so they don't run together. For optimum results, take glucosamine with 400 milligrams of MSM three times a day, which may slash inflammatory chemicals called cytokines linked with arthritis pain.

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