Arthritis and Disability

Although arthritis is the most common primary disabling condition among women, it is also a serious secondary condition that can result, for example, from overuse of certain joints in walking with crutches or pushing a wheelchair.

Arthritis is one of the most common chronic health conditions in the United States, affecting more than 15 percent of the total U.S. population. Osteoarthritis, called the "wear and tear" arthritis, is the most common form of arthritis.

• It is a chronic disease affecting synovial joints, particularly large weight-bearing joints.
• The incidence of osteoarthritis increases with age with nearly 100 percent of both males and females showing signs of osteoarthritis by age 75.

Osteoarthritis is a secondary condition that commonly develops as people age with an underlying primary disability. Like other secondary conditions, if left undetected and untreated, it can result in secondary functional limitation or disability.

In one survey of secondary health conditions in women with physical disabilities, 66 percent reported experiencing a limitation due to arthritis in the past 3 months. In fact, arthritis ranked 2nd in terms of severity on a list of 43 secondary and other health conditions.

A study conducted to determine which secondary conditions cause the most limitation for persons with disabilities found that 42 percent of the persons surveyed reported that arthritis had been a problem for them in the past year (arthritis was not the primary condition). In this study, arthritis was sixteenth in a list of 40 secondary health conditions in terms of severity. Another recent study of women with functional limitations reported that 37 percent indicated that they experienced arthritis secondary to their primary disability.

Among the causes of secondary osteoarthritis that have been identified are previous rheumatoid arthritis, underlying orthopedic disorders or conditions affecting normal mobility, and previous trauma. Some investigators working with persons with cerebral palsy or spina bifida have discussed the contribution of microtrauma that occurs from walking on hips that have abnormal biomechanics. Among persons with lower limb impairment, osteoarthritis of the upper extremities has been associated with long-term manual wheelchair use. Overweight and obesity, known to be highly prevalent in women with physical disabilities, are also known to contribute to osteoarthritis.

Osteoarthritis as a secondary condition is anticipated to increase as people are living longer with primary physical disabilities.

Treatment of osteoarthritis as a secondary condition is important in order to relieve pain and reduce additional disability, but prevention also needs to be emphasized. While arthritis was not even mentioned in earlier versions of Healthy People, there are now a number of arthritis objectives, included an objective related to prevention, in Healthy People 2010. It could be argued that prevention efforts are even more important for persons with life-long disabilities who may experience the disabling effects of arthritis at an even earlier age.