It’s no secret that different medical issues can affect men and women differently. It’s just basic biology, and it’s no less true when it comes to arthritis. There are several different types of arthritis, the most-common being rheumatoid arthritis – an autoimmune disease – and osteoarthritis. Women can be nearly four times more likely to experience rheumatoid arthritis, and osteoarthritis of the hands and knees affects women almost twice as much as men. There are differences in the symptoms people have with each arthritis type, but regardless of which type you’re experiencing – and whether you’re a woman or a man – experts say it’s best to seek treatment for arthritis pain as soon as possible.
Blount Memorial rheumatologist Dr. Annika Cutinha says the first step is determining which type of arthritis a patient is experiencing, as that naturally will help determine how it will be treated. “I put patients into two categories,” she explained. “The first category is osteoarthritis, which also is known as wear-and-tear arthritis. The second category is inflammatory arthritis, which encompasses several types of arthritis, including the most-common type: rheumatoid arthritis. Arthritis from wear and tear is basically mechanical. The more you use something, the more it gets worn out. The lining between the two bones tends to wear out, so the more you use those joints, the more tenderness and other symptoms you’ll have, and activity tends to make things worse,” she explained. “Inflammation is very different because it tends to bother people when they’re resting. Usually, when they’re moving, they’re feeling better. Inflammatory arthritis also causes a lot of joint stiffness and joint swelling. There are certain types of inflammatory arthritis that we tend to see more often in women, such as rheumatoid arthritis and lupus, as well as certain types of wear-and-tear arthritis that usually involve women and their hands and knees,” she added.
While both inflammatory arthritis and osteoarthritis can cause discomfort and pain, Cutinha says they’re very different and require different treatments. “The management techniques for wear-and-tear arthritis and inflammatory arthritis are completely different,” she said. “Wear-and-tear basically requires symptom management and modification of how patients perform the tasks that result in the arthritis symptoms. For instance, instead of walking five miles and experiencing knee pain, I will suggest using a bike or maybe walking in the shallow end of a swimming pool. This way, the patient can continue to exercise, but the stress on the joints is being reduced. I also will recommend weight loss, as each pound we gain puts an extra five pounds on the joints. Wear-and-tear arthritis patients tend to be more likely to take Tylenol and non-steroidal medicines such as ibuprofen. If those steps don’t produce satisfactory results, we can do injections for the joints or refer the patient for a potential joint replacement procedure,” she explained. “When it comes to inflammation, we have a completely different set of medicines which range from disease-modifying agents to biologics. This is why it’s so important to determine which type of arthritis the patient has so that we can use the right medicine. Some patients actually can experience both types at the same time. Patients can have an inflammatory type of arthritis that can wear out the joint lining,” she said.
“A lot of inflammation gets missed because people just assume their pain is coming from wear and tear,” Cutinha said. “However, if we intervene early with medicines for inflammation, we can potentially make a significant difference well in advance before things get out of hand. Once we detect what the problem is, treatment tends to be the same for both men and women. Women sometimes tend to have to try multiple types of medications before finding one that works best for them, though. Generally speaking, women also are more prone to having higher pain levels. When we have patients with inflammatory arthritis, they also can develop low bone density, which can lead to osteoporosis. Osteoporosis doesn’t necessarily cause bone pain, but it can cause you to break a bone more easily, which also can lead to the increased pain. Female patients are more likely to experience this, too, particularly if they’re on steroids for inflammatory arthritis,” she explained.
“The sooner patients are seen, the easier it is to figure out what the problem is,” Cutinha said. “When time passes, it becomes a situation where there are too many variables on the table. We’re dealing with one thing on top of another. It’s much easier to figure things out when we see them early. This typically results in patients needing less medication, as well. If a patient comes in early enough, he or she might be able to get by with one or two medicines, but if that patient waits too long, the list of medicines can get much longer. Timing matters,” she added.
Dr. Cutinha sees patients in her office at East Tennessee Medical Group, located at 266 Joule St. in Alcoa. For more information or to schedule an appointment, call 865-984-3864.