Arthritis: Protect Your Livelihood with Early Diagnosis

March 12, 2014

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With about 50 million Americans (one out of five) and 4.5 million Canadians suffering from some sort of arthritis or chronic joint pain, it is not surprising that there are many musicians affected. Instances of some types of arthritis among professional musicians may actually be elevated due to repetitive movements related to playing instruments or even lifting heavy gear.

There are more than 100 types of arthritis that can strike at any age. Among the most common are osteoarthritis, rheumatoid arthritis, fibromyalgia, and osteoporosis. Though there is no cure for arthritis, in many instances, there are things you can do to slow or stop its progression, help ease some of its symptoms, or even prevent its development altogether.

If you show symptoms of one or more of these diseases you should visit your doctor. Timely diagnosis and treatment could prolong your musical career.

Osteoarthritis

Sometimes called degenerative joint disease, osteoarthritis (OA) is the most common type of arthritis. OA is characterized by the breakdown of the joint’s cartilage, which cushions the ends of the bones to allow easy joint movement. When cartilage breaks down, bones rub together, causing pain, stiffness, and loss of movement. OA is common in the hands and weight-bearing joints like hips, knees, and spine.

Symptoms of OA include pain and stiffness in joints after a period of inactivity or excessive use, a grating or catching sensation during joint movement, and bony growths on the margins of joints. In the early stages of OA there is no swelling. Because the risk of developing OA is increased by repetitive movements, or joint overuse, the condition can be quite common in musicians aged 40 and older. Other risk factors are genetic predisposition, excess weight, joint or nerve injury, inactivity, and aging.

Usually doctors can diagnose OA through a physical examination and review of medical history. X-rays and magnetic resonance imaging (MRI) may be used to rule out other conditions and determine how much damage has occurred. Sometimes blood work or fluid from affected joints is examined to rule out other forms of arthritis.

Treatment includes various medications, creams, or gels and exercise. Heat can be applied to reduce pain and stiffness, but cold should be applied if the joint is inflamed. Arthroscopic surgery may be used to clean out cartilage debris, and joint replacement is usually a last resort.

Rheumatoid Arthritis

The body’s immune system attacks healthy joints in rheumatoid arthritis (RA), causing inflammation of the lining (or synovium) of joints. This can lead to long-term joint damage, chronic pain, and loss of function. People of all ages can get RA, but the most common onset is between the ages of 25 and 50. Early  diagnosis of RA is important as 75% of the damage often occurs in the first five years.

The disease progresses in three stages, each with its own symptoms. First, swelling of the synovial lining causes pain, warmth, stiffness, redness, and swelling around the joint. Second, the division and growth of cells (pannus) causes the synovium to thicken. In the third stage, inflamed cells release enzymes that may digest bone and cartilage, causing a now painful joint to lose its shape and alignment, reducing range of movement.

RA can start gradually or with sudden flu-like symptoms, which vary from person to person. You may feel weak and tired, have a fever, or lose weight, but joint pain will be the main problem. Affected joints usually follow a symmetrical pattern. For example, if the knuckles on the right hand are inflamed, the knuckles on the left hand are also inflamed.

A systematic disease, RA can affect other organs of the body. Though there is no cure, treatments include various medicines, exercise, and other therapies to manage symptoms. Early diagnosis and treatment can limit joint damage and help to maintain your full ability to work as a musician.

Fibromyalgia

Fibromyalgia causes widespread muscle pain and certain areas of the body become particularly sensitive to pressure. Other symptoms include difficulty sleeping, fatigue, depression, anxiety, cognitive difficulties, headaches, irritable bladder or bowel, jaw problems, and painful menstruation. Less common than OA and RA, fibromyalgia affects 3% to 6% of the population, mostly women aged 40 to 75.

The disease is more common in people who suffer from RA, though researchers are not sure what causes fibromyalgia and it is difficult to diagnose. There is no lab test for it and its effects on the body are invisible. Usually, fibromyalgia patients have widespread pain,  plus at least 11 of 18 characteristic sites of deep muscle tenderness.

There is no cure, but the goal of treatment is to manage the pain and other symptoms. Heat can be used for temporary pain relief. Other than various medications, a doctor may advise patients to follow an exercise regiment.

Osteoporosis

With “porous bone,” or osteoporosis, bones become fragile and prone to breakage. Most commonly, fractures occur in the hip, spine, or wrist, though a break could occur in any bone. Osteoporosis occurs as our bones start to age and cells die at a more rapid rate than new ones can be produced, a process that begins around age 40.

You may have osteoporosis for years before noticing any symptoms. Many people first notice a sharp pain in their lower back or may break a bone during a minor bump or fall. Factors contributing to the development of osteoporosis include aging, genetic predisposition, lack of exercise, hormone changes, and a diet poor in calcium and vitamin D.

Preventing osteoporosis is much easier than curing it. The most important aspect of prevention is maintaining a diet that builds strong bones, particularly when you are between 10 and 30 years of age.

A doctor can confirm diagnosis with bone density tests, as well as with X-rays, and blood and/or urine tests. Treatment focuses on reducing the rate of bone loss and building new bone through medications, hormones, diet, and exercise.

After Diagnosis

Talk to your doctor about your risk of developing arthritis and discuss preventative measures. Tell your doctor about any symptoms you may be experiencing. For most musicians, a diagnosis of arthritis should not be career ending. Working with your doctor and learning all you can about your particular type of arthritis are important steps to take. The Arthritis Foundation (www.arthritis.org) and The Arthritis Society (www.arthritis.ca) provide a wealth of information. Also, seek out other musicians with arthritis to find out what helps them, as well as to offer each other support.

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