Arthritis
Classification and external resources
Hands affected by rheumatoid arthritis, an autoimmune form of arthritis
ICD-10	M00-M25
ICD-9	710-719
DiseasesDB	15237
MedlinePlus	001243
eMedicine	topic list
MeSH	D001168

Arthritis (from Greek arthro-, joint + -itis, inflammation; plural: arthritides) is a form of joint disorder that involves inflammation of one or more joints.^[1]

There are over 100 different forms of arthritis.^[2][3] The most common form, osteoarthritis (degenerative joint disease), is a result of trauma to the joint, infection of the joint, or age. Other arthritis forms are rheumatoid arthritis, psoriatic arthritis, and related autoimmune diseases. Septic arthritis is caused by joint infection.

The major complaint by individuals who have arthritis is joint pain. Pain is often a constant and may be localized to the joint affected. The pain from arthritis is due to inflammation that occurs around the joint, damage to the joint from disease, daily wear and tear of joint, muscle strains caused by forceful movements against stiff, painful joints and fatigue.

Classification[link]

There are several diseases where joint pain is primary, and is considered the main feature. Generally when a person has "arthritis" it means that they have one of these diseases, which include:

• Ankylosing spondylitis
• Gout and pseudo-gout
• Juvenile idiopathic arthritis
• Osteoarthritis
• Rheumatoid arthritis
• Septic arthritis
• Still's disease

Joint pain can also be a symptom of other diseases. In this case, the arthritis is considered to be secondary to the main disease; these include:

• Ehlers-Danlos Syndrome
• Familial Mediterranean fever
• Haemochromatosis
• Henoch-Schönlein purpura
• Hepatitis
• Hyperimmunoglobulinemia D with recurrent fever
• Inflammatory bowel disease (Including Crohn's Disease and Ulcerative Colitis)
• Lyme disease
• Psoriasis (Psoriatic arthritis)
• Reactive arthritis
• Sarcoidosis
• TNF receptor associated periodic syndrome
• Wegener's granulomatosis (and many other vasculitis syndromes)

An undifferentiated arthritis is an arthritis that does not fit into well-known clinical disease categories, possibly being an early stage of a definite rheumatic disease.^[4]

Signs and symptoms[link]

Regardless of the type of arthritis, the common symptoms for all arthritis disorders include varied levels of pain, swelling, joint stiffness, and sometimes a constant ache around the joint(s). Arthritic disorders like lupus and rheumatoid can also affect other organs in the body with a variety of symptoms.^[6]

• Inability to use the hand or walk
• Malaise and a feeling of tiredness
• Fever
• Weight loss
• Poor sleep
• Muscle aches and pains
• Tenderness
• Difficulty moving the joint

It is common in advanced arthritis for significant secondary changes to occur. For example, in someone who has limited their physical activity:

• Muscle weakness
• Loss of flexibility
• Decreased aerobic fitness

These changes can also impact on life and social roles, such as community involvement.

Disability[link]

Arthritis is the most common cause of disability in the USA.^[7] More than 20 million individuals with arthritis have severe limitations in function on a daily basis. Absenteeism and frequent visits to the physician are common in individuals who have arthritis. Arthritis makes it very difficult for individuals to be physically active and many become home bound.^[8]

It is estimated that the total cost of arthritis cases is close to $100 billion of which nearly 50% is from lost earnings. Each year, arthritis results in nearly 1 million hospitalizations and close to 45 million outpatient visits to health care centers.^[9]

Arthritis can make it very difficult for the individual to remain physically active, contributing to an increased risk of obesity, high cholesterol or vulnerability to heart disease. Individuals with arthritis are also at increased risk of depression, which may be related to fear of worsening symptoms.

Diagnosis[link]

Diagnosis is made by clinical examination from an appropriate health professional, and may be supported by other tests such as radiology and blood tests, depending on the type of suspected arthritis. All arthritides potentially feature pain. Pain patterns may differ depending on the arthritides and the location. Rheumatoid arthritis is generally worse in the morning and associated with stiffness; in the early stages, patients often have no symptoms after a morning shower. Osteoarthritis, on the other hand, tends to be worse after exercise. In the aged and children, pain might not be the main presenting feature; the aged patient simply moves less, the infantile patient refuses to use the affected limb.

Elements of the history of the disorder guide diagnosis. Important features are speed and time of onset, pattern of joint involvement, symmetry of symptoms, early morning stiffness, tenderness, gelling or locking with inactivity, aggravating and relieving factors, and other systemic symptoms. Physical examination may confirm the diagnosis, or may indicate systemic disease. Radiographs are often used to follow progression or help assess severity.

Osteoarthritis[link]

Osteoarthritis is the most common form of arthritis.^[10] It can affect both the larger and the smaller joints of the body, including the hands, feet, back, hip or knee. The disease is essentially one acquired from daily wear and tear of the joint; however, osteoarthritis can also occur as a result of injury. Osteoarthritis begins in the cartilage and eventually causes the two opposing bones to erode into each other. Initially, the condition starts with minor pain while walking but soon the pain can be continuous and even occur at night. The pain can be debilitating and prevent one from doing some activities. Osteoarthritis typically affects the weight bearing joints such as the back, spine, and pelvis. Unlike rheumatoid arthritis, osteoarthritis is most commonly a disease of the elderly. More than 30 percent of females have some degree of osteoarthritis by age 65. Risk factors for osteoarthritis include: prior joint trauma, obesity, and a sedentary lifestyle.

Osteoarthritis, like rheumatoid arthritis, cannot be cured, but one can prevent the condition from worsening. Physical therapy to strengthen muscles and joints is very helpful. Pain medications are widely required by individuals with osteoarthritis. For some patients, weight loss can reduce the stress on the joints. When the disease is far advanced and the pain is continuous, surgery may be an option. Unlike rheumatoid arthritis, joint replacement does help many individuals with osteoarthritis.^[11]

Rheumatoid arthritis[link]

Rheumatoid arthritis is a disorder in which the body's own immune system starts to attack body tissues. The attack is not only directed at the joint but to many other parts of the body. In rheumatoid arthritis, most damage occurs to the joint lining and cartilage which eventually results in erosion of two opposing bones. Rheumatoid arthritis often affects joints in the fingers, wrists, knees and elbows. The disease is symmetrical (appears on both sides of the body) and can lead to severe deformity in a few years if not treated. Rheumatoid arthritis occurs mostly in people aged 20 and above. In children, the disorder can present with a skin rash, fever, pain, disability, and limitations in daily activities. Often, it is not clear why the rheumatoid arthritis occurred. With earlier diagnosis and aggressive treatment, many individuals can lead a decent quality of life. The drugs to treat rheumatoid arthritis range from corticosteroids to monoclonal antibodies given intravenously. The latest drugs like Remicade can significantly improve quality of life in the short term. In rare cases, surgery may be required to replace joints but there is no cure for the illness.^[12]

Lupus[link]

This is a common collagen vascular disorder that can be present with severe arthritis. Other features of lupus include a skin rash, extreme photosensitivity, hair loss, kidney problems, lung fibrosis and constant joint pain.^[13]

Gout[link]

Gout is caused by deposition of uric acid crystals in the joint, causing inflammation. There is also an uncommon form of gouty arthritis caused by the formation of rhomboid crystals of calcium pyrophosphate known as pseudogout. In the early stages, the gouty arthritis usually occurs in one joint, but with time, it can occur in many joints and be quite crippling. The joints in gout can often become swollen and lose function.^[14]

Other[link]

Infectious arthritis is another severe form of arthritis. It presents with sudden onset of chills, fever and joint pain. The condition is caused by bacteria elsewhere in the body. Infectious arthritis must be rapidly diagnosed and treated promptly to prevent irreversible and permanent joint damage.^[18]

Psoriasis can develop into psoriatic arthritis. With psoriatic arthritis, most individuals develop the skin problem first and then the arthritis. The typical features are of continuous joint pains, stiffness and swelling. The disease does recur with periods of remission but there is no cure for the disorder. A small percentage develop a severe painful and destructive form of arthritis which destroys the small joints in the hands and can lead to permanent disability and loss of hand function.^[19]

Treatment[link]

There is no cure for either rheumatoid or osteoarthritis. Treatment options vary depending on the type of arthritis and include physical therapy, lifestyle changes (including exercise and weight control), orthopedic bracing, medications. Joint replacement surgery may be required in eroding forms of arthritis. Medications can help reduce inflammation in the joint which decreases pain. Moreover, by decreasing inflammation, the joint damage may be slowed.^[20]

Physical and Occupational Therapy[link]

In general, studies have shown that physical exercise of the affected joint can have noticeable improvement in terms of long-term pain relief. Furthermore, exercise of the arthritic joint is encouraged to maintain the health of the particular joint and the overall body of the person.^[21]

Individuals with arthritis can benefit from both physical and occupational therapy. In arthritis the joints become stiff and the range of movement can be limited. Physical therapy has been shown to significantly improve function, decrease pain, and delay need for surgical intervention in advanced cases.^[22] Exercise prescribed by a physical therapist has been shown to be more effective than medications in treating osteoarthritis of the knee. Exercise often focuses on improving muscle strength, endurance and flexibility. In some cases, exercises may be designed to train balance. Occupational therapy can provide assistance with activities as well as equipment.

Medications[link]

There are several types of medications that are used for the treatment of arthritis. Treatment typically begins with medications that have the fewest side effects with further medications being added if insufficiently effective.^[23]

Treatment also depends on the type of the arthritis. For example, the first-line treatment for osteoarthritis is acetaminophen while for inflammatory arthritis it involves non-steroidal anti-inflammatory drugs like ibuprofen.

Epidemiology[link]

Arthritis is predominantly a disease of the elderly, but children can also be affected by the disease. More than 70% of individuals in North America affected by arthritis are over the age of 65. Arthritis is more common in women than men at all ages and affects all races, ethnic groups and cultures. In the United States a CDC survey based on data from 2007–2009 showed 22.2% (49.9 million) of adults aged ≥18 years had self-reported doctor-diagnosed arthritis, and 9.4% (21.1 million or 42.4% of those with arthritis) had arthritis-attributable activity limitation (AAAL). With an aging population this number is expected to increase.^[24]

History[link]

While evidence of primary ankle (kaki) osteoarthritis has been discovered in dinosaurs, the first known traces of human arthritis date back as far as 4500 BC. In early reports, arthritis was frequently referred to as the most common ailment of prehistoric peoples.^[25] It was noted in skeletal remains of Native Americans found in Tennessee and parts of what is now Olathe, Kansas. Evidence of arthritis has been found throughout history, from Ötzi, a mummy (circa 3000 BC) found along the border of modern Italy and Austria, to the Egyptian mummies circa 2590 BC^[26]

In 1715 William Musgrave published the second edition of his most important medical work De arthritide symptomatica which concerned arthritis and its effects.^[27]

Blood tests and X-rays of the affected joints often are performed to make the diagnosis. Screening blood tests are indicated if certain arthritides are suspected. These might include: rheumatoid factor, antinuclear factor (ANF), extractable nuclear antigen, and specific antibodies.

See also[link]

• Arthritis Care (charity in the UK)
• Arthritis Foundation (US not-for-profit)
• Knee arthritis
• Osteoimmunology

References[link]

External links[link]

• Arthritis at the Open Directory Project
• American College of Rheumatology – US professional society of rheumatologists
• Arthritis Foundation – US national not-for-profit organization for arthritis

Partap Chauhan is an Indian Ayurvedic doctor and the pioneer of online Ayurvedic medicine.^[1][2] He started the world’s first online Ayurvedic clinic, Ayurvedic.org, in the year 1995.^[3] Chauhan is the winner of UN’s World Summit Award for his Teledoc project on rural medicine.^[4]

He is the founder of Jiva Ayurveda, an Ayurvedic company which offers online, telephonic and personal consultation to patients across the world.^[5]

Early life and education[link]

This unreferenced section requires citations to ensure verifiability.

Chauhan was born in Palla, a village in Faridabad, Haryana (India), on January 15, 1963. He received his school education in Palla, after which he did his B.A.M.S. from Tibia College, University of Delhi. Upon completion of his formal education, he did a five-year apprenticeship with Ayurveda expert, Nanak Chand Sharma, who taught him Ayurvedic Pharmacology, Alchemy and Rasashastra.

Awards & Memberships[link]

• International Charaka Award from Association of Ayurvedic Professionals of North America (2009)
• Co-winner of World Summit Award for e-Health given by World Summit Award Foundation (2003)^[6]. He won the award with Steven Paul Rudolph, Educational Director of Jiva Institute.
• Best Ayurvedic Physician Award by Azmal Khan Society (2004)^[7]
• Best Indian Website Award given to Ayurvedic.org created by Chauhan (1998)
• Promotion of Ayurveda Globally Award by Government of India (2001)
• Best of Net Award for the best alternative medicine website (1997)
• Best Ayurvedic Drug Manufacturing Unit to Jiva Ayurvedic Pharmacy, founded by Chauhan (2005)

Chauhan is a member of the Advisory Committee, Ministry of Health, Government of India, and the prestigious NAMA (National Ayurvedic Medical Association), USA. He serves as the Chairman, International Cell to AIIMGA (All India Indian Medicine Graduate Association, New Delhi). He is a visiting faculty in Ayurveda Gurukula, Japan and Kripalu School of Ayurveda, USA.^[8] He is also an advisor to Ayurveda.pl in Poland.

Publications[link]

Chauhan is a regular contributor to several health periodicals, magazines and websites^[9][10] His published works include:

• Eternal Health (2000)^[11]
• Eternal Beauty (2008)
• Ayurvedic Home Remedies (2010)

Television Shows[link]

Chauhan’s TV shows, Eternal Health and Jivananda, are broadcast on a number of channels including Zee Jagran, Care World TV and P7 News.

References[link]

External links[link]

• Official Site

Shane L. Koyczan (born 22 May 1976) is a Canadian poet and writer. Born in Yellowknife, Northwest Territories, Koyczan grew up in Penticton, British Columbia. In 2000, he became the first Canadian to win the Individual Championship title at the US National Poetry Slam.^[1] Together with Mighty Mike McGee and C. R. Avery, he is the co-founder of spoken word, "talk rock" trio, Tons of Fun University (T.O.F.U.). In August 2007 Shane Koyczan and his work were the subject of an episode of the television documentary series Heart of a Poet, produced by Canadian filmmaker Maureen Judge for broadcaster Bravo!.^[2]

Koyczan has published two books, poetry collection Visiting Hours, and Stickboy, a novel in verse. Visiting Hours was selected by both the Guardian and Globe and Mail for their 2005 Best Books of the Year lists.

Koyczan’s "We Are More" and Ivan Bielinski’s "La première fois", commissioned by the Canadian Tourism Commission, were unveiled at Canada Day festivities on Parliament Hill in Ottawa on 1 July 2007.^[3] Koyczan performed a variation on his piece at the Opening Ceremony of the 2010 Winter Olympics in Vancouver.^[4]

Koyczan also collaborated on Vancouver-based musician Dan Mangan's Roboteering EP on the track Tragic Turn of Events - Move Pen Move.

Bibliography[link]

• I'm Calling you friend
• Help Wanted
• I Drew That For You
• Visiting Hours (2005, House of Parlance Media; ISBN 978-0-9738131-0-4)
• Stickboy ( 2008, House of Parlance Media ISBN 978-0-9738131-6-6)^[5]

Discography[link]

• Perfect
• 2nd Time Around
• Visiting Hours
• American Pie Chart
• Shut Up And Say Something

With Tons of Fun University (ToFU):

• The Them They're Talking About (2005)
• Hard to Tell (2009)

As Shane Koyczan and The Short Story Long:

• A Pretty Decent Cape in My Closet (2007)
  • includes "The Crickets Have Arthritis"

As Shane Koyczan and The Short Story Long:

• "Remembrance Year" (2012)

Filmography[link]

• The 2000 National Poetry Slam Finals (2000, The Wordsmith Press)

Notes[link]

External links[link]

• Shane Koyczan and the Short Story Long at MySpace
• Text of "We Are More", as recited at the 2010 Olympics opening

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The Crickets are now recognized in Lubbock, Texas, with a downtown avenue named in their honor.

The Crickets are a rock & roll band from Lubbock, Texas, formed by singer/songwriter Buddy Holly in the 1950s. Their first hit record was "That'll Be the Day", released in 1957. They helped set the template for subsequent rock bands such as the Beatles, with their guitar-bass-drums arrangements and tendency to write their own material. After Holly's death in 1959 the band continued to tour and record with different vocalists, releasing new material into the 21st century.

Formation[link]

Holly had been making demo recordings with local musician friends since 1954. Sonny Curtis, Jerry Allison, and Larry Welborn participated in these sessions. In 1956 Holly's band (then known informally as Buddy and the Two Tones (meaning Buddy Holly with Sonny Curtis and Don Guess),^[1] posthumous releases refer to The Three Tunes) recorded an album's worth of rockabilly numbers in Nashville, Tennessee for Decca; the records were no more than mildly successful, and the band didn't hit pay dirt until 1957, when producer and recording engineer Norman Petty hosted Holly's sessions in Clovis, New Mexico.

Holly had already recorded for another label under his own name, so to avoid legal problems he needed a new name for his group. As the Crickets recalled in John Goldrosen's book The Buddy Holly Story, they were inspired by other groups named after birds. They were then considering insects-centered names, apparently unaware of the Bronx R&B vocal group The Crickets, who recorded for Jay-Dee.^[2] It is worth noting that they almost chose the name "Beetles".^[3] Years later, The Beatles chose their band name partly in homage to The Crickets.^[4]

The Crickets were lead guitarist and vocalist Buddy Holly, drummer Jerry Allison, bassist Joe B. Mauldin, and rhythm guitarist Niki Sullivan. Sullivan dropped out after a little more than one year to resume his education. The Crickets, now a trio, continued to make stage and TV appearances, and recorded more songs, many composed by the band members themselves.

Early success[link]

During 1957 Norman Petty arranged for The Crickets' recordings to be marketed under two separate names. The solo vocals went out as "Buddy Holly" and the songs with dubbed backing vocals were issued as "The Crickets." Petty reasoned, correctly, that disc jockeys might be reluctant to program a single artist too heavily, but would have no problem playing records by two seemingly different groups. Some disc jockeys referred to the band as "Buddy Holly and The Crickets," but the record labels never used this wording until after Holly's death.

In 1958, Holly broke with producer Petty and moved to New York to be more involved with the publishing and recording businesses. Allison and Mauldin chose not to move and returned to Lubbock. Holly now recorded under his own name with studio musicians Tommy Allsup and Carl Bunch. Waylon Jennings toured with him shortly after The Crickets folded.

Allison and Mauldin looked forward to rejoining Holly after he returned from a winter tour through the northern Midwest. In the meantime, Joe B. Mauldin, J.I. Allison, and Sonny Curtis (a friend and collaborator with Buddy) began recording new songs as The Crickets, with Earl Sinks on vocals. While recording, it was announced that Holly was killed in a plane crash while on tour.

After Holly's death[link]

The Crickets went on performing after Holly's death.^[5] David Box, a native of Lubbock, Texas and a near identical Buddy Holly soundalike, would join the group as lead vocalist for their 1960 single of "Dont Cha Know" (Side A), and "Peggy Sue Got Married"
(Side B) released as Coral 62238 after the departure of Earl Sinks. David Box ironically would later die in a charter plane crash on October 23, 1964 while touring as a solo singer.^[6][7]

In 1962, The Crickets' version of the Gerry Goffin–Carole King song "Don't Ever Change" (Liberty Records) reached the top 5 in the British single charts.^[8] The Crickets would also release in 1962 their album entitled "Bobby Vee Meets the Crickets" with Bobby Vee singing on lead vocals. In 1964, The Crickets recorded their version of the rock and surf song "California Sun" for their album of the same title.^[9]

In 1978, the award-winning film, The Buddy Holly Story, starring Gary Busey as Buddy Holly, presented an engaging but somewhat inaccurate depiction of the band's early years. Allison and Mauldin's names were altered as Jesse Charles and Ray Bob Simmons wherein Charles is portrayed with racial attitudes, and Sullivan was written out of the film altogether which made them vote their portrayal as negative.

21st Century[link]

The Crickets released "The Crickets and Their Buddies" in 2004 which features several classics from all parts of their career featuring guest appearances by several prominent artists including Eric Clapton, Rodney Crowell, Waylon Jennings, Nanci Griffith, John Prine, Graham Nash, Bobby Vee, Tonio K. and more. The album was produced and mixed by Greg Ladanyi and included editing and additional mixes by Dave Carlock, Rob Hill, and Rogers Masson.^[10]

On October 28, 2008, The Crickets were inducted into the Musicians' Hall of Fame in Nashville, Tennessee. They performed "Peggy Sue", "Not Fade Away" and "That'll Be the Day" at the ceremony, accompanied by guest guitarist Keith Richards.^[11][12]

Allison and Mauldin are still touring^[when?] with Sonny Curtis, a highly successful songwriter and childhood friend/bandmate of Buddy Holly's, on vocals and guitar.^[13]

On April 14, 2012, The Crickets were inducted into the Rock and Roll Hall of Fame by a special committee, aimed at correcting the mistake of not including the band with Buddy Holly when he was first inducted in 1986. The inducted members include Jerry Allison, Sonny Curtis, Joe B. Mauldin, and Niki Sullivan. The group was unable to attend the ceremony due to illness of Joe B Mauldin.

Discography[link]

• The "Chirping" Crickets (1957, with Buddy Holly)
• In Style with the Crickets (1960)
• Bobby Vee Meets the Crickets (1962)
• Something Old, Something New (1963)
• California Sun (1964)
• Rock Reflections (1971)
• Remnants (1973)
• Bubblegum, Pop, Ballads & Boogie (1973)
• Long Way from Lubbock (1975) (With Albert Lee).
• Back in Style (1975)
• 3 Piece (1988)
• T Shirt (1988)
• Cover to Cover (1995)
• The Original (1996)
• Rockin (2000)
• Too Much Monday Morning
• Crickets and Their Buddies (2004)
• About Time Too (With Mike Berry)

References[link]

External links[link]

• Buddy Holly & The Crickets Online
• Official website