Author: justchunty

Rheumatoid arthritis is a type of arthritis where your immune system attacks the tissue lining the joints on both sides of your body. It may affect other parts of your body too. The exact cause is unknown. Treatment options include lifestyle changes, physical therapy, occupational therapy, nutritional therapy, medication and surgery.

What is rheumatoid arthritis?

Rheumatoid arthritis (RA) is an autoimmune disease that is chronic (ongoing). It occurs in the joints on both sides of your body, which makes it different from other types of arthritis. You may have symptoms of pain and inflammation in your:

• Fingers.
• Hands.
• Wrists
• Knees
• Ankles.
• Feet.
• Toes.

Uncontrolled inflammation damages cartilage, which normally acts as a “shock absorber” in your joints. In time, this can deform your joints. Eventually, your bone itself erodes. This can lead to the fusion of your joint (an effort of your body to protect itself from constant irritation).

Specific cells in your immune system (your body’s infection-fighting system) aid this process. These substances are produced in your joints but also circulate and cause symptoms throughout your body. In addition to affecting your joints, rheumatoid arthritis sometimes affects other parts of your body, including your:

• Skin.
• Eyes.
• Mouth.
• Lungs.
• Heart.

Who gets rheumatoid arthritis?

Rheumatoid arthritis affects more than 1.3 million people in the United States. It’s 2.5 times more common in people designated female at birth than in people designated male at birth.

What’s the age of onset for rheumatoid arthritis?

RA usually starts to develop between the ages of 30 and 60. But anyone can develop rheumatoid arthritis. In children and young adults — usually between the ages of 16 and 40 — it’s called young-onset rheumatoid arthritis (YORA). In people who develop symptoms after they turn 60, it’s called later-onset rheumatoid arthritis (LORA).

What are the symptoms of rheumatoid arthritis?

Rheumatoid arthritis affects everyone differently. In some people, joint symptoms develop over several years. In other people, rheumatoid arthritis symptoms progress rapidly. Many people have time with symptoms (flares) and then time with no symptoms (remission).

Symptoms of rheumatoid arthritis include:

• Pain, swelling, stiffness and tenderness in more than one joint.
• Stiffness, especially in the morning or after sitting for long periods.
• Pain and stiffness in the same joints on both sides of your body.
• Fatigue (extreme tiredness).
• Weakness.
• Fever.

Does rheumatoid arthritis cause fatigue?

Everyone’s experience of rheumatoid arthritis is a little different. But many people with RA say that fatigue is among the worst symptoms of the disease.

Living with chronic pain can be exhausting. And fatigue can make it more difficult to manage your pain. It’s important to pay attention to your body and take breaks before you get too tired.

What are rheumatoid arthritis flare symptoms?

The symptoms of a rheumatoid arthritis flare aren’t much different from the symptoms of rheumatoid arthritis. But people with RA have ups and downs. A flare is a time when you have significant symptoms after feeling better for a while. With treatment, you’ll likely have periods of time when you feel better. Then, stress, changes in weather, certain foods or infections trigger a period of increased disease activity.

Although you can’t prevent flares altogether, there are steps you can take to help you manage them. It might help to write your symptoms down every day in a journal, along with what’s going on in your life. Share this journal with your rheumatologist, who may help you identify triggers. Then you can work to manage those triggers.

What causes rheumatoid arthritis?

The exact cause of rheumatoid arthritis is unknown. Researchers think it’s caused by a combination of genetics, hormones and environmental factors.

Normally, your immune system protects your body from disease. With rheumatoid arthritis, something triggers your immune system to attack your joints. An infection, smoking or physical or emotional stress may be triggering.

Is rheumatoid arthritis genetic?

Scientists have studied many genes as potential risk factors for RA. Certain genetic variations and non-genetic factors contribute to your risk of developing rheumatoid arthritis. Non-genetic factors include sex and exposure to irritants and pollutants.

People born with variations in the human leukocyte antigen (HLA) genes are more likely to develop rheumatoid arthritis. HLA genes help your immune system tell the difference between proteins your body makes and proteins from invaders like viruses and bacteria.

What are the risk factors for developing rheumatoid arthritis?

There are several risk factors for developing rheumatoid arthritis. These include:

• Family history: You’re more likely to develop RA if you have a close relative who also has it.
• Sex: Women and people designated female at birth are two to three times more likely to develop rheumatoid arthritis.
• Smoking: Smoking increases a person’s risk of rheumatoid arthritis and makes the disease worse.
• Obesity: Your chances of developing RA are higher if you have obesity.

How is rheumatoid arthritis diagnosed?

Your healthcare provider may refer you to a physician who specializes in arthritis (rheumatologist). Rheumatologists diagnose people with rheumatoid arthritis based on a combination of several factors. They’ll do a physical exam and ask you about your medical history and symptoms. Your rheumatologist will order blood tests and imaging tests.

The blood tests look for inflammation and blood proteins (antibodies) that are signs of rheumatoid arthritis. These may include:

• Erythrocyte sedimentation rate (ESR) or “sed rate” confirms inflammation in your joints.
• C-reactive protein (CRP).
• About 80% of people with RA test positive for rheumatoid factor (RF).
• About 60% to 70% of people living with rheumatoid arthritis have antibodies to cyclic citrullinated peptides (CCP) (proteins).

Your rheumatologist may order imaging tests to look for signs that your joints are wearing away. Rheumatoid arthritis can cause the ends of the bones within your joints to wear down. The imaging tests may include:

• X-rays.
• Ultrasounds.
• Magnetic resonance imaging (MRI) scans.

In some cases, your provider may watch how you do over time before making a definitive diagnosis of rheumatoid arthritis.

What are the diagnostic criteria for rheumatoid arthritis?

Diagnostic criteria are a set of signs, symptoms and test results your provider looks for before telling you that you’ve got rheumatoid arthritis. They’re based on years of research and clinical practice. Some people with RA don’t have all the criteria. Generally, though, the diagnostic criteria for rheumatoid arthritis include:

• Inflammatory arthritis in two or more large joints (shoulders, elbows, hips, knees and ankles).
• Inflammatory arthritis in smaller joints.
• Positive biomarker tests like rheumatoid factor (RF) or CCP antibodies.
• Elevated levels of CRP or an elevated sed rate.
• Your symptoms have lasted more than six weeks.

What are the goals of treating rheumatoid arthritis?

The most important goal of treating rheumatoid arthritis is to reduce joint pain and swelling. Doing so should help maintain or improve joint function. The long-term goal of treatment is to slow or stop joint damage. Controlling joint inflammation reduces your pain and improves your quality of life.

How is rheumatoid arthritis treated?

Joint damage generally occurs within the first two years of diagnosis, so it’s important to see your provider if you notice symptoms. Treating rheumatoid arthritis in this “window of opportunity” can help prevent long-term consequences.

Treatments for rheumatoid arthritis include lifestyle changes, therapies, medicine and surgery. Your provider considers your age, health, medical history and how bad your symptoms are when deciding on a treatment.

What medications treat rheumatoid arthritis?

Early treatment with certain drugs can improve your long-term outcome. Combinations of drugs may be more effective than, and appear to be as safe as, single-drug therapy.

There are many medications to decrease joint pain, swelling and inflammation, and to prevent or slow down the disease. Medications that treat rheumatoid arthritis include:

Non-steroidal anti-inflammatory drugs (NSAIDs)

Non-steroidal anti-inflammatory drugs decrease pain and inflammation. They include products like:

• Ibuprofen (Advil®, Motrin®).
• Naproxen (Aleve®).
• Aspirin.

COX-2 inhibitors

COX-2 inhibitors are another kind of NSAID. They include products like celecoxib (Celebrex®). COX-2 inhibitors have fewer bleeding side effects on your stomach than typical NSAIDs.

Corticosteroids

Corticosteroids, also known as steroids, also can help with pain and inflammation. They include prednisone and cortisone.

Disease-modifying antirheumatic drugs (DMARDs)

Unlike other NSAIDs, DMARDs actually can slow the disease process by modifying your immune system. Your provider may prescribe DMARDs alone and in combination with steroids or other drugs. Common DMARDs include:

• Methotrexate (Trexall®).
• Hydroxychloroquine (Plaquenil®).
• Sulfasalazine (Azulfidine®).
• Leflunomide (Arava®).

Janus kinase (JAK) inhibitors

JAK inhibitors are another type of DMARD. Rheumatologists often prescribe JAK inhibitors for people who don’t improve taking methotrexate alone. These products include:

• Tofacitinib (Xeljanz®).
• Baracitinib (Olumiant®).

Biologics

If you don’t respond well to DMARDs, your provider may prescribe biologic response agents (biologics). Biologics target the molecules that cause inflammation in your joints. Providers think biologics are more effective because they attack the cells at a more specific level. These products include:

• Etanercept (Enbrel®).
• Infliximab (Remicade®).
• Adalimumab (Humira®).
• Anakinra (Kinaret®).
• Abatacept (Orencia®).
• Rituximab (Rituxan®).
• Certolizumab (Cimzia®).
• Golimumab (Simponi®).
• Tocilizumab (Actemra®).

Biologics tend to work rapidly — within two to six weeks. Your provider may prescribe them alone or in combination with a DMARD like methotrexate.

What is the safest drug for rheumatoid arthritis?

The safest drug for rheumatoid arthritis is one that gives you the most benefit with the least amount of negative side effects. This varies depending on your health history and the severity of your RA symptoms. Your healthcare provider will work with you to develop a treatment program. The drugs your healthcare provider prescribes will match the seriousness of your condition.

It’s important to meet with your healthcare provider regularly. They’ll watch for any side effects and change your treatment, if necessary. Your healthcare provider may order tests to determine how effective your treatment is and if you have any side effects.

Will changing my diet help my rheumatoid arthritis?

When combined with the treatments and medications your provider recommends, changes in diet may help reduce inflammation and other symptoms of RA. But it won’t cure you. You can talk with your doctor about adding good fats and minimizing bad fats, salt and processed carbohydrates. No herbal or nutritional supplements, like collagen, can cure rheumatoid arthritis. These dietary changes are safer and most successful when monitored by your rheumatologist.

But there are lifestyle changes you can make that may help relieve your symptoms. Your rheumatologist may recommend weight loss to reduce stress on inflamed joints.

People with rheumatoid arthritis also have a higher risk of coronary artery disease. High blood cholesterol (a risk factor for coronary artery disease) can respond to changes in diet. A nutritionist can recommend specific foods to eat or avoid to reach a desirable cholesterol level.

When is surgery used to treat rheumatoid arthritis?

Surgery may be an option to restore function to severely damaged joints. Your provider may also recommend surgery if your pain isn’t controlled with medication. Surgeries that treat RA include:

• Knee replacement.
• Hip replacement.
• Other surgeries to correct a deformity.

What is the prognosis (outlook) for people who have rheumatoid arthritis?

Although there’s no cure for rheumatoid arthritis, there are many effective methods for decreasing your pain and inflammation and slowing down your disease process. Early diagnosis and effective treatment are very important.

What types of lifestyle changes can help with rheumatoid arthritis?

Having a lifelong illness like rheumatoid arthritis may make you feel like you don’t have much control over your quality of life. While there are aspects of RA that you can’t control, there are things you can do to help you feel the best that you can.

Such lifestyle changes include:

Rest

When your joints are inflamed, the risk of injury to your joints and nearby soft tissue structures (such as tendons and ligaments) is high. This is why you need to rest your inflamed joints. But it’s still important for you to exercise. Maintaining a good range of motion in your joints and good fitness overall are important in coping with RA.

Exercise

Pain and stiffness can slow you down. Some people with rheumatoid arthritis become inactive. But inactivity can lead to a loss of joint motion and loss of muscle strength. These, in turn, decrease joint stability and increase pain and fatigue.

Regular exercise can help prevent and reverse these effects. You might want to start by seeing a physical or occupational therapist for advice about how to exercise safely. Beneficial workouts include:

• Range-of-motion exercises to preserve and restore joint motion.
• Exercises to increase strength.
• Exercises to increase endurance (walking, swimming and cycling).

What are the early signs of rheumatoid arthritis?

Early signs of rheumatoid arthritis include tenderness or pain in small joints like those in your fingers or toes. Or you might notice pain in a larger joint like your knee or shoulder. These early signs of RA are like an alarm clock set to vibrate. It might not always been enough to get your attention. But the early signs are important because the sooner you’re diagnosed with RA, the sooner your treatment can begin. And prompt treatment may mean you are less likely to have permanent, painful joint damage.

What is early stage rheumatoid arthritis?

Providers sometimes use the term “early rheumatoid arthritis” to describe the condition in people who’ve had symptoms of rheumatoid arthritis for fewer than six months.

What are the four stages of rheumatoid arthritis?

• Stage 1: In early stage rheumatoid arthritis, the tissue around your joint(s) is inflamed. You may have some pain and stiffness. If your provider ordered X-rays, they wouldn’t see destructive changes in your bones.
• Stage 2: The inflammation has begun to damage the cartilage in your joints. You might notice stiffness and a decreased range of motion.
• Stage 3: The inflammation is so severe that it damages your bones. You’ll have more pain, stiffness and even less range of motion than in stage 2, and you may start to see physical changes.
• Stage 4: In this stage, the inflammation stops but your joints keep getting worse. You’ll have severe pain, swelling, stiffness and loss of mobility.

What’s the normal sed rate for rheumatoid arthritis?

Sed rate (erythrocyte sedimentation rate, also known as ESR) is a blood test that helps detect inflammation in your body. Your healthcare provider may also use this test to watch how your RA progresses. Normal sed rates are as follows:

People designated male at birth

Age	Erythrocyte sedimentation rate
< 50 years old	≤ 15 mm/hr
“50 years old”	≤ 20 mm/hr

People designated female at birth

Age	Erythrocyte sedimentation rate
< 50 years old	≤ 20 mm/hr
“50 years old”	≤ 30 mm/hr

In rheumatoid arthritis, your sed rate is likely higher than normal. To take part in clinical trials related to rheumatoid arthritis, you usually need an ESR of ≥ 28 mm/hr. With treatment, your sed rate may decrease. If you reach the normal ranges listed above, you may be in remission.

What is the difference?

Rheumatoid arthritis vs. osteoarthritis

Rheumatoid arthritis and osteoarthritis are both common causes of pain and stiffness in joints. But they have different causes. In osteoarthritis, inflammation and injury break down your cartilage over time. In rheumatoid arthritis, your immune system attacks the lining of your joints.

Rheumatoid arthritis vs. gout

Rheumatoid arthritis and gout are both painful types of arthritis. Gout symptoms include intense pain, redness, stiffness, swelling and warmth in your big toe or other joints. In gout, uric acid crystals cause inflammation. In rheumatoid arthritis, it’s your immune system that causes joint damage.

Is rheumatoid arthritis a disability?

The Americans with Disabilities Act (ADA) says that a disability is a physical or mental impairment that limits one or more major life activity. If RA impacts your ability to function, you may qualify for disability benefits from the Social Security Administration.

Can rheumatoid arthritis go away?

No, rheumatoid arthritis doesn’t go away. It’s a condition you’ll have for the rest of your life. But you may have periods where you don’t notice symptoms. These times of feeling better (remission) may come and go.

That said, the damage RA causes in your joints is here to stay. If you don’t see a provider for RA treatment, the disease can cause permanent damage to your cartilage and, eventually, your joints. RA can also harm organs like your lung and heart.

A note from QBan Health Care Services

If you have rheumatoid arthritis, you may feel like you’re on a lifelong roller coaster of pain and fatigue. It’s important to share these feelings and your symptoms with your healthcare provider. Along with X-rays and blood tests, what you say about your quality of life will help inform your treatment. Your healthcare provider will assess your symptoms and recommend the right treatment plan for your needs. Most people can manage rheumatoid arthritis and still do the activities they care about.

Osteoarthritis is the most common type of arthritis. It happens when the cartilage that lines your joints is worn down or damaged and your bones rub together when you use that joint. A healthcare provider will help you find a combination of treatments to manage your symptoms.

What is osteoarthritis?

Osteoarthritis is the most common type of arthritis (a condition that affects your joints). Healthcare providers sometimes refer to it as degenerative joint disease or OA. It happens when the cartilage that lines your joints is worn down over time and your bones rub against each other when you use your affected joints.

Usually, the ends of bones in your joints are capped in a layer of tough, smooth cartilage. Cartilage is like a two-in-one shock absorber and lubricant — it helps the bones in your joints move past each other smoothly and safely. If you have osteoarthritis, the cartilage in your affected joints wears away over time. Eventually, your bones rub against each other when you move your joints.

Osteoarthritis can affect any of your joints, but most commonly develops in your:

• Hands.
• Knees.
• Hips.
• Neck (cervical spine).
• Lower back (lumbar spine).

Types of osteoarthritis

A healthcare provider might classify osteoarthritis as one of two types:

• Primary osteoarthritis is the most common form of osteoarthritis that develops in your joints over time. Experts think it’s usually caused by normal wear and tear of using your joints throughout your life.
• Secondary osteoarthritis happens when something directly damages one of your joints enough to cause osteoarthritis. Injuries and traumas are common causes of secondary osteoarthritis. Other types of arthritis can damage the cartilage in your joints enough to cause osteoarthritis, too.

How common is osteoarthritis?

Osteoarthritis is very common. Experts estimate that more than 80% of adults older than 55 have osteoarthritis, even if some of them never experience symptoms.

Around 60% of people with osteoarthritis have symptoms they can notice or feel.

What are osteoarthritis symptoms?

The most common symptoms of osteoarthritis include:

• Pain in a joint (especially when you’re moving it).
• Stiffness.
• Swelling near a joint.
• A decreased range of motion (how far you can move a joint).
• Feeling like a joint isn’t as strong or stable as it usually is.
• A joint looking noticeably different than it used to (joint deformity).

What causes osteoarthritis?

Experts aren’t sure what causes osteoarthritis. Primary osteoarthritis usually develops slowly as you age. As you get older, normal wear and tear on your joints might contribute to their cartilage breaking down.

Anything that directly damages your joints can also cause osteoarthritis, including:

• Sports injuries.
• Falls.
• Car accidents.
• Health conditions that affect your joints, like Ehlers-Danlos syndrome or joint hypermobility syndrome.

Other forms of arthritis (specifically inflammatory arthritis) can cause osteoarthritis, including:

• Rheumatoid arthritis.
• Gout.
• Psoriatic arthritis

Osteoarthritis risk factors

Anyone can develop osteoarthritis. Adults older than 55 and people who are in postmenopause are more likely to develop osteoarthritis.

People with certain health conditions are more likely to experience osteoarthritis, including:

• Obesity (having a body mass index, or BMI, greater than 30) or overweight (having a BMI over 25).
• Diabetes.
• High cholesterol (hyperlipidemia).
• Some autoimmune diseases that affect your joints.

How is osteoarthritis diagnosed?

A healthcare provider will diagnose osteoarthritis with a physical exam and imaging tests. They’ll look at your joints and ask you when you first noticed any symptoms. Tell them if any activities make your symptoms worse, or if they come and go.

What tests are done to diagnose osteoarthritis?

Your healthcare provider might use X-rays to take pictures of your joints. They might also use an MRI (magnetic resonance imaging) or CT (computed tomography) scan.

You might need blood tests to rule out other conditions or issues that cause similar symptoms.

How is osteoarthritis treated?

Your healthcare provider will help you find treatments that relieve your osteoarthritis symptoms. There’s no cure for arthritis, and you can’t regrow the cartilage in your affected joints. Your provider will help you find ways to manage your symptoms when you’re experiencing them.

The most common treatments for osteoarthritis include:

• Medication: Over-the-counter (OTC) pain relievers can help reduce pain and inflammation. You might need medication you take by mouth or topical pain relievers (creams, ointments or patches you put on your skin near your affected joints).
• Exercise: Moving your joints can relieve stiffness and strengthen the muscles around them. Low-impact activities like swimming, water aerobics and weight training can all help. Your provider might recommend that you work with a physical therapist.
• Supportive devices: Wearing shoe inserts or a brace can support and stabilize your joints. Using a cane or walker can take pressure off your affected joints and help you move safely.
• Heat and cold therapies: Applying heat or cold to your affected joints might help relieve pain and stiffness. Your provider will tell you how often (and for how long) you should apply a heating pad, ice packs or a cool compress.
• Complementary therapy: Complementary therapies may work alongside other treatment options. Examples of complementary medicine include acupuncture, massage, meditation, tai chi and dietary supplements. Talk to your provider before you start taking any herbal or dietary supplements.
• Surgery: Most people don’t need surgery to treat osteoarthritis. Your provider might recommend surgery if you’re experiencing severe symptoms and other treatments haven’t worked. You might need a joint replacement (arthroplasty). Your provider or surgeon will tell you what to expect.

How can I prevent osteoarthritis?

The best way to prevent osteoarthritis is to maintain good overall health, including:

• Avoiding tobacco products.
• Doing low-impact exercise.
• Following a diet plan that’s healthy for you.
• Always wearing your seatbelt.
• Wearing proper protective equipment for any activity, sport or work you’re doing.
• Visiting a healthcare provider for regular checkups and as soon as you notice any changes in your joints.

What can I expect if I have osteoarthritis?

Most people with osteoarthritis need to manage their symptoms for the rest of their lives. Your healthcare provider will help you find the right combination of treatments to reduce your symptoms.

If you have osteoarthritis, it’s important to stay as active as possible. If joint pain and other symptoms make it too hard for you to move, you may face a greater risk for other serious health conditions like heart disease, diabetes and some types of cancer.

Talk to your healthcare provider if osteoarthritis makes it hard (or impossible) to stay active. They’ll help you find new treatments to manage your symptoms.

What can I do to make living with osteoarthritis easier?

You might need to tweak your routine to make living with osteoarthritis easier. Depending on when you’re experiencing symptoms (and how severe they are), you may need to avoid or modify your activities while you’re managing symptoms. You might work with an occupational therapist if you need help performing your daily tasks. Occupational therapists are healthcare providers who can help you manage physical challenges like arthritis. They may recommend:

• Adaptive equipment, such as grips for opening jars.
• Techniques for doing hobbies, sports or other activities safely.
• Tips for reducing joint pain during arthritic flare-ups.

When should I see my healthcare provider?

Visit a healthcare provider as soon as you notice any symptoms of osteoarthritis. Even minor joint pain can be a sign that you need treatment — especially if it doesn’t get better in a few days.

You can’t repair any cartilage degeneration (breakdown) that’s already happened, but starting osteoarthritis treatment can slow down further damage inside your joints.

Talk to your provider if it feels like your symptoms are coming back more often or are more severe than they used to be. Ask your provider about other treatment options or changes you can make to your existing treatments if you feel like they’re not working as well as they usually do.

What questions should I ask my doctor?

• Do I have osteoarthritis or another type of arthritis?
• Which of my joints are affected?
• Which treatments will I need?
• Will I need surgery?
• Would working with a physical therapist or occupational therapist help me?

At what age does osteoarthritis usually start?

Osteoarthritis usually affects people older than 55. However, there’s no set timeline or age restriction on when you might experience it. It also doesn’t start the way some health conditions do — there’s not usually an exact starting point your healthcare provider can precisely identify.

It can take a long time for the cartilage in your affected joints to wear down enough to cause pain and stiffness. So, even if you first notice symptoms around age 55, that doesn’t mean osteoarthritis started exactly at that time.

A note from QBan Health Care Services

Osteoarthritis is a type of arthritis that happens when cartilage in your joints wears down. Without that slippery, smooth shock absorber, your joints can feel stiff, painful or like they’re grinding together when you use them.

The best thing to do for osteoarthritis is to visit a healthcare provider as soon as you notice symptoms, especially if they’re making it hard to participate in your usual activities. You’ll probably have to manage your symptoms for a long time, but your provider will help you find a combination of treatments that keeps you active and your joints safe and supported.

Lupus is an autoimmune disease that makes your immune system damage organs and tissue throughout your body. It causes inflammation that can affect your skin, joints, blood and organs like your kidneys, lungs and heart. A healthcare provider will help you find medications to manage your symptoms and reduce how often you experience flare-ups.

What is lupus?

Lupus is a condition that causes inflammation throughout your body. It’s an autoimmune disease, which means your immune system damages your body instead of protecting it. You may experience symptoms throughout your body depending on where your autoimmune system damages tissue, including in your:

• Skin.
• Blood.
• Joints.
• Kidneys.
• Brain.
• Heart.
• Lungs.

Visit a healthcare provider if you notice new pain, rashes or changes to your skin, hair or eyes.

Types of lupus

Healthcare providers sometimes call lupus systemic lupus erythematosus (SLE). It’s the most common type of lupus, and means you have lupus throughout your body. Other types include:

• Cutaneous lupus erythematous: Lupus that only affects your skin.
• Drug-induced lupus: Some medications trigger lupus symptoms as a side effect. It’s usually temporary and might go away after you stop taking the medication that caused it.
• Neonatal lupus: Babies are sometimes born with lupus. Babies born to biological parents with lupus aren’t certain to have lupus, but they might have an increased risk.

What are lupus symptoms?

Lupus causes symptoms throughout your body, depending on which organs or systems it affects. Everyone experiences a different combination and severity of symptoms.

Lupus symptoms usually come and go in waves called flare-ups. During a flare-up, the symptoms can be severe enough to affect your daily routine. You might also have periods of remission when you have mild or no symptoms.

Symptoms usually develop slowly. You might notice one or two signs of lupus at first, and then more or different symptoms later on. The most common symptoms include:

• Joint pain, muscle pain or chest pain (especially when you’re taking a deep breath).
• Headaches.
• Rashes (it’s common to have a rash across your face that providers sometimes call a butterfly rash).
• Fever.
• Hair loss.
• Mouth sores.
• Fatigue (feeling tired all the time).
• Shortness of breath (dyspnea).
• Swollen glands.
• Swelling in your arms, legs or on your face.
• Confusion.
• Blood clots.

Lupus can sometimes cause other health conditions or issues, including:

• Photosensitivity (sensitivity to sunlight).
• Dry eye.
• Depression (or other mental health conditions).
• Seizures.
• Anemia.
• Raynaud’s syndrome.
• Osteoporosis.
• Heart disease.
• Kidney disease.

What causes lupus?

Experts don’t know for certain what causes lupus. Studies have found that certain factors about your health or where you live may trigger lupus:

• Genetic factors: Having certain genetic mutations may make you more likely to have lupus.
• Hormones: Reactions to certain hormones in your body (especially estrogen) may make you more likely to develop lupus.
• Environmental factors: Aspects about where you live and how much pollution or sunlight you’re exposed to might affect your lupus risk.
• Your health history: Smoking, your stress level and having certain other health conditions (like other autoimmune diseases) might trigger lupus.

Risk factors

Anyone can develop lupus, but some groups of people have a higher risk:

• People assigned female at birth (AFAB), especially people AFAB between the ages of 15 and 44.
• Black people.
• Hispanic people.
• Asian people.
• Native Americans, Alaska Natives and First Nations people.
• Pacific Islanders.
• People with a biological parent who has lupus.

How is lupus diagnosed?

A healthcare provider will diagnose lupus with a physical exam and some tests. They’ll examine your symptoms and talk to you about what you’re experiencing. Tell your provider when you first noticed symptoms or changes in your body. Your provider will ask about your medical history, including conditions you may have now and how you’re treating or managing them.

Lupus can be tricky to diagnose because it can affect so many parts of your body and cause lots of different symptoms. Even small changes or issues that seem unusual for you can be a key. Don’t be afraid to tell your provider about anything you’ve felt or sensed — you know your body better than anyone.

Which tests do providers use to diagnose lupus?

There’s not one test that can confirm a lupus diagnosis. Diagnosing it is usually part of a differential diagnosis. This means your provider will probably use a few tests to determine what’s causing your symptoms before ruling out other conditions and diagnosing you with lupus. They might use:

• Blood tests to see how well your immune system is working and to check for infections or other issues like anemia or low blood cell counts.
• Urinalysis to check your pee for signs of infections or other health conditions.
• An antinuclear antibody (ANA) test looks for antibodies (protein markers that show a history of your body fighting off infections). People who have lupus usually have certain antibodies that show their immune system has been overly active.
• A biopsy of your skin or kidney tissue can show if your immune system has damaged them.

What is lupus treatment?

Your healthcare provider will suggest treatments for lupus that manage your symptoms. The goal is minimizing damage to your organs and how much lupus affects your day-to-day life. Most people with lupus need a combination of medications to help them prevent flare-ups and lessen their symptom severity during one. You might need:

• Hydroxychloroquine: Hydroxychloroquine is a disease-modifying antirheumatic drug (DMARD) that can relieve lupus symptoms and slow down how they progress (change or get worse).
• Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter (OTC) NSAIDs relieve pain and reduce inflammation. Your provider will tell you which type of NSAID will work best for you, and how often you should take it. Don’t take NSAIDs for more than 10 days in a row without talking to your provider.
• Corticosteroids: Corticosteroids are prescription medications that reduce inflammation. Prednisone is a common corticosteroid providers use to manage lupus. Your provider might prescribe you pills you take by mouth or inject a corticosteroid directly into one of your joints.
• Immunosuppressants: Immunosuppressants are medications that hold back your immune system and stop it from being as active. They can help prevent tissue damage and inflammation.

You might need other medications or treatments to manage specific lupus symptoms you have or other health conditions it’s causing. For example, you may need treatment for anemia, high blood pressure (hypertension) or osteoporosis if lupus causes those issues.

Can I prevent lupus?

You can’t prevent lupus because experts aren’t sure what causes it. Talk to a healthcare provider about your risk if one of your biological parents has lupus.

How can I prevent lupus flare-ups?

You might be able to prevent and reduce lupus flare-ups by avoiding activities that trigger your symptoms, including:

• Avoiding sun exposure: Spending too much time in the sun can trigger lupus symptoms in some people. Try to avoid going outside when the sun is brightest (usually between 10 a.m. and 4 p.m.). Wear long sleeves, a hat or sun-protective clothing. Use a sunscreen that’s at least SPF 50.
• Staying active: Joint pain can make it hard or painful to move. But moving and gently using your joints can be the best way to relieve symptoms like pain and stiffness. Walking, biking, swimming, yoga and tai chi are all great ways to move your body without putting too much stress on your joints. Ask your healthcare provider which types of activities are safest for you.
• Getting enough sleep and protecting your mental health: Living with lupus can be frustrating. Getting the right amount of sleep (seven to nine hours for adults) and reducing your stress can help prevent flare-ups for some people. A psychologist or other mental health professional can help you develop healthy coping mechanisms.

What can I expect if I have lupus?

Lupus is a lifelong (chronic) condition. You should expect to manage lupus symptoms for the rest of your life.

Lupus can be unpredictable, and the way it impacts you can change over time. You’ll need to regularly visit your healthcare provider so they can track changes in your symptoms.

You’ll probably work with a team of providers as you learn to live with lupus. Your primary care provider will suggest specialists who can help with specific issues or symptoms. You’ll probably need to visit a rheumatologist — a healthcare provider who specializes in diagnosing and treating autoimmune diseases. Which specialists you need to visit depends on which symptoms you have and how they affect your body.

Is there a cure for lupus?

There’s currently no cure for lupus. Your healthcare provider will help you find a combination of treatments to manage your symptoms and hopefully put lupus into remission (long periods of time with no symptoms or flare-ups).

When should I see my healthcare provider?

Visit a healthcare provider as soon as you notice any new or changing symptoms. Even small shifts in what you’re feeling and experiencing can be important.

Talk to your provider if it feels like your treatments aren’t managing lupus symptoms as well as they used to. Tell your provider if you’re having flare-ups more often — or if the flare-ups cause more severe symptoms. They’ll help you adjust your treatments as needed.

Go to the emergency room or call 911 (or your local emergency services number) if you’re experiencing any of the following symptoms:

• You can’t breathe.
• You’re in severe pain.
• You think you’re experiencing heart attack symptoms.

What questions should I ask my healthcare provider?

• Do I have lupus or another autoimmune disease?
• Which medications will I need?
• How often should I see you for follow-up appointments?
• Will I need to visit other specialists?
• Can you suggest any support groups or other mental health resources?

A note from QBan Health Care Services

Lupus can be a frustrating, tiring condition. Pain, inflammation and irritation throughout your body can be exhausting. But don’t forget to appreciate yourself. Living with a chronic condition is hard work, and you deserve credit for managing your symptoms every day. Ask your provider about mental health resources and support groups if you think talking to someone about how you’re feeling could help you.

Don’t be afraid to talk to your provider and ask questions. Even small changes in your symptoms or health can be a sign that lupus is affecting you differently. Remember, you’re the best judge of when something isn’t quite right in your body.

Bursitis is a painful swelling, usually around your joints. It’s common in the shoulders, elbows, knees and feet. You’re more likely to get it if you have a job or hobby that puts a lot of stress on your joints.

What is bursitis?

Bursitis is painful swelling in a small, fluid-filled sac called a bursa. Bursae (the plural of bursa) cushion spaces around bones and other tissue. They’re like bubble wrap that protects structures throughout your body. Bursae cushion the spaces between bones and your:

• Muscles.
• Tendons.
• Skin.

Bursitis happens when a bursa becomes irritated and swells. The most common causes of bursitis are overuse and putting too much pressure on a bursa. The pain from an inflamed bursa may develop suddenly or build up over time.

Types of bursitis

There are more than 150 bursae in your body. Bursitis can affect any of them. You’re most likely to develop bursitis in joints you use for repetitive motions or in places you put a lot of pressure, including your:

• Shoulders (subacromial bursitis).
• Elbows (olecranon bursitis — sometimes called miner’s elbow or barfly’s elbow).
• Knees (prepatellar bursitis — housemaid’s knee).
• Feet (especially near your heel, big toe or the ball of your foot).
• Hips (iliopectineal or trochanteric bursitis).
• Butt (ischial bursitis or weaver’s bottom).

Healthcare providers might refer to different types of bursitis with a specific name, but they’re all the same issue — swelling in and around a bursa.

What are bursitis symptoms?

The most common symptoms of bursitis are:

• Pain, especially when you’re moving the affected part of your body.
• A limited range of motion (how far you can move a body part).
• Swelling.

If you have an infection that’s causing bursitis, you might have other symptoms, including:

• Discoloration or redness on your skin.
• A feeling of warmth or heat.
• Fever.
• Chills.

What causes bursitis?

Repetitive motions — like a pitcher throwing a baseball or lifting heavy boxes at work — commonly cause bursitis. Spending time in positions that put pressure on a specific part of your body (such as kneeling) can cause it, too.

It’s less common, but injuries and infections can cause bursitis, as well.

Activities that can lead to bursitis include:

• Carpentry.
• Gardening and raking.
• Painting.
• Poor posture or a poorly positioned joint or bone (due to different leg lengths, bone spurs, or arthritis in a joint).
• Scrubbing.
• Shoveling.
• Playing sports like tennis, golf and baseball.
• Playing an instrument.

Bursitis risk factors

Anyone can experience bursitis. People who are more likely to develop it include:

• Athletes.
• People who do physical work or manual labor.
• Musicians.

People with certain health conditions have a higher risk of bursitis, including:

• Arthritis (especially inflammatory arthritis like gout and psoriatic arthritis).
• Diabetes.
• Thyroid disease.

How is bursitis diagnosed?

A healthcare provider will diagnose bursitis with a physical exam. They’ll ask you about your symptoms and examine the area around your affected body part. Tell your provider what you were doing before you noticed symptoms for the first time and if your job or a hobby requires you to do a repetitive motion.

What tests are done to diagnose bursitis?

Your provider might use some tests to diagnose bursitis, including:

X-rays to rule out other conditions.

Ultrasound or MRI (magnetic resonance imaging) to detect swollen bursae.

A blood test to look for infection.

An aspiration (taking a sample of fluid) of your affected bursa if they think it’s infected.

What is the best way to treat bursitis?

Usually, rest is all you’ll need to treat bursitis. Avoid the activity or positions that irritated your bursa.

Taking a break from activities that put pressure on that part of your body will give it time to heal and prevent further injury. Ask your provider how long you’ll need to rest and avoid physical activities.

Your provider might suggest at-home treatments to reduce the pain and swelling while your bursa heals:

• Elevate the injured area.
• Take over-the-counter (OTC) pain relievers like ibuprofen, naproxen or acetaminophen. Don’t take pain relievers for more than 10 days in a row without talking to your provider.
• Ice the area. Apply a cold compress or ice packs wrapped in a thin towel to the area for 15 minutes at a time, a few times a day.
• Apply heat (like a heating pad or a hot water bottle wrapped in a towel). Your provider might suggest alternating ice and heat.
• Wear a splint, sling or brace to keep the injured area supported.

Most cases of bursitis heal on their own with rest and at-home treatments. But your provider may recommend additional treatment options, including:

• Antibiotics if you have an infection.
• Physical therapy to increase your range of motion.
• Occupational therapy to learn how to move in ways that don’t stress the area.
• Corticosteroid injections to decrease inflammation and pain.
• Surgery to resect (remove) your bursa if other treatments aren’t effective and you’re still experiencing symptoms for six months or longer.

How can I prevent bursitis?

The best way to prevent bursitis is to avoid overusing your body. To prevent bursitis:

Learn the proper posture or technique for sports or work activities.

Ease into new exercises or activities to avoid injury.

Avoid sitting or kneeling too long. These positions put a lot of pressure on your joints.

Use cushions and pads when you kneel or lean on your elbows.

Take breaks if you’re doing a repetitive task.

How long does bursitis usually last?

Bursitis is usually short-lived. Most people heal within a few weeks. Follow your healthcare provider’s recommendations and don’t resume physical activities before your bursa has healed. Even if your pain improves, putting pressure or stress on your bursa before it’s completely healed increases your risk of reinjuring it.

Will I need to miss work or school while I’m recovering from bursitis?

If a repetitive motion that’s part of your job or studies causes bursitis, you might need to miss work or school while you’re recovering. Tell your provider about your usual routine and they’ll explain which parts of it you need to modify or take a break from while you’re resting your injured bursa.

What happens if bursitis is left untreated?

The longer you put pressure or additional stress on an injured bursa, the longer it’ll take to recover. It also increases your risk of chronic bursitis (bursitis that comes and goes in the same area).

Chronic bursitis

You can get bursitis more than once in the same area. When you have repeated bursitis episodes, it’s considered a chronic (long-lasting) condition. Bursitis may come and go. The same kind of irritation that caused the original inflammation can trigger a new episode. Repeated flare-ups may damage the bursa and reduce your mobility in that joint.

When should I see my healthcare provider?

Visit a healthcare provider if you have any of the following symptoms:

• Pain that interferes with your day-to-day activities.
• Soreness that doesn’t get better in a few days with at-home treatment.
• Bursitis that comes back (recurs).
• Fever.
• Discoloration or redness, swelling or a feeling of warmth in an injured area.

What questions should I ask my doctor?

• Which type of bursitis do I have?
• Will I need any tests?
• Which treatments will I need?
• How long do I need to rest?
• When can I resume sports or other physical activities?

What is the difference between bursitis and arthritis?

Arthritis and bursitis both affect your joints. Bursitis is usually a short-term issue that’s caused by overusing or putting excess stress on a bursa around one of your joints. It doesn’t create long-lasting damage unless you continue to stress the area.

Arthritis happens when cartilage in a joint breaks down over time. Arthritis is usually a long-term condition that you’ll need to manage for the rest of your life.

What is the difference between bursitis and tendinitis?

Bursitis and tendinitis are both painful conditions that happen when tissue in your body is irritated and swells. Bursitis is inflammation in one or more of your bursae.

Tendinitis is inflammation or irritation of a tendon. Tendons are pieces of connective tissue between muscles and bones. Tendinitis can be either acute (short-term) or chronic (long-term).

Doing a repetitive activity can cause both bursitis and tendinitis — like doing the same motion for a sport, or using the same part of your body for physical work frequently.

A note from QBan Health Care Services

Bursitis is painful, and it can be frustrating to learn your job or hobby you love caused an injury inside your body. The good news is that bursitis is usually preventable. The first step is figuring out which movements caused the irritation.

Your healthcare provider will help you find treatments that let your injured bursae heal and solutions to prevent bursitis in the future. Don’t rush your recovery — rest for as long as your provider suggests. It might be annoying to skip sports or an activity that you’re used to doing every day, but it’s important to give your body all the time it needs to heal.

Tendonitis (tendinitis) is a condition where the connective tissues between your muscles and bones (tendons) inflame. Often caused by repetitive activities, tendonitis can be painful. It can happen in your elbow, knee, shoulder, hip, Achilles tendon and base of your thumb. Rest and avoiding strenuous activities help tendons heal.

What is tendonitis?

Tendonitis (tendinitis) is the inflammation or irritation of a tendon that makes it swell. Tendons are strands of connective tissue between muscles and bones that help you move. This condition usually happens after a repetitive strain or overuse injury. It’s common in your shoulders, elbows and knees. If you have tendonitis, you’ll feel pain and soreness around your affected joint, usually near where the tendon attaches to the bone. Tendonitis can be either acute (short-term) or chronic (long-term).

Types of tendonitis

Types of tendonitis get their names after sports and the area of your body where injuries happen. Some of the most common types of tendonitis include:

• Tennis elbow.
• Golfer’s elbow.
• Pitcher’s shoulder.
• Swimmer’s shoulder.
• Runner’s knee (jumper’s knee).

How common is it?

Tendonitis is a relatively common condition. This is because people participate in occupations, activities or hobbies where they can easily overuse or injure their tendons.

What are the symptoms of tendonitis?

The most common symptoms of tendonitis include:

• Pain at the site of your tendon and the surrounding area. This pain can get worse when you move.
• Stiff joints or difficulty moving your joints.
• Hearing and feeling a cracking or popping sensation when you move.
• Swelling, often with skin discoloration (red to purple or darker than your natural skin tone).

The pain you feel with tendonitis may be gradual or sudden and severe, especially if you have calcium deposits. Calcium deposits are a buildup of calcium in your tissues that looks like firm white to yellow bumps on your skin. These bumps can cause itchy skin.

Where on my body will I have symptoms of tendonitis?

Tendinitis can occur in almost any area of your body where a tendon connects a bone to a muscle. The most common places are:

• Base of your thumb.
• Elbow, usually along the outer part of the forearm, when your palm is facing up, near where the tendon attaches to the outside part of the elbow.
• Shoulder.
• Hip.
• Knee, usually below the kneecap where your tendon attaches to your lower leg (tibia).
• Achilles tendon, which connects your calf muscles to your heel bone.

What causes tendonitis?

Causes of tendonitis could include:

• Overuse or repetitive movements over time (like running or throwing).
• Strain from sudden movements.
• An injury.

In addition, tendonitis could be a side effect of a medication, including statins or drugs that lower cholesterol or fluoroquinolone antibiotics.

Certain underlying medical conditions can also cause tendonitis, such as:

• Diabetes.
• Rheumatoid arthritis.
• Gout/pseudo gout.
• Osteoarthritis.
• An infection.

What are the risk factors for tendonitis?

Anyone can get tendonitis. But it’s more common in those who do repetitive activities. Some of these activities include:

• Gardening/landscaping.
• Woodworking.
• Shoveling.
• Painting.
• Scrubbing.
• Playing sports like tennis, golf or baseball.

Other risk factors for tendonitis include:

• Poor posture.
• Presence of certain conditions that can weaken your muscles.
• Your age. After age 40, your tendons tolerate less stress, are less elastic and tear more easily

What are the complications of tendonitis?

If left untreated, tendonitis could lead to:

• Chronic tendonitis (a constant, dull pain when you move).
• Difficulty or inability to move the affected part of your body.
• Torn tendons (tendon rupture).
• Muscle weakness.

How is tendonitis diagnosed?

A healthcare provider will diagnose tendonitis after a physical exam and testing. During the exam, your provider will take a complete medical history and ask you questions about your symptoms. They’ll order tests to confirm a diagnosis. Imaging tests help your provider see your tendons and could include:

• An X-ray.
• An MRI (magnetic resonance imaging).

How is tendonitis treated?

There are two steps to treat tendonitis. The first step includes:

• Icing the area the day of your injury.
• Avoiding activities that cause symptoms.
• Resting the injured area.
• Taking over-the-counter (OTC) anti-inflammatory medicines.

If tendonitis doesn’t improve in about three weeks, a healthcare provider will offer additional treatment that could include:

• Corticosteroid injections: Corticosteroids (often called “steroids”) work quickly to decrease the inflammation and pain in your tendon.
• Physical therapy: Physical therapy includes range of motion exercises and splinting (thumb, forearm or hands). Physical therapy will focus on reducing inflammation, improving soft tissue mobility to the muscle (where that tendon originates from), and restoring movement, function and strength over time. With tendinitis-type injuries, a gradual loading of the tendon (eccentric loading), is essential to improving the condition and restoring function. Therapy may also be useful in screening other joints for mobility deficits that may have led to the development of tendonitis. A common example is looking at shoulder mobility when working with a person who has a tennis elbow.
• Surgery: This is rarely needed and is only for severe symptoms that don’t respond to other treatments.

Are there side effects of the treatment?

Before you begin treatment, talk to your healthcare provider about possible side effects. You may experience:

• Pain at your injection site if you receive corticosteroid injections.
• Soreness after physical therapy.
• Bleeding or an infection after surgery.

How long does tendonitis take to heal?

It could take between two to three weeks for your tendon to heal after tendonitis treatment. It can take a few months if you have a severe case of tendonitis. The best way to speed up your healing time is to rest. Don’t participate in strenuous exercises or activities that can put stress on your healing tendon. Your healthcare provider will let you know when it’s safe to return to your favorite sports and activities after your tendon heals.

Can I prevent tendonitis?

To avoid getting tendonitis, follow these tips:

• Avoid staying in the same position. Take breaks every 30 minutes.
• Learn proper posture and body positions for all activities.
• Position your body directly in front of the object you want to pick up. Reach for the object by stretching your arm and hand directly forward toward the object. Never grab objects with your arm in a sideways position. If reaching for an object overhead, center your body and reach up and grab the item with both hands.
• Use a firm, but not a tightly squeezed, grip when working with or picking up objects.
• Don’t use one hand to carry heavy objects. Don’t hold the heavy object in one hand at the side of your body.
• Avoid sitting with your leg folded under your bottom.
• Stop any activity if you feel pain.

How can I lower my risk of tendonitis?

You can reduce your risk of developing tendonitis by following these steps before exercising or starting a sports activity:

• Stretch and warm up before starting the activity.
• Wear properly sized and fitted clothes, shoes and equipment.
• Start slow. Gradually increase your activity level.
• Stop your activity if you feel pain.

What can I expect if I have tendonitis?

Most people diagnosed with tendonitis have an excellent prognosis after treatment and rest. It may take a few weeks to a couple of months to recover from tendonitis, depending on the severity of your injury. Wait until your healthcare provider gives you the “all clear” to resume your regular physical activities.

If you develop tendonitis and receive treatment for it, you can get the injury again in the future if you put too much stress on your tendons. This is a repetitive strain injury. Your healthcare provider, sports medicine physician or physical therapist can give you advice to reduce your risk of developing repeat tendonitis in the future.

When should I see a healthcare provider?

You should see a healthcare provider if you experience any of the following:

• Fever (over 100 degrees Fahrenheit or 38 degrees Celsius.).
• Swelling, redness and warmth.
• General illness.
• Multiple sites of pain.
• Inability to move the affected area.

These could be signs of another condition that needs more immediate attention.

What questions should I ask my doctor?

You may want to ask your healthcare provider:

• Do I have tendonitis or arthritis?
• When can I return to playing sports or exercising?
• Are there side effects of the treatment?
• Do I need surgery?

A note from QBan Health Care Services

Tendonitis can be a frustrating condition. You’ll need to stop and rest for a few weeks to let your tendon heal after an injury that causes it to swell. This can be challenging if you’re an active person or you play sports. Don’t return to the track or field until your healthcare provider tells you it’s safe to do so. Follow your provider’s instructions to prevent injuries that lead to tendonitis.

Sprains are common injuries. They happen when ligaments around one of your joints are stretched or torn. Sport injuries and falls are the most common causes. You can usually manage your symptoms at home with the RICE method, but you should visit a healthcare provider to get any injury diagnosed.

What is a sprain?

A sprain is an injury that happens when one of your ligaments is stretched or torn.

Ligaments are bands of tissue that connect bones throughout your body. They’re like ropes that hold your muscles and bones together and prevent them from moving too far. Ligaments also make sure your joints only move in the direction(s) they’re supposed to.

Sprains happen when ligaments around one of your joints are damaged. Visit a healthcare provider if you notice pain, swelling or it’s hard to use or put weight on a joint — especially if you’ve experienced a fall, injury or accident.

Types of sprains

Any joint supported by ligaments can be sprained. The most commonly sprained joints are:

• Ankle sprains (including high ankle sprains).
• Wrist sprains.
• Knee sprains.
• Finger sprains (sometimes called jammed fingers).
• Thumb sprains.

How common are sprains?

Sprains are very common. They’re one of the most common injuries, especially among athletes.

What are sprain symptoms?

The most common sprain symptoms include:

• Pain.
• Swelling.
• Bruising or discoloration.
• Instability (feeling like you can’t put weight on the joint or move comfortably).
• Reduced range of motion (it’s hard or painful to move the joint as far as usual).

What causes sprains?

Anything that forces your joint to move too much or too far can cause a sprain. The most common causes include:

• Sports injuries.
• Falls.
• Slipping and catching yourself suddenly.
• Rolling an ankle or twisting a knee while walking, running or jumping.
• Repetitive strain injuries (overusing a joint or performing a repetitive motion for work, a sport or a hobby).

What are the risk factors for sprains?

Anyone can experience a sprain, but some people are more likely to sprain a joint, including:

• Athletes.
• Workers with physically demanding jobs.
• People who have a hobby or activity that makes them perform repetitive motions.

Exercise habits that can increase your injury risk (especially sprains) include:

• Suddenly increasing your workout or activity intensity.
• Starting a new sport or activity without the proper equipment or training (working out with poor form or wearing the wrong kind of shoes, for example).
• Playing the same sport year-round with no offseason.

How are sprains diagnosed?

A healthcare provider will diagnose a sprain with a physical exam. Your provider will examine your injured joint. Tell them when you first noticed symptoms, especially if you know exactly what caused the injury.

Healthcare providers grade sprains based on their severity:

• Grade 1 sprain (mild): Very little or no tearing in your ligament.
• Grade 2 sprain (moderate): Your ligament is partially torn, but not all the way through.
• Grade 3 sprain (severe): Your ligament is completely torn.

What tests do providers use to diagnose sprains?

You might need imaging tests to take pictures of your joint and the tissue around it. These tests can show damage inside your joint and help diagnose other injuries like bone fractures. Your provider might use:

• X-rays.
• Ultrasound.
• Magnetic resonance imaging (MRI).

How are sprains treated?

After you see a provider for a diagnosis, you should be able to treat sprain symptoms at home by following the R.I.C.E. method:

• Rest: Avoid the activity that caused your injury. Try not to use the injured part of your body while it heals.
• Ice: Apply a cold compress to your injury 15 minutes at a time, a few times a day. Wrap ice packs in a towel or thin cloth so they’re not directly touching your skin.
• Compression: Wrap an elastic bandage around your injured joint to help reduce swelling. Your provider can show you how to apply a compression wrap safely.
• Elevation: Keep your joint above the level of your heart as often as you can.

Over-the-counter NSAIDs (aspirin or ibuprofen) or acetaminophen can reduce pain and inflammation. Talk to your provider before taking over-the-counter (OTC) pain medication for longer than 10 days.

Other treatments you may need include:

• A brace or splint that supports your joint and holds it in place.
• A walking boot.
• Crutches.
• Physical therapy.

It’s rare to need surgery after a sprain. You may need surgery for a severe sprain or other injuries like a broken bone or dislocation. Some people need surgery if they’ve sprained the same joint multiple times.

How soon after treatment will I feel better?

You should start feeling better gradually after you start treating your symptoms. The most important part of healing after a sprain is to avoid using that joint or putting more stress on it. Ask your provider how much you can use your joint while you’re recovering.

How can I prevent sprains?

There might not be any way to prevent a sprain, especially if you’re an athlete.

During sports or other physical activities:

• Wear the proper protective equipment.
• Don’t “play through the pain” if something hurts during or after physical activity.
• Give your body time to rest and recover after intense activity.
• Stretch and warm up before playing sports or working out.
• Cool down and stretch after physical activity.

Follow these general safety tips to reduce your risk of an injury:

• Make sure your home and workspace are free from clutter that could trip you or others.
• Always use the proper tools or equipment at home to reach things. Never stand on chairs, tables or countertops.
• Use your cane or walker if you have difficulty walking or have an increased risk of falls.

What can I expect if I have a sprain?

You should expect to make a full recovery. Sprains are usually temporary injuries, and shouldn’t have a long-term impact on your health or ability to stay active.

Spraining a joint can make you more likely to injure it again in the future. Ask your provider about your unique risk and what you can do to prevent future sprains.

How long does it take to recover from a sprain?

Your sprain recovery time will depend on which joint is sprained and how severe it was. Most sprains take a few weeks to heal. More severe (grade 3) sprains can take a few months. Your healthcare provider will tell you what to expect.

When should I see my healthcare provider?

Visit a healthcare provider if you’ve experienced an injury and have sprain symptoms. Talk to your provider if you’ve started treating a sprain and your symptoms aren’t improving after a few days (or if they’re getting worse).

When should I go to the emergency room?

Go to the ER if you experience any of the following:

• Extreme pain.
• Swelling that’s getting worse.
• Discoloration.
• Numbness.

What questions should I ask my provider?

• Do I have a sprain or another type of injury?
• Which grade of sprain do I have?
• Which treatments will I need?
• When can I resume physical activity or play sports again?

What are sprains vs. strains?

Sprains and strains are similar injuries — the difference is what’s damaged.

Sprains happen when a ligament is torn or damaged, usually when one of your joints moves further than it should.

Muscle strains happen when one of your muscles is torn. People also sometimes call strains pulled muscles or muscle tears. Providers sometimes call tendon tears strains.

Sprains and strains are both common sports injuries. Visit a healthcare provider if you’re experiencing pain, swelling and can’t move a joint or muscle as well as you usually can.

A note from QBan Health Care Services

Almost everyone’s twisted an ankle, jammed a finger or had some kind of sprain in their lives. They’re one of the most common injuries. Even if most sprains aren’t serious and will heal with rest and at-home treatments, don’t ignore pain, swelling or instability in a joint. See a healthcare provider to get any injury diagnosed correctly, especially if it’s making it hard to use or move a joint.

Joint pain can be felt in the joints throughout your body. It may be a symptom of many different health conditions. Arthritis is the most common cause of joint pain. There are more than 100 kinds of arthritis. Joint pain may range from mild to severe. Treatments vary from simple at-home care to surgery, depending on your condition.

What is joint pain?

Joint pain is discomfort that affects one or more joints in your body. A joint is where the ends of two or more of your bones come together. For example, your hip joint is where your thigh bone meets your pelvis.

Joint discomfort is common and usually felt in your hands, feet, hips, knees or spine. Pain in your joints may be constant, or it can come and go. Sometimes, your joints can feel stiff, achy or sore. Some people complain of a burning, throbbing or “grating” sensation. In addition, your joints may feel stiff in the morning but loosen up and feel better with movement and activity. However, too much activity could make your pain worse.

Joint pain may affect the function of your joints and can limit your ability to do basic tasks. Severe, painful joints can interfere with your quality of life. Treatment should focus not only on pain but on getting back to daily activities and living your life to the fullest.

What causes joint pain?

The most common causes of joint pain include:

• Osteoarthritis: Osteoarthritis, a common type of arthritis, happens over time when your cartilage — the protective cushion between your bones — wears away. Your joints become painful and stiff. Osteoarthritis develops slowly and usually occurs after age 45.
• Rheumatoid arthritis (RA): RA is a chronic disease that causes swelling and pain in your joints. Often, your joints deform (usually occurring in your fingers and wrists).
• Gout: Gout is a painful condition where acidic crystals from your body collect in your joint, causing severe pain and swelling. This usually occurs in your big toe.
• Bursitis: Overuse causes bursitis. It’s usually found in your hip, knee, elbow or shoulder.
• Tendinitis: Tendinitis is inflammation of your tendons — the flexible bands that connect bone and muscle. It’s typically seen in your elbow, heel or shoulder. Overuse often causes it.

In addition, viral infections, rash or fever may make joint movement painful. Injuries, such as broken bones or sprains, can also cause joint pain.

What are the risk factors for joint pain?

Joint pain tends to affect people who have:

• Arthritis or other long-term (chronic) medical conditions.
• Previous injuries to a joint.
• Repeatedly used and/or overused a muscle.
• Depression, anxiety and/or stress.
• Overweight (having a BMI, or body mass index, greater than 25) or obesity (having a BMI greater than 30).

Age is also a factor in stiff and painful joints. After years of use and wear and tear on your joints, problems may arise after age 45.

What is the treatment for joint pain?

Although there may not be a cure for joint pain, there are ways to manage it. Sometimes, the pain may go away by taking over-the-counter (OTC) medication or by performing simple daily exercises. Other times, the pain may be signaling problems that can only be corrected with prescription medication or surgery.

Joint pain treatment includes:

• Simple at-home remedies: Your healthcare provider may recommend applying a heating pad or ice onto the affected area for short periods, several times a day. Soaking in a warm bathtub may also offer relief.
• Exercise: Exercise can help get back strength and function. Walking, swimming or another low-impact aerobic exercise is best. People who participate in strenuous workouts or sports activities may need to scale it back or begin a low-impact workout routine. Gentle stretching exercises will also help. Check with your provider before beginning or continuing any exercise program.
• Weight loss: Your provider may suggest losing weight, if needed, to lessen the strain on your joints.
• Medication: Acetaminophen (Tylenol®) or nonsteroidal anti-inflammatory drugs (NSAIDs) may help ease your pain. Both medicines are available over the counter, but stronger doses may need a prescription. If you have a history of stomach ulcers, kidney disease or liver disease, check with your provider to see if this is a good option for you.
• Topical treatments: Your provider may recommend topical treatments like ointments or gels that you can rub into your skin over the affected joint area to help ease pain. You may find some of these over the counter, or your provider may write a prescription.
• Dietary supplements: Dietary supplements like glucosamine may help relieve pain. Ask your provider before taking any over-the-counter supplements.

If those medications or treatments don’t ease your pain, your healthcare provider may prescribe:

• Supportive aids — such as a brace, a cane or an orthotic device in your shoe — to help support your joint and allow ease of movement.
• Physical or occupational therapy, along with a balanced fitness program, to gradually help ease pain and improve flexibility.
• Antidepressants to help improve sleep.
• Steroids, often given by injection into your joint, to provide short-term relief of pain and swelling.
• Pain relievers to help ease pain.

It’s important to remember that medicine, even those available over the counter, affects people differently. What helps one person may not work for another. Be sure to follow your provider’s directions carefully when taking any medicine and tell them if you have any side effects.

What surgical options are available to relieve joint pain?

Surgery may be an option if your joint pain is long-lasting and doesn’t lessen with drugs, physical therapy or exercise.

Surgical options that are available include:

Arthroscopy

Arthroscopy is a procedure where a surgeon makes two or three small cuts (incisions) in the flesh over your joint. They get into your joint using an arthroscope — a thin, flexible, fiberoptic instrument — and repair your cartilage or remove bone chips in or near your joint.

Joint fusion

Joint fusion is a procedure in which a surgeon fastens together the ends of your bones, eliminating the joint. The surgeon may use plates, screws, pins or rods to hold your bones in place while they heal. Surgeons most commonly perform joint fusions on your hands, ankles and spine.

Osteotomy

During an osteotomy, a surgeon realigns or reshapes the long bones of your arm or leg to take pressure off the damaged portion of your joint. This procedure can help relieve pain and restore movement in your joint.

Joint replacement

If other treatments don’t help, you may need joint replacement surgery to replace your joint when the cartilage that cushions and protects the ends of your bones wears away. This can be done for hip, knee and shoulder joints. A surgeon removes parts of your bone and implants an artificial joint made from metal or plastic. This procedure has had excellent results and most people feel long-lasting pain relief after this type of surgery.

What symptoms of joint pain are cause for concern?

Symptoms of joint pain range from mild to disabling. Without cartilage, bones rub directly against each other as your joint moves. Symptoms can include:

• Swelling.
• Stiff or enlarged joint.
• Numbness.
• Noisy joints, or clicking, grinding or snapping sounds when moving your joint.
• Painful movement.
• Difficulty bending or straightening your joint.
• Loss of motion.
• A hot and swollen joint. (This needs immediate evaluation.)

When should joint pain be treated by a healthcare provider?

If pain is interfering with your daily life activities, it’s time to talk to a healthcare provider about the problem. It’s important to diagnose the cause of your pain quickly and begin treatment to relieve pain and maintain healthy, functioning joints.

You should see a provider if:

• Pain is accompanied by a fever.
• You have unexplained weight loss — 10 pounds (4.5 kilograms) or more.
• Pain is preventing you from walking normally.

During the appointment, your provider will ask many questions to figure out what may be the cause of your pain. You should be ready to answer questions about:

• Previous injuries to your joint.
• When your joint pain began.
• A family history of joint pain.
• The type of pain you’re experiencing.

Your provider will perform an examination of the affected joint to see if there’s pain or limited motion. They’ll also look for signs of injury to your surrounding muscles, tendons and ligaments.

If necessary, your provider may also order X-rays or blood tests. X-rays can show if there’s joint deterioration, fluid in your joint, bone spurs or other issues that may be contributing to your pain. Blood tests will help confirm a diagnosis or rule out other diseases that may be causing your pain.

A note from QBan Health Care Services

Joint pain can be seen as a red flag — your body’s putting up the signal that something’s not quite right. Despite this warning, it’s not always easy to figure out why you’re in pain and how to fix it. If you’ve been experiencing joint pain, see your healthcare provider. They’ll ask you lots of questions to try to determine what’s going on. It may take some time and a little bit of trial and error, but eventually, you should start to feel some relief and be able to get back to the things you love.

Skin cancer happens when something changes how your skin cells grow, like exposure to ultraviolet light. Symptoms include new bumps or patches on your skin, or changes in the size, shape or color of skin growths. Most skin cancer is treatable if it’s caught early. Treatments include Mohs surgery, cryotherapy, chemotherapy and radiation.

What is skin cancer?

Skin cancer is a disease that involves the growth of abnormal cells in your skin tissues. Normally, as skin cells grow old and die, new cells form to replace them. When this process doesn’t work as it should — like after exposure to ultraviolet (UV) light from the sun — cells grow more quickly. These cells may be noncancerous (benign), which don’t spread or cause harm. Or they may be cancerous.

Skin cancer can spread to nearby tissue or other areas in your body if it’s not caught early. Fortunately, if skin cancer is identified and treated in early stages, most are cured. So, it’s important to talk with your healthcare provider if you think you have any signs of skin cancer.

Types of skin cancer

There are three main types of skin cancer:

• Basal cell carcinoma, which forms in your basal cells in the lower part of your epidermis (the outside layer of your skin).
• Squamous cell carcinoma, which forms in your squamous cells in the outside layer of your skin.
• Melanoma, which forms in cells called melanocytes. Melanocytes produce melanin, a brown pigment that gives your skin its color and protects against some of the sun’s damaging UV rays. This is the most serious type of skin cancer because it can spread to other areas of your body.

Other types of skin cancer include:

• Kaposi sarcoma.
• Merkel cell carcinoma.
• Sebaceous gland carcinoma.
• Dermatofibrosarcoma protuberans.

How common is skin cancer?

Skin cancer is the most common cancer diagnosed in the U.S. In fact, about 1 in 5 people develop skin cancer at some point in their life.

What are the signs and symptoms of skin cancer?

The most common warning sign of skin cancer is a change on your skin — typically a new growth or a change in an existing growth or mole. Skin cancer symptoms include:

• A new mole. Or a mole that changes in size, shape or color, or that bleeds.
• A pearly or waxy bump on your face, ears or neck.
• A flat, pink/red- or brown-colored patch or bump.
• Areas on your skin that look like scars.
• Sores that look crusty, have a depression in the middle or bleed often.
• A wound or sore that won’t heal, or that heals but comes back again.
• A rough, scaly lesion that might itch, bleed and become crusty.

What does skin cancer look like?

Skin cancer looks different depending on what type of skin cancer you have. Thinking of the ABCDE rule tells you what signs to watch for:

• Asymmetry: Irregular shape.
• Border: Blurry or irregularly shaped edges.
• Color: Mole with more than one color.
• Diameter: Larger than a pencil eraser (6 millimeters).
• Evolution: Enlarging, changing in shape, color or size. (This is the most important sign.)

If you’re worried about a mole or another skin lesion, make an appointment and show it to your healthcare provider. They’ll check your skin and may ask you to see a dermatologist and have the lesion further evaluated.

What causes the condition?

The main cause of skin cancer is overexposure to sunlight, especially when you have sunburn and blistering. UV rays from the sun damage DNA in your skin, causing abnormal cells to form. These abnormal cells rapidly divide in a disorganized way, forming a mass of cancer cells.

What are the risk factors for skin cancer?

Anyone can get skin cancer, regardless of race or sex. But some groups get it more than others. Before the age of 50, skin cancer is more common in women and people assigned female at birth (AFAB). After 50, though, it’s more common in men and people assigned male at birth (AMAB). And it’s about 30 times more common in non-Hispanic white people than non-Hispanic Black people or people of Asian/Pacific Islander descent. Unfortunately, skin cancer is often diagnosed in later stages for people with darker skin tones. This makes it more difficult to treat.

Although anyone can develop skin cancer, you’re at increased risk if you:

• Spend a considerable amount of time working or playing in the sun.
• Get easily sunburned or have a history of sunburns.
• Live in a sunny or high-altitude climate.
• Tan or use tanning beds.
• Have light-colored eyes, blond or red hair and fair or freckled skin.
• Have many moles  or irregularly shaped moles.
• Have actinic keratosis (precancerous skin growths that are rough, scaly, dark pink-to-brown patches).
• Have a family history of skin cancer.
• Have had an organ transplant.
• Take medications that suppress or weaken your immune system.
• Have been exposed to UV light therapy for treating skin conditions such as eczema or psoriasis.

How is skin cancer diagnosed?

First, a dermatologist may ask you if you’ve noticed changes in any existing moles, freckles or other skin spots, or if you’ve noticed any new skin growths. Next, they’ll examine all of your skin, including your scalp, ears, palms of your hands, soles of your feet, between your toes, around your genitals and between your buttocks.

What tests will be done to diagnose skin cancer?

If your provider suspects skin cancer, they may perform a biopsy. In a biopsy, a sample of tissue is removed and sent to a laboratory where a pathologist examines it under a microscope. Your dermatologist will tell you if your skin lesion is skin cancer, what type you have and discuss treatment options.

What are skin cancer stages?

Cancer stages tell you how much cancer is in your body. The stages of skin cancer range from stage 0 to stage IV. In general, the higher the number, the more cancer has spread and the harder it is to treat. But the staging for melanoma is different from non-melanoma skin cancers that start in your basal or squamous cells.

Melanoma staging

• Stage 0 (melanoma in situ): The melanoma is only in the top layer of your skin.
• Stage I: The melanoma is low risk and there’s no evidence that it has spread. It’s generally curable with surgery.
• Stage II: It has some features that indicate that it’s likely to come back (recur), but there’s no evidence of spread.
• Stage III: The melanoma has spread to nearby lymph nodes or nearby skin.
• Stage IV: The melanoma has spread to more distant lymph nodes or skin, or has spread to internal organs.

Non-melanoma staging

• Stage 0: Cancer is only in the top layer of your skin.
• Stage I (1): Cancer is in the top and middle layers of your skin.
• Stage II (2): Cancer is in the top and middle layers of your skin and moves to target your nerves or deeper layers of skin.
• Stage III (3): Cancer has spread beyond your skin to your lymph nodes.
• Stage IIIV (4): Cancer has spread to other parts of your body and your organs like your liver, lungs or brain.

How is skin cancer treated?

Treatment depends on the stage of cancer. Sometimes, a biopsy alone can remove all the cancer tissue if it’s small and limited to the surface of your skin. Other common skin cancer treatments, used alone or in combination, include:

• Cryotherapy: Your dermatologist uses liquid nitrogen to freeze skin cancer. The dead cells slough off after treatment.
• Excisional surgery: Your dermatologist removes the tumor and some surrounding healthy skin to be sure all the cancer is gone.
• Mohs surgery: Your dermatologist removes only diseased tissue, saving as much surrounding normal tissue as possible. Providers use this to treat basal cell and squamous cell cancers and, sometimes, other skin cancers that develop near sensitive or cosmetically important areas, like your eyelids, ears, lips, forehead, scalp, fingers or genital area.
• Curettage and electrodesiccation: Your dermatologist uses an instrument with a sharp, looped edge to remove cancer cells as it scrapes across the tumor. Then, they use an electric needle to destroy any remaining cancer cells. Providers often use this to treat basal cell and squamous cell cancers and precancerous skin tumors.
• Chemotherapy:  Your dermatologist or oncologist uses medications to kill cancer cells. Anticancer medications can be applied directly on the skin (topical chemotherapy) if limited to your skin’s top layer or provided through pills or an IV if the cancer has spread to other parts of your body.
• Immunotherapy: Your oncologist gives you medications to train your immune system to kill cancer cells.
• Radiation therapy: Your radiation oncologist uses radiation (strong beams of energy) to kill cancer cells or keep them from growing and dividing.
• Photodynamic therapy: Your dermatologist coats your skin with medication, which they activate with a blue or red fluorescent light. This therapy destroys precancerous cells while leaving normal cells alone.

Complications/side effects of the treatment

The side effects of skin cancer treatment depend on what treatments your healthcare provider think will work best for you. Chemotherapy for skin cancer can lead to nausea, vomiting, diarrhea and hair loss. Other side effects or complications of skin cancer treatment include:

• Bleeding.
• Pain and swelling.
• Scars.
• Nerve damage that results in loss of feeling.
• Skin infection.
• Regrowth of the tumor after it’s been removed.

Can skin cancer be prevented?

In most cases, skin cancer can be prevented. The best way to protect yourself is to avoid too much sunlight and sunburns. UV rays from the sun damage your skin, and over time, this may lead to skin cancer.

How can I lower my risk?

Ways to protect yourself from skin cancer include:

• Use a broad-spectrum sunscreen with a skin protection factor (SPF) of 30 or higher. Broad-spectrum sunscreens protect against both UV-B and UV-A rays. Apply the sunscreen 30 minutes before you go outside. Wear sunscreen every day, even on cloudy days and during the winter months.
• Wear hats with wide brims to protect your face and ears.
• Wear long-sleeved shirts and pants to protect your arms and legs. Look for clothing with an ultraviolet protection factor label for extra protection.
• Wear sunglasses to protect your eyes. Look for glasses that block both UV-B and UV-A rays.
• Use a lip balm with sunscreen.
• Avoid the sun between 10 a.m. and 4 p.m.
• Avoid tanning beds. If you want a tanned look, use a spray-on tanning product.
• Ask your healthcare provider or pharmacist if any of the medications you take make your skin more sensitive to sunlight. Some medications known to make your skin more sensitive to the sun include tetracycline and fluoroquinolone antibiotics, tricyclic antibiotics, the antifungal agent griseofulvin and statin cholesterol-lowering drugs.
• Regularly check all your skin for any changes in size, shape or color of skin growths or the development of new skin spots. Don’t forget to check your scalp, ears, the palms of your hands, soles of your feet, between your toes, your genital area and between your buttocks. Use mirrors and even take pictures to help identify changes in your skin over time. Make an appointment for a full-body skin exam with your dermatologist if you notice any changes in a mole or other skin spot.

What is the outlook for people with skin cancer?

Nearly all skin cancers can be cured if they’re treated before they have a chance to spread. The earlier skin cancer is found and removed, the better your chance for a full recovery. It’s important to continue following up with your dermatologist to make sure cancer doesn’t come back. If something seems wrong, call your doctor right away.

Most skin cancer deaths are from melanoma. If you’re diagnosed with melanoma:

• The five-year survival rate is 99% if it’s detected before it spreads to your lymph nodes.
• The five-year survival rate is 66% if it has spread to nearby lymph nodes.
• The five-year survival rate is 27% if it has spread to distant lymph nodes and other organs.

When should I see my healthcare provider?

Make an appointment to see a healthcare provider or dermatologist as soon as you notice:

• Any changes to your skin or changes in the size, shape or color of existing moles or other skin lesions.
• The appearance of a new growth on your skin.
• A sore that doesn’t heal.
• Spots on your skin that are different from others.
• Any spots that change, itch or bleed.

Your provider will check your skin, take a biopsy (if needed), make a diagnosis and discuss treatment. Also, see a dermatologist annually for a full skin review.

What questions should I ask my healthcare provider?

Questions to ask your dermatologist may include:

• What type of skin cancer do I have?
• What stage is my skin cancer?
• What tests will I need?
• What’s the best treatment for my skin cancer?
• What are the side effects of that treatment?
• What are the potential complications of this cancer and the treatment for it?
• What outcome can I expect?
• Do I have an increased risk of additional skin cancers?
• How often should I be seen for follow-up checkups?

How does skin cancer become a life-threatening cancer?

You may wonder how cancer on the surface of your skin becomes a life-threatening cancer. It seems logical to think you could just scrape off the skin with the cancer cells or even remove the cancerous skin lesion with a minor skin surgery and that’s all that would be needed. These techniques are successfully used if cancer is caught early.

But if skin cancer isn’t caught early, something that’s “just on my skin” can grow and spread beyond the immediate area. Cancer cells can break away and travel through your bloodstream or lymph system. They can settle in other areas of your body and begin to grow and develop into new tumors. This travel and spread is called metastasis.

The type of cancer cell where cancer first started — called primary cancer — determines the type of cancer. For example, if malignant melanoma metastasized to your lungs, the cancer would still be called malignant melanoma. This is how that superficial skin cancer can turn into life-threatening cancer.

Why does skin cancer occur in more non-sun-exposed body areas in people of color?

Scientists don’t fully know why people with darker skin tones develop cancer in non-sun-exposed areas like the palms of your hands and feet. They think that the sun is less of a factor, though. That said, dermatologists still see plenty of UV sunlight-induced melanomas and squamous cell skin cancer in people with skin tones ranging from fair to very dark.

Are all moles cancerous?

Most moles aren’t cancerous. Some moles are present at birth. Others develop up to about age 40. Most adults have between 10 and 40 moles.

In rare cases, a mole can turn into melanoma. If you have more than 50 moles, you have an increased chance of developing melanoma.

A note from QBan Health Care Services

Skin cancer can happen to anyone. What may seem like an innocent cosmetic imperfection may not be. Performing regular skin self-checks is important for everyone. But it’s especially important if you have an increased risk of skin cancer.

Your skin is the largest organ in your body. And it needs as much attention as any other health concern. Check your skin every month for any changes in skin spots or any new skin growths. Take steps to protect your skin from the sun. And don’t forget to schedule regular skin checks with your dermatologist.

Alopecia areata is an autoimmune disease that attacks your body’s hair follicles, causing patchy hair loss. Medications and therapies can help your hair regrow, though severe cases may not respond to treatment.

What is alopecia areata?

Alopecia areata is an autoimmune disease that causes patchy hair loss anywhere on your body, but it most commonly affects the hair on the skin that covers your head (scalp). “Alopecia” is a medical term for hair loss or baldness, and “areata” means that it occurs in small, random areas.

There are many different classifications of alopecia areata. The classifications depend on the amount of hair you’ve lost and where you’ve lost it on your body.

• Alopecia areata totalis: You’ve lost all your hair on your scalp.
• Alopecia areata universalis: You’ve lost all your hair on your scalp and all your body hair.
• Diffuse alopecia areata: Your hair is thinning rather than falling out in patches.
• Ophiasis alopecia areata: You’ve lost a band of hair on the bottom back sides of your scalp (occipitotemporal scalp).

Who gets alopecia areata?

Anyone can develop alopecia areata. But your chances of having alopecia areata are greater if:

• You’re a child.
• You have a family history of alopecia areata.
• You or your family members have an autoimmune disorder, including diabetes, lupus or thyroid disease.

How common is alopecia areata?

Alopecia areata is common. Nearly 7 million people in the United States have alopecia areata, and approximately 20% of cases involve children. Of people who have alopecia areata, 5% have alopecia areata totalis, and 1% have alopecia areata universalis.

It’s the second-most common form of hair loss, behind female pattern baldness and male pattern baldness.

What happens if you have alopecia areata?

Alopecia areata causes your hair to fall out in patches. The patches are usually small and round — about the size of a quarter — but the shape and amount of hair you lose may be bigger or smaller.

Your nails may also develop dents or pits (cupuliform depressions). They may make your nails feel coarse or gritty, like sandpaper.

Alopecia areata doesn’t typically affect your physical health. However, it can affect you psychosocially (how society and social groups affect your thoughts and emotions) and psychologically (how you think about yourself and your behavior). You may experience stress, anxiety and depression.

What are the symptoms of alopecia areata?

Common symptoms of alopecia areata include:

• Patches of hair loss, including your scalp, facial hair, eyebrows, eyelashes and body hair.
• Nail pitting.

Your patches won’t typically have any other symptoms, but in rare cases, they may:

• Itch (pruritus).
• Change color (red, purple, brown or gray).
• Develop visible, mouth-like openings in your hair follicles (follicular ostia).
• Have black dots, which are hair shafts that are visible in the follicular ostia (cadaver hairs).
• Grow short hairs that are thicker on the top and narrow toward your scalp (exclamation point hairs).
• Grow white hairs.

What causes alopecia areata?

Alopecia areata is an autoimmune disease that causes your immune system to attack your body. Your immune system attacks your hair follicles because it thinks they’re foreign invaders — bacteria, viruses, parasites or fungi — that cause infection, illness and disease.

When this happens, your hair begins to fall out, often in clumps the size and shape of a quarter. The extent of the hair loss varies. In some cases, it’s only in a few spots. In others, the hair loss may be more significant, including total hair loss.

Your genetic makeup (the parts of your cells that determine your physical traits, like eye color, height or hair color) may trigger your body’s autoimmune reaction. Or your genetic makeup combined with a virus or another substance you encounter may trigger the reaction.

Is alopecia areata contagious?

No, alopecia areata isn’t contagious. You can’t spread alopecia areata through skin-to-skin contact or airborne particles.

How is alopecia areata diagnosed?

Your healthcare provider can usually diagnose alopecia areata through a physical exam. They’ll ask about your medical history, including when you started noticing hair loss and whether you have a family history of alopecia areata or autoimmune disorders. They may also examine your nails.

What tests will be done to diagnose alopecia areata?

If your healthcare provider can’t make a diagnosis after a physical examination of your bald spots, they may:

• Examine your scalp for signs of infection.
• Take a sample of your hair and send it to a lab for analysis.
• Take a scalp biopsy to check for skin disease.
• Conduct blood tests.

Can alopecia areata go away?

No, alopecia areata doesn’t go away. Medications and other treatments help manage your hair loss, but they won’t cure the disease. Alopecia areata totalis and alopecia areata universalis are more severe and less likely to respond to treatment.

How is alopecia areata managed?

Treatment options include:

• Corticosteroids: Anti-inflammatory drugs are often used to treat autoimmune diseases. Corticosteroids are injected into your scalp or other areas, taken orally as a pill or applied topically (rubbed into your skin) as an ointment, cream or foam. Your body’s response to corticosteroids may be slow. Some side effects include increased appetite, weight gain, changes in mood and blurred vision.
• Minoxidil (Rogaine®): Minoxidil is a topical drug that treats male and female pattern baldness. It usually takes about 12 weeks of treatment before your hair begins to grow. Some side effects include headache, scalp irritation and unusual hair growth.
• Phototherapy: Phototherapy uses ultraviolet light from special lamps. Your healthcare provider may use a drug called psoralen combined with ultraviolet A (PUVA) or ultraviolet B (PUVB). The ultraviolet light waves in phototherapy can help certain skin and nail disorders, including alopecia areata.
• Platelet-rich plasma: A healthcare provider removes blood from your body, processes it and then injects it into your scalp to stimulate hair growth. Some side effects may include scalp pain and irritation, dizziness, nausea and vomiting.
• Topical immunotherapy: Your healthcare provider rubs an allergen into your skin to create an allergic reaction (contact dermatitis), which produces hair growth. Some side effects include scalp irritation, swollen lymph nodes (lymphadenopathy), eczema and skin discoloration.
• Styling techniques: If your body doesn’t respond to other treatment options, you may be able to obscure or hide your hair loss with certain hairstyles, wigs or hair weaves.

Can hair grow back from alopecia?

Alopecia areata can be unpredictable. In some people, their hair grows back but falls out again later. In others, their hair grows back and never falls out again. Each case of alopecia areata is unique. Even if someone loses all of their hair, there’s a chance that it’ll grow back. Depending on your therapy and its effectiveness, you may see new hair growth between four and 12 weeks after starting.

How can I prevent alopecia areata?

There isn’t any way to prevent alopecia areata. Treatments can reduce your symptoms. If you have alopecia areata, it may come and go throughout your life.

What can I expect if I have alopecia areata?

In mild cases of alopecia areata, you may have flare-ups and times when symptoms go away (remission). Alopecia areata totalis and alopecia areata universalis are more severe, and your body is less likely to respond to treatment options.

How do I take care of myself?

There are various cosmetic and protective techniques that people with alopecia areata can use to take care of themselves, including:

• Use makeup to hide or minimize hair loss.
• If you’ve lost your eyelashes, wear sunglasses to protect your eyes from the sun and the environment.
• Wear coverings (wigs, hats or scarves) to protect your head from the elements.
• Eat a well-balanced diet. Hair growth is a vitamin- and mineral-dependent process. Although not specifically related to alopecia areata, people who follow fad diets often have problems with hair loss. The Mediterranean diet includes fruits, vegetables and protein that may help strengthen your hair and minimize loss.
• Consider taking vitamin D supplements.

Things to avoid when you have alopecia areata

• The elements: Hair protects us from the sun and wind. Our eyelashes help keep debris out of our eyes. If you have alopecia areata, you’ll need to take precautions to protect your skin (and sometimes, your eyes) when you’re outside.
• A lot of stress: Although never proven through large trials or investigations, many people with new onset alopecia areata had recent stresses in life, such as work, family, deaths, surgeries, accidents and so on.
• Hair products and treatments that contain harsh chemicals: This includes chemical straighteners and permanent waves. Try to find gentle shampoos and conditioners without silicones and parabens.

When should I see my healthcare provider?

Call a healthcare provider as soon as you notice hair loss. After you start treatment, contact your healthcare provider if:

• You develop new symptoms.
• Your symptoms don’t improve after treatment.
• Your affected areas look infected (red, purple, gray or white skin; irritation and swelling).

What questions should I ask my healthcare provider?

• How can you tell that I have alopecia areata?
• If I don’t have alopecia areata, what’s causing my hair to fall out?
• What medications or treatments do you recommend?
• What’s the complete list of side effects of the medications and treatments?
• When should I expect to see new hair growth after treatment?
• What else can I do to prevent further hair loss?
• Should I see a dermatologist?

A note from QBan Health Care Services

It can be alarming to notice hair loss. Alopecia areata is a common condition that causes hair loss anywhere on your body, but it usually affects your scalp. Everyone loses hair when they shampoo or brush, it’s part of the hair growth process. But if you have alopecia areata, you might notice more hair loss than usual. Or you might not notice until you see patchy baldness. Reach out to your healthcare provider as soon as you notice hair loss, especially if it causes stress, anxiety or depression.

Vitiligo causes your skin to lose color or pigmentation. Smooth white or light areas called macules or patches appear on your skin. It generally starts on your hands, forearms, feet and face. Globally, about 1% of the population has vitiligo. Treatment isn’t necessary, but it’s available if you don’t like the changes to your skin tone.

What is vitiligo?

Vitiligo (pronounced “vit-il-EYE-go”) is a skin condition that causes your skin to lose its color or pigment. This causes your skin to appear lighter than your natural skin tone or turn white. Areas of your skin that lose their pigment are called macules if they’re less than 1 centimeter wide, or patches if they’re larger than 1 centimeter. If you have vitiligo on a part of your body that has hair, your hair may turn white or silver.

The condition occurs when your body’s immune system destroys melanocytes. Melanocytes are skin cells that produce melanin, the chemical that gives skin its color, or pigmentation.

Who does vitiligo affect?

Vitiligo affects all races and sexes equally. It’s more visible in people with darker skin tones. Although vitiligo can develop in anyone at any age, macules or patches usually become apparent before age 30.

You might be at a higher risk of developing vitiligo if you have certain autoimmune conditions like:

• Addison’s disease.
• Anemia.
• Diabetes (Type 1).
• Lupus.
• Psoriasis.
• Rheumatoid arthritis.
• Thyroid disease.

How common is vitiligo?

Vitiligo occurs in over 1% of the population throughout the world.

How does vitiligo start and progress?

Vitiligo usually starts with a few small white macules or patches that may gradually spread over your body. Vitiligo typically begins on your hands, forearms, feet and face, but can develop on any part of your body, including your mucous membranes (the moist lining of your mouth, nose, genital and rectal areas), your eyes and inner ears.

Sometimes, larger patches continue to widen and spread, but they usually stay in the same place for years. The location of smaller macules shifts and changes over time, as certain areas of skin lose and regain their pigment.

The amount of affected skin varies for each person diagnosed with vitiligo. Some people experience a few depigmented areas, while others have a widespread loss of skin color.

What are the types of vitiligo?

Types of vitiligo include:

• Generalized: This is the most common type of vitiligo that causes macules to appear in various places on your body.
• Segmental: This type only affects one side of your body or one area, such as your hands or face.
• Mucosal: Mucosal vitiligo affects mucous membranes of your mouth and/or genitals.
• Focal: Focal vitiligo is a rare type where the macules develop in a small area and don’t spread in a certain pattern within one to two years.
• Trichome: This type causes a bullseye with a white or colorless center, then an area of lighter pigmentation, and an area of your natural skin tone.
• Universal: This rare type of vitiligo causes more than 80% of your skin to not have pigment.

What are the symptoms of vitiligo?

Signs and symptoms of vitiligo include:

• Patches of skin or mucous membranes that lose color. These can appear white or lighter than your natural skin tone.
• Patches of hair on your body turn silver, gray or white.

Symptoms can be mild and only affect a small area of your body or severe and affect a large area of your skin. Some people with vitiligo experience itchy skin before depigmentation starts.

Where will I have symptoms of vitiligo?

Symptoms of vitiligo can appear anywhere on the skin of your body. The most common places to have symptoms of vitiligo include on your:

• Hands.
• Feet.
• Arms.
• Face.
• Mucous membranes (inside of your mouth, lips and nose).
• Genitals (penis).

What causes vitiligo?

A lack of pigment in your skin (melanin) causes vitiligo. The reason why this happens is unknown. Research suggests vitiligo could be the result of:

• An autoimmune condition: Your immune system mistakes healthy cells (melanocytes) as foreign invaders like bacteria that can cause harm to your body. This makes your immune system overreact and develop antibodies to destroy your melanocytes.
• Genetic changes: A genetic mutation or a change to your body’s DNA can affect how your melanocytes function. There are over 30 genes that can increase your risk of developing vitiligo.
• Stress: The amount of pigment your melanocyte cells produce may change if you experience frequent emotional stress or physical stress on your body, especially after an injury.
• Environmental triggers: Factors like ultraviolet radiation and toxic chemical exposure can affect how your melanocyte cells function.

Is vitiligo genetic?

While research is ongoing to learn more about the causes of vitiligo, studies indicate that about 30% of vitiligo cases are genetic. This means that the condition is hereditary and you could potentially inherit vitiligo from your biological family. Several possible genetic mutations affect how melanocyte cells function. If a genetic mutation targets the cells that give your skin pigment, you’ll experience symptoms of vitiligo.

Is vitiligo painful?

No, vitiligo isn’t painful. However, you can get painful sunburns on lighter patches of skin affected by vitiligo. It’s important to protect yourself against the sun with measures like using sunscreen, staying out of the sun during the hours that it’s strongest and wearing protective clothing.

Does vitiligo cause complications?

Although vitiligo is mainly a cosmetic condition, vitiligo may cause:

• Sensitive skin: Macules and patches lack melanocytes, so your skin can be more sensitive to sunlight than the rest of your skin. This can cause your skin to quickly burn instead of tanning.
• Eye abnormalities: People with vitiligo may have some abnormalities in their retinas (the inner layer of your eye that contains light-sensitive cells) and some variation of color in their irises (the colored part of your eye). In some cases, there’s inflammation of the retina or iris, but vision usually isn’t affected.
• Predisposition to autoimmune conditions: People with vitiligo may be more likely to get other autoimmune conditions that affect how their body’s immune system functions. Common autoimmune conditions include hypothyroidism, diabetes and anemia.
• Emotional challenges: People with vitiligo may feel embarrassed about the way their skin looks. Some people diagnosed with vitiligo develop low self-esteem. This could cause anxiety or depression and make someone want to isolate themselves or avoid social situations. If this happens, you should talk to your healthcare provider, a mental health professional or your family and friends.

How is vitiligo diagnosed?

A visual examination by a healthcare provider usually leads to an accurate diagnosis of vitiligo. Your provider may use a Wood’s lamp to look at your skin. This lamp uses an ultraviolet (UV) light that shines onto your skin to help your provider differentiate vitiligo from other skin conditions. In addition, your provider may ask you questions about your medical history and family medical history.

What other conditions look like vitiligo?

There are other conditions that make your skin change or lose pigmentation, including:

• Chemical leukoderma: Exposure to some industrial chemicals causes damage to skin cells, resulting in linear or splotchy white areas of skin.
• Tinea versicolor: This yeast infection can create dark spots that show on light skin, or light spots that show on darker skin.
• Albinism: This genetic condition means that you have lower levels of melanin in your skin, hair and/or eyes.
• Pityriasis alba: This condition starts with red and scaly areas of skin, which fade into scaly lighter patches of skin.

How is vitiligo treated?

Treatment for vitiligo isn’t necessary, as the condition isn’t harmful to your body and is only cosmetic. If you have widespread vitiligo or your physical symptoms affect your emotional well-being, your healthcare provider can help you find a treatment option to create a uniform skin tone by either restoring color (repigmentation) or eliminating the remaining color (depigmentation) in your skin. Common treatments for vitiligo include:

• Medications.
• Light therapy.
• Depigmentation therapy.
• Surgery.
• Counseling.

Medications

There isn’t a specific medication to stop vitiligo from affecting your skin but there are certain drugs that can slow the speed of pigmentation loss, help melanocytes regrow or bring color back to your skin. Medications to treat vitiligo could include:

• Corticosteroids.
• Topical Janus kinase inhibitors (ruxolitinib).
• Calcineurin inhibitors.

Light therapy

Light therapy or phototherapy is the treatment to help return color to your skin. Your provider will use light boxes, ultraviolet B (UVB) lights or medical-grade lasers directed at your skin for a short amount of time. It can take several light therapy sessions to see results on your skin.

Combining oral psoralen medication and ultraviolet A light (PUVA) treats large areas of skin with vitiligo. This treatment is effective for people with vitiligo on their head, neck, trunk, upper arms and legs.

Depigmentation therapy

Depigmentation therapy removes the color of your natural skin tone to match areas of your skin affected with vitiligo. Depigmentation therapy uses the drug monobenzone. You can apply this medication to pigmented patches of your skin. This will turn your skin white to match the areas of your skin with vitiligo.

Surgery

Surgery is a treatment option for people diagnosed with vitiligo. Surgical treatment could include:

• Skin grafts: Skin is taken from one part of your body and used to cover another part. Possible complications include scarring, infection or a failure to repigment. This might also be called mini grafting.
• Blister grafting: Blister grafting uses suction to create a blister on your skin and your provider will then remove the top of the blister to attach it to an area of your skin affected by vitiligo.

Your healthcare provider might not recommend surgery if you:

• Have quickly spreading vitiligo.
• Scar easily.
• Develop raised scars that grow larger than a wound (keloids).

Counseling

Some people diagnosed with vitiligo find counseling or visiting a mental health professional beneficial to help improve their self-esteem, anxiety or depression that can be associated with changes to their skin. Vitiligo can cause psychological distress and can affect a person’s outlook and social interactions. If this happens, your caregiver may suggest that you meet with a counselor or attend a support group.

How can I prevent vitiligo?

As there could be several causes of vitiligo, there’s no known way to prevent it. You can reduce your risk of developing vitiligo by:

• Practicing safe sun exposure habits.
• Taking care of your skin by using a moisturizer daily.
• Avoiding stress or injury to your body.
• Managing any underlying autoimmune conditions.

What can I expect if I have vitiligo?

Vitiligo affects your appearance and can affect how you feel about your skin in social situations. Many people find comfort in speaking with a mental health professional to help them feel more confident and build their self-esteem.

There’s no cure for vitiligo but if you’d like to get treatment, your healthcare provider will help you choose the treatment that’s right for you and your skin.

Will my natural skin color return with vitiligo?

About 10% to 20% of people who have vitiligo fully regain their skin color. This is most common among people who:

• Receive an early diagnosis before age 20.
• Experience the peak of the condition spreading within six months or less.
• Have symptoms mainly in their facial area.

It’s less likely that you’ll regain your pigment if you:

• Develop vitiligo symptoms after age 20.
• Have symptoms on your lips, limbs or hands.

How do I hide vitiligo?

If you’re uncomfortable with how vitiligo looks on your skin, you can hide macules or patches at home by:

• Using sunscreen with an SPF of 30 or higher. The use of sunscreens minimizes tanning and limits the contrast between affected and normal skin.
• Wearing makeup to camouflage depigmented areas.
• Dying your hair with hair dye to help it blend in with unaffected hair on your head.
• Getting micropigmentation, which is a tattoo over your vitiligo spots. It acts as permanent makeup to hide symptoms of the condition.

Is vitiligo contagious?

No. Vitiligo isn’t contagious. It doesn’t spread from person to person through physical contact.

When should I see my healthcare provider?

Contact your healthcare provider if:

• Your skin loses pigmentation or color rapidly.
• Depigmentation spreads to a large area of your body.
• The changes to your skin affect your mental health and well-being.

What questions should I ask my doctor?

• What type of vitiligo do I have?
• Will my skin get its pigment back?
• How do I protect myself from the sun?
• What treatment options are best for my skin?
• Will my future children inherit this condition?

What’s the difference between tinea versicolor and vitiligo?

Tinea versicolor and vitiligo are different conditions that affect the pigment of your skin. Tinea versicolor is a fungal infection that causes your skin to develop white, yellow, red, pink or brown spots. Vitiligo is an autoimmune condition where you lose pigment. It causes your skin to turn lighter than your natural skin tone or white.

Is piebaldism the same as vitiligo?

No. Both conditions cause white or light patches of skin or hair. Piebaldism occurs when a portion of your skin doesn’t have melanocytes, which are cells that produce pigment (melanin). You’re born with piebaldism. Vitiligo occurs when your body has melanocytes, but they’re destroyed. You develop vitiligo during your lifetime.

A note from QBan Health Care Services

Vitiligo is a condition that causes cosmetic changes to your skin. It doesn’t need treatment because it isn’t dangerous. But it’s common for vitiligo skin changes to affect self-esteem and make people feel insecure or uncomfortable. Reach out to your healthcare provider to discuss how your physical appearance affects your mental health. There’s no cure for vitiligo, but treatment is available to help you feel more comfortable.