Participation of individuals with arthritis in self-management education and evidence-based physical activity may effectively contribute to alleviating pain, increasing functioning and physical activity, and improving quality of life and mood, according to a Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report.

Approximately a quarter of adults in the United States have arthritis, which is often associated with physical inactivity and severe joint pain — symptoms linked to poor mental and physical health outcomes. The CDC analyzed Behavioral Risk Factor Surveillance System data from 2017 to estimate state-specific arthritis information, including overall prevalence and the prevalence of physical inactivity and severe joint pain. The Behavioral Risk Factor Surveillance System is an ongoing national phone (cellular and landline) survey of noninstitutionalized US adults aged 18 and older conducted by state and territorial health departments.

In 2017, the median state prevalence of arthritis was 22.8% (range: 15.7% in the District of Columbia to 34.6% in West Virginia), with the highest prevalence found in the Appalachia and Lower Mississippi Valley regions.

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Arthritis prevalence was found to increase with increasing age (ranging from 8.1% in individuals aged 18 to 44 to 50.4% in individuals aged 65 and older), to be higher in: women vs men (25.4% vs 19.1%, respectively), in American Indian/Alaska Natives (29.7%) vs other racial/ethnic groups (range, 12.8% to 25.5%), and in individuals who are disabled/unable to work (51.3%) compared with individuals who are retired (34.3%), unemployed (26.0%), or self-employed/employed (17.7%).   

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In individuals with arthritis, the prevalence of physical inactivity (median, 33.7%; range: 23.2% in Colorado to 44.4% in Kentucky) and severe joint pain (median, 30.3%; range: 20.8% in Colorado to 45.2% in Mississippi) were highest in the southeastern states. The prevalence of physical inactivity was higher in individuals with severe vs moderate or no/mild joint pain (47.0%, 31.8%, and 22.6%, respectively).

Age-standardized severe joint pain prevalence was ≥40% in the following groups: lesbian/gay/bisexual/queer/questioning (40.7%; reported by 27 states), non-Hispanic American Indians/Alaska Natives (42.0%), Hispanics (42.0%), retired persons (45.8%), non-Hispanic blacks (50.9%), individuals living at ≤125% federal poverty level (51.6%), individuals with less than a high school diploma (54.1%), and individuals unable to work/disabled (66.9%). Age-standardized physical inactivity was ≥40% in the following groups: non-Hispanic blacks (40.4%), individuals living at ≤125% federal poverty level (42.6%), individuals with less than a high school diploma (46.4%), and individuals unable to work/disabled (51.2%).

Joint pain caused by arthritis is often managed with medications that are associated with a range of adverse effects. The 2016 National Pain Strategy advised multifaceted and individualized pain management strategies that include nonpharmacologic approaches, and the American College of Rheumatology recommends the use of regular physical activity as a nonpharmacologic option for pain relief.

Although fear of pain is often cited by individuals with arthritis as a barrier to exercise, increased physical activity has been shown to reduce pain, improve physical functioning and mental health, and prevent or delay disability and limitations with few adverse effects.

“This report provides the most current state-specific and demographic data for arthritis, severe joint pain, and physical inactivity. These data can extend collaborations among CDC, state health departments, and community organizations to increase access to and use of arthritis-appropriate, evidence-based interventions to help participants reduce joint pain and improve physical function and quality of life,” concluded the report authors.

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Guglielmo D, Murphy LB, Boring MA, et al. State-specific severe joint pain and physical inactivity among adults with arthritis — United States, 2017. MMWR Morb Mortal Wkly Rep. 2019;68(17):381-387.