(April 3, 2008 - Insidermedicine) Welcome to Insidermedicine's If I Had, where we get a chance to ask an expert what they would do if they had a medical condition.

On a recent trip to Atlanta, we caught up with Dr. Teresa Brady, PhD, a Senior Behavioral Scientist at the Centers for Disease Control.  Dr. Brady is also a Senior Fellow at CDC's National Center for Chronic Disease Prevention and Health Promotion, and specializes in arthritis.

We asked Dr. Brady what she would do if she was experiencing pain, swelling or stiffness in a joint.

If I had joint symptoms indicative of arthritis

If I were experiencing joint symptoms (pain, swelling, stiffness in a joint) that lasted for more than about 6 weeks, then I would seek medical attention. This is particularly important for people who may have systemic inflammatory arthritis, like rheumatoid arthritis, because there is good evidence now that early and aggressive treatment can actually change the course of the disease. Most people aren’t going to have rheumatoid arthritis; most people, if they have a form of arthritis, will probably have osteoarthritis or degenerative joint disease, but they would still want to make sure that they check in to confirm that they don’t have a systemic inflammatory type.

If I had osteoarthritis, I would want to make sure that I was taking whatever medications were prescribed (provided any medications had been prescribed), but then I would also want to learn what I can about the disease (eg. attend self-management education programs), I would want to make sure I was being physically active, both in terms of exercising the joint that’s involved, and then also my general physical activity level to maintain good fitness, and then finally, particularly with osteoarthritis of the hip and knee, I would want to make sure that I did not gain weight, and that I maintained as normal a weight as possible. These are all critical factors and key public health messages for people with arthritis.


How is Arthritis diagnosed?

The diagnosis of most forms of arthritis is usually based on history (what you tell the physician), and physical (what they see when they examine you). There are some lab tests that they can do to try to clarify, and they may take X-rays, but most of the diagnosis is really done by what you tell the physician, and what they see when they examine you.


What should someone with arthritis ask their doctor?

What a person with arthritis should really ask their physician is ‘what can I do to take care of it?”. We know there isn’t a cure for most forms of arthritis, but there is a lot that you can do. One of the things that we learned from our audience research is that many people think that they have to just tolerate arthritis, not actively manage it, and particularly the key public health messages that we’re talking about (namely, learn about your disease, be active, control your weight), are critical to self-management and individual responsibility. In other words, turn the tables around on the physician, don’t go in expecting the physician’s going to manage it for you, find out what you can do to manage your disease.


In Summary

If I had joint symptoms, I would first want to get a diagnosis to make sure I wasn’t dealing with a inflammatory type of arthritis, I would want to learn as much as I could about my disease (I might attend a course like an arthritis self-management program or the chronic disease self-management program) I would be physically active and specifically exercise the joints that were involved, and I would control my weight. Finally I would want to remain optimistic – I wouldn’t want to get hopeless about having arthritis. I would want to make sure that my optimism was coming through in my self-management activities.