Introduction to Arthritis and the Challenge of Chronic Disease

In the United States today, more than 15 percent of the entire population-or about 40 million people-suffer from arthritis. It is a disease that does not discriminate; men and women of all races are at risk of developing some form of arthritis, and close to 200,000 children suffer from its effects. This disease, of which there are more than 100 different forms, involves the inflammation of joints, surrounding tendons, ligaments, and cartilage, as well as destruction of bone. It can affect any part of the body, from the feet to the knees, back, shoulders, elbows, fingers and, in certain types of arthritis, heart, lung, or other organs as well.

Humankind has suffered from arthritis for as long as we've been recording medical history. X-ray studies of bones from our earliest ancestors, including mummified Egyptians, attest that arthritis has long been a significant health problem. The credit for first describing the condition goes to the Greek physician Hippocrates, who gave it the Greek word for "swollen joint." Rheumatism, a word that we still often use interchangeably with arthritis, derives from the Greek word rheumatismos, which means "flowing mucus," referring to the swelling that occurs when fluid fills a joint. Some historical sources estimate that as much as 70 percent of the population of ancient Rome had some form of arthritis, a fact that led researchers to postulate that the Romans used their infamously decadent "Roman baths" as therapy for this often painful and limiting disease.

The symptoms of arthritis range from mild aches and flu like discomfort to all-consuming, crippling, chronic pain. Currently, no cure exists for arthritis. Instead, it is a chronic condition that continues to perplex and frustrate both those who suffer with it and their healers.

The Challenge of Chronic Disease

Within the modern, Western medical tradition, physicians and researchers often divide health problems into those considered acute and those considered chronic. Acute health problems generally begin abruptly with a single, readily identifiable cause. Scientific literature has thoroughly documented the course of these illnesses, which tend to respond well to specific treatments, such as medication or surgery. When treatment succeeds in eliminating the symptoms and effects of the acute illness, doctors consider patients "cured"-brought back to a normal state of health.

Appendicitis is an example of an acute illness. So is an infection with the bacterium Streptococcus, such as tonsillitis. Each has distinct symptoms: nausea and abdominal pain in the case of appendicitis; sore throat with swollen tonsils and fever with tonsillitis. Appendicitis necessitates surgery followed by a period of recovery. Tonsillitis usually resolves quickly with a 10-day course of antibiotic medication, usually consisting of penicillin.

Chronic illnesses, on the other hand, tend to start slowly, proceed slowly, and last over several years, even over an entire lifespan. Doctors usually have trouble diagnosing a chronic illness since its symptoms and course tend to be subtle (at least at first) and unpredictable. Unlike acute disease, chronic disease often has several possible, sometimes coexisting causes, ranging from genetic factors to lifestyle and environmental influences to individual physiological qualities. Almost by definition, chronic illnesses have no "cure," no simple solution. Because each of them generally has more than one cause, no one drug or surgical procedure is able to remedy them.

As different as each type of chronic illness may be from another-asthma, for instance, has a set of symptoms and effects markedly different from arthritis-they have a number of disturbing similarities. Indeed, the lives of all those with chronic illnesses almost inevitably change, both physically and emotionally. Without proper care and patient involvement in an effective therapy program, those with a chronic illness like arthritis often must curtail physical activities such as grocery shopping, knitting, golfing, and gardening. As a result, muscles and tendons become weak from lack of use. Should such limitations persist, a sense of isolation and helplessness begins to sink in, leaving the person with a chronic illness vulnerable to clinical depression.

Modern mainstream medicine offers few successful options for the treatment of arthritis. It remains stymied by the complexity of the disease and, perhaps most important, by its apparently systemic and fundamental nature. Holistic medicine, on the other hand, is remarkably suited to exploring just these issues. Its view of health is based on establishing and maintaining internal balance, of helping the body to maintain its own proper structure and function by providing it with all the nutrients, physical exercise, and emotional support it requires.