Ask An Expert: Family History of Arthritis

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Ask An Expert: Family History of Arthritis

Question:

I have a strong family history of arthritis. Are there steps I can take now to prevent arthritis or at least delay onset?

Answer:

In most cases, the answer is "no" — even when the risk of developing arthritis seems high, there are no known ways to delay its onset or prevent it altogether.

However, there is a longer answer, because "arthritis" is not a single disease and because family history is not destiny. Although knowing your family history is important, plenty of people with arthritis are the only unlucky ones in the family with joint trouble.

There are more than 100 types of arthritis — some run in families and some do not. The most common form of arthritis is osteoarthritis (also called degenerative joint disease), and there is a large genetic contribution. Obesity is a risk factor for hip and knee osteoarthritis, so losing excess pounds and avoiding obesity could reduce the risk of osteoarthritis, at least in those weight-bearing joints. Osteoarthritis can also follow significant trauma, so avoiding broken bones or other major injuries (to the extent this is possible), may reduce the risk of osteoarthritis.

Rheumatoid arthritis, affecting up to 3 percent of the population, can also run in families. There is no known way to effectively delay the onset or prevent rheumatoid arthritis. Although there is still no cure, more highly effective medications are available than ever before.

Arthritis associated with gout is another common form of arthritis that can run in families; even so, it is exceedingly uncommon among premenopausal women, regardless of family history. It may be prevented by moderation of alcohol intake, and by avoiding certain medications (such as diuretics or "water pills"). Once it develops, gout can often be prevented by taking appropriate medications and, in some cases, by making dietary changes.

Certain infections may be complicated by arthritis; avoiding these infections can prevent the associated arthritis. For example, bacterial triggers of arthritis may be avoided by practicing "safe sex," not using intravenous drugs, and by using insect repellants to prevent Lyme disease.

So, the bad news is that for most people, arthritis is not preventable. However, the good news is that certain types of arthritis are preventable, relatives of people with arthritis are frequently spared from these joint problems, and medications to control arthritis are often effective.

Robert Shmerling, M.D., is associate physician and clinical chief of rheumatology at Beth Israel Deaconess Medical Center and an associate professor in medicine at Harvard Medical School. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program and has been a practicing rheumatologist for over 25 years.

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Last updated:	January 24, 2007