Introduction to Arthritis and the Challenge of Chronic Disease

In the United States today, more than 15 percent of the entire population-or about 40
million people-suffer from arthritis. It is a disease that does not discriminate; men and
women of all races are at risk of developing some form of arthritis, and close to 200,000
children suffer from its effects. This disease, of which there are more than 100 different
forms, involves the inflammation of joints, surrounding tendons, ligaments, and
cartilage, as well as destruction of bone. It can affect any part of the body, from the feet to
the knees, back, shoulders, elbows, fingers and, in certain types of arthritis, heart, lung,
or other organs as well.

Humankind has suffered from arthritis for as long as we've been recording medical
history. X-ray studies of bones from our earliest ancestors, including mummified
Egyptians, attest that arthritis has long been a significant health problem. The credit for
first describing the condition goes to the Greek physician Hippocrates, who gave it the
Greek word for "swollen joint." Rheumatism, a word that we still often use
interchangeably with arthritis, derives from the Greek word rheumatismos, which means
"flowing mucus," referring to the swelling that occurs when fluid fills a joint. Some
historical sources estimate that as much as 70 percent of the population of ancient
Rome had some form of arthritis, a fact that led researchers to postulate that the
Romans used their infamously decadent "Roman baths" as therapy for this often painful
and limiting disease.

The symptoms of arthritis range from mild aches and flu like discomfort to all-
consuming, crippling, chronic pain. Currently, no cure exists for arthritis. Instead, it is a
chronic condition that continues to perplex and frustrate both those who suffer with it and
their healers.

The Challenge of Chronic Disease

Within the modern, Western medical tradition, physicians and researchers often divide
health problems into those considered acute and those considered chronic. Acute
health problems generally begin abruptly with a single, readily identifiable cause.
Scientific literature has thoroughly documented the course of these illnesses, which tend
to respond well to specific treatments, such as medication or surgery. When treatment
succeeds in eliminating the symptoms and effects of the acute illness, doctors consider
patients "cured"-brought back to a normal state of health.

Appendicitis is an example of an acute illness. So is an infection with the bacterium
Streptococcus, such as tonsillitis. Each has distinct symptoms: nausea and abdominal
pain in the case of appendicitis; sore throat with swollen tonsils and fever with tonsillitis.
Appendicitis necessitates surgery followed by a period of recovery. Tonsillitis usually
resolves quickly with a 10-day course of antibiotic medication, usually consisting of
penicillin.

Chronic illnesses, on the other hand, tend to start slowly, proceed slowly, and last over
several years, even over an entire lifespan. Doctors usually have trouble diagnosing a
chronic illness since its symptoms and course tend to be subtle (at least at first) and
unpredictable. Unlike acute disease, chronic disease often has several possible,
sometimes coexisting causes, ranging from genetic factors to lifestyle and
environmental influences to individual physiological qualities. Almost by definition,
chronic illnesses have no "cure," no simple solution. Because each of them generally
has more than one cause, no one drug or surgical procedure is able to remedy them.
As different as each type of chronic illness may be from another-asthma, for instance,
has a set of symptoms and effects markedly different from arthritis-they have a number
of disturbing similarities. Indeed, the lives of all those with chronic illnesses almost
inevitably change, both physically and emotionally. Without proper care and patient
involvement in an effective therapy program, those with a chronic illness like arthritis
often must curtail physical activities such as grocery shopping, knitting, golfing, and
gardening. As a result, muscles and tendons become weak from lack of use. Should
such limitations persist, a sense of isolation and helplessness begins to sink in, leaving
the person with a chronic illness vulnerable to clinical depression.

Modern mainstream medicine offers few successful options for the treatment of arthritis.
It remains stymied by the complexity of the disease and, perhaps most important, by its
apparently systemic and fundamental nature. Holistic medicine, on the other hand, is
remarkably suited to exploring just these issues. Its view of health is based on
establishing and maintaining internal balance, of helping the body to maintain its own
proper structure and function by providing it with all the nutrients, physical exercise, and
emotional support it requires.

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