Arthritis pain that begins slowly in one joint and is left untreated can eventually wallop the entire body, leading to disability and costly surgeries, researchers reported Sunday.
Studies being discussed at the American College of Rheumatology's annual meeting in Washington, D.C., through Wednesday find that when osteoarthritis progresses to multiple joints, it can cause havoc by triggering pain everywhere in the body from head to toe. New ways of managing the disease, which afflicts 27 million Americans, can prevent the crippling pain from spreading and improve overall health, says Joanne Jordan, chairman of the U.S. Bone and Joint Initiative's Chronic Osteoarthritis Management Initiative.
"We need to treat the pain early on before it gets generalized," says Jordan, director of the University of North Carolina's Thurston Arthritis Research Center. "When pain becomes generalized, things that ordinarily wouldn't hurt are hurtful. For instance, you can pat someone on the shoulder, and their shoulder, which might not be near the afflicted joint, will hurt. They'll wince or cry out."
In these patients, for whom the pain has taken on a life of its own, doctors need to treat it "aggressively," she says. "Sometimes a patient will go to the doctor and say they hurt everywhere, and the doctor isn't always sympathetic.
"What we're discovering is the central nervous system rewires itself when pain keeps occurring from one place and generalizes the pain instead to other places in the body."
Jordan says new research finds that the pain burden can be relieved by treating it with muscle relaxants and antidepressants, but more therapies need to be developed.
Adam Goode, a researcher at Duke University, presented findings Sunday on how pain perception changes in someone with moderate to severe osteoarthritis. In a study of 1,602 people taking part in the Johnston County (N.C.) Osteoarthritis Project, Goode tested them by attaching a dolorimeter, a device to measure pain thresholds, to the neck area and applying pressure.
"Compared with people who didn't have any knee or hip symptoms, those who had symptoms in both knees and both hips were 50% more likely to feel that pressure as painful," he says.
Specialists at the meeting are targeting solutions to end the pain cycle. The Chronic Osteoarthritis Management Initiative, developed by medical professionals in orthopedics, physical therapy, sports medicine and rheumatology, calls for managing osteoarthritis in the same way other chronic diseases are.
Tops on the list: prevention. By getting an early diagnosis, people can stay active and reduce their likelihood of having arthritis worsen other chronic health problems, including obesity, diabetes and heart disease, Jordan says.
"Many doctors assume an inevitable trajectory of aging and osteoarthritis," she says. "And they think joint-replacement surgery will address the problem."
This "joint death and rebirth process" can be transformed, she says, by identifying risk factors (such as family history, obesity and sports injuries early in life) and doing regular follow-ups.
To see more of USAToday.com, or to subscribe, go to http://www.usatoday.com
Copyright 2012 USA TODAY, a division of Gannett Co. Inc.