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  • Number of Americans Reporting Arthritis-Related Activity Limitations on the Rise

    In brief:

    • CDC estimates arthritis prevalence in the US, based on more than 100,000 responses to National Health Interview Survey, 2013-2015
    • Total prevalence is estimated at 54.4 million Americans—about 20% of the US population, with 32 million being of working age
    • Number of Americans reporting arthritis-attributed activity limitations rose by 20% since 2002
    • Highest percentages of activity limitations were among Americans with comorbidities: heart disease, diabetes, and obesity
    • CDC recommends more widespread use of physical activity and cognitive behavioral therapy as a "proven strategy;" recommends against use of opioids

    The overall prevalence of arthritis in the US may be about the same as it was 15 year ago, but its burden on Americans is worsening at a rapid pace—and in a particularly troubling way. According to the US Centers for Disease Control and Prevention (CDC), the number of Americans with arthritis who report that the condition limits their activities has jumped by 20% since 2002. It's a trend the CDC believes can only be countered by "existing, underused, evidence-based interventions," specifically interventions that promote physical activity, which the CDC describes as "a proven strategy for managing arthritis."

    In its report released March 7, the CDC analyzed results from 3 years of National Health Interview Surveys conducted between 2013 and 2015, focusing on respondents who reported arthritis (for the CDC, that includes osteoarthritis, rheumatoid arthritis, lupus, gout, and fibromyalgia). The sample was balanced to reflect US population demographics, which allowed CDC to make overall estimates based on the results, and compared with statistics from 2002. Among the findings:

    • Just over 20% of Americans—about 54.4 million people—had doctor-diagnosed arthritis, a number that didn't change much over the 3-year study period, and is similar to statistics from 2002.
    • During that same time span, the number of Americans who reported arthritis-attributable activity limitations rose to 23.7 million, or 43.5% of adults with arthritis, up from 35.9% in 2002, and adjusted for age.
    • Activity limitations were even more prevalent among Americans with comorbidities, such as heart disease (54.5%), diabetes (54%), and obesity (49%).
    • Of those who reported arthritis, almost half (49.6%) were 65 and older; 29.3% were 45-64 years old, and 7.1% were aged 18-44.

    The percentage of individuals with an activity limitation who have arthritis and another condition such as heart disease, diabetes, or obesity are particularly worrisome, according to the CDC, because physical activity has been proven to be effective for those conditions as well. The higher level of inactivity "[suggests] that arthritis-specific barriers to physical activity (concerns about worsening pain, damaging joints, and safely exercising) might be important concerns for adults with these conditions," the CDC writes.

    When it comes to what to do about the problem, the CDC points out that while opioids are often prescribed for arthritis, "better ways to help manage arthritis often exist," and the agency suggests exercise therapy and cognitive behavioral therapy. The CDC also mentions acetaminophen and nonsteroidal anti-inflammatory drugs, but writes that "although medications can help, nonpharmaceutical measures help as well." The suggestions are consistent with the CDC guidelines for the treatment of chronic pain, which recommend nondrug approaches including physical therapy as a first-line treatment. APTA's #ChoosePT campaign incorporates the CDC recommendations in its efforts to promote physical therapy as a healthy, effective alternative to opioids for many conditions.

    "Our findings suggest that the burden of arthritis is increasing and requires more widespread use of existing, underused, evidence-based interventions," the CDC writes. "Physical activity is a proven strategy for managing arthritis, with known benefits for the management of many chronic conditions."

    What it all boils down to, according to the CDC, is a straightforward idea: do what works. And what works are nondrug approaches.

    "Given the high prevalence of arthritis and the increase in arthritis-attributable activity limitations in the United States," the reports states, "health care providers and public health practitioners can address arthritis and other chronic conditions by prioritizing proven, nonpharmaceutical interventions, such as self-management education and appropriate physical activity, as effective ways to improve health outcomes."

    APTA offers multiple resources on arthritis management through community-based programs, including an overview of evidence-based programs and a decision aid to help physical therapists (PTs) choose an appropriate program for the patient. Patients can learn more about the PT’s role in arthritis treatment at MoveForwardPT.com's webpages on osteoarthritis and rheumatoid arthritis. PTs can access tests and measures as well as clinical practice guidelines at PTNow (select the appropriate health condition in the tests and measures area; search by topic in the CPG area).

    Additionally, the US Bone and Joint Initiative (USBJI) offers a series of free public education programs aimed at helping providers increase community awareness of osteoarthritis treatment. APTA is a founding member of USBJI.

    Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.

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