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Rheumatoid Arthritis and Osteoporosis

Part 1 of 2 - What Rheumatoid Arthritis Patients Need to Know About Osteoporosis


Updated May 29, 2014

Rheumatoid Arthritis Patients Have Greater Osteoporosis Risks

Studies have found an increased risk of bone loss and fracture in individuals with rheumatoid arthritis. People with rheumatoid arthritis are at increased risk for osteoporosis for many reasons:

  • Glucocorticoid (corticosteroid) medications such as prednisone often prescribed for the treatment of rheumatoid arthritis can trigger significant bone loss.
  • Pain and loss of joint function caused by the disease can result in inactivity, further increasing osteoporosis risk.
  • Studies also show that bone loss in rheumatoid arthritis may occur as a direct result of the disease. The bone loss is most pronounced in areas immediately surrounding the affected joints.

Also of concern is the fact that women, a group already at increased osteoporosis risk, are two to three times more likely than men to suffer from rheumatoid arthritis as well.

What Is Rheumatoid Arthritis?

Rheumatoid arthritis (RA) is an autoimmune disease, a disorder in which the body attacks its own healthy cells and tissues. In rheumatoid arthritis the membranes surrounding the joints become inflamed and release enzymes that cause the surrounding cartilage and bone to wear away. In severe cases, other tissues and body organs also can be affected.

Individuals with rheumatoid arthritis often experience pain, swelling and stiffness in their joints, especially those in the hands and feet. Limited motion of the affected joints can also occur, curtailing one's ability to accomplish even the most basic everyday tasks. About one-quarter of those with rheumatoid arthritis can develop rheumatoid nodules (bumps) that grow under the skin, usually close to the joints. Other symptoms that can also occur in individuals with rheumatoid arthritis include:

According to NIAMS, it is estimated that about 2.1 million people in the United States have rheumatoid arthritis. The disease occurs in all racial and ethnic groups, but affects two to three times as many women as men. Rheumatoid arthritis is more commonly found in older individuals, though the disease typically begins in middle age. Children and young adults can also be affected.

What Is Juvenile Rheumatoid Arthritis?

Juvenile rheumatoid arthritis (JRA) occurs in children sixteen years of age or younger. Children with severe juvenile rheumatoid arthritis may be candidates for glucocorticoid (corticosteroid) medication, the use of which has been linked to bone loss in children as well as adults. Physical activity can be challenging in children with juvenile rheumatoid arthritis since it may cause pain. Incorporating physical activities recommended by the child's physician, and a diet rich in calcium and vitamin D are especially important for these children to help optimize peak bone mass and reduce the risk of future fracture.

What Is Osteoporosis?

Osteoporosis is a condition in which the bones become less dense and more likely to fracture. Fractures from osteoporosis can result in significant pain and disability. It is a major health threat for an estimated 44 million Americans, 80% of whom are women.

Osteoporosis Risk Factors

Risk factors for developing osteoporosis include:

  • thinness or small frame
  • family history of the disease
  • for women, being postmenopausal, having an early menopause, or not having menstrual periods (amenorrhea)
  • abnormal absence of menstrual periods
  • prolonged use of certain medications (such as corticosteroids)
  • low calcium intake
  • physical inactivity
  • smoking
  • excessive alcohol intake

Osteoporosis is a silent disease that can often be prevented. However, if undetected, it can progress for many years without symptoms until a fracture occurs.

Go on to Part 2 --- Osteoporosis Prevention & Treatment --->

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