BioWorld Executive Editor

I well remember the day I ceded control of my spinal column. Years ago, I bent over at the waist with my daughter in one arm to pick up my house keys. I felt a disturbance in my lumbar force that felt like lava running down my spine. It was just my spine crying and giving me a preview of the abyss of suffering that I was to experience forevermore at the whim of my musculoskeletal system. As I fought blacking out, visions of my dad recurred with his admonition, "Bend with your knees — your waist is only good for holding up your pants!" It was too late. My moment of negligence sucker-punched my C5 and C6 vertebrae into misalignment and ruptured L4 and L5 into an arthritic descent that would make every step I took a step-by-step pain-management decision. Long story short, four surgeries and a trillion hours of therapy later, now only every other step I take is a pain-management decision.

For a decade, I developed a stoic demeanor and labeled myself as just another trooper with a "bad back," the generic term that the uninformed, unaware and undead use to diagnose themselves as they live in pain-shrouded delusion, insisting they have a condition, rather than a disease.

That Crick in Your Neck Is Chronic Disease
Millions of people are shuffling along with latent, undiagnosed cases of arthritis, attributing their ailments to everything from "just getting older" to "sometimes my knee just acts up," but the truth will one day be manifested in what will contribute to staggering arthritis statistics.

After a lifetime of sliding in the mud-rock at Woodstock, marching from Selma to Washington in wingtips, pushing the McDonald's sign to "40 Billion Sold," doing the Twist, running with the bulls, breakdancing, skateboarding, imprisoning feet in stylish, pointed shoes that shape your toes into ice cream cones, texting nonstop, mistaking our spinal column for a weight-bearing muscle, killing mutants with repetitive thumb strokes, and even just slouching in front of the TV for 3.5 hours a day in spine-transforming positions ... it's no wonder we all have a crick in our necks, a weather-forecasting hipbone, a Quasimodo posture and that trick knee that morphs into enough positions to qualify you for membership in the Transformers! "Arthrito-bots ... TRANSFORM!"

Sadly, we have gone from the '60s to our 60s, as we have gone from the Age of Aquarius to the Age of Arthritis.

With apologies to James Rado, Gerome Ragni and Galt MacDermot, who wrote the original songs for the musical Hair ...

When OA is in the seventh disc
And L-5 disc aligns with none
Then pain will guide the spinal cord
And mobility is gone
This is the dawning of the Age of Arthritis
Age of Arthritis
Arthri-i-tis!

Quality of life devo-o-lving, sympathy from youngsters miss-i-ing
Slip-on shoes, top-loading wa-a-shers, COX-2 inhibitor cocktails,
Arthri-i-tiiis, Arthri-i-tiiis,
Let the Enbrel, let the Enbrel in, the Celebrex,
When you're in pain ...

Anti-inflammatories
Psoriasis and gout abounding
Lyme diseased cranium
And the hip is true titanium
Arthritis, Arthritis!

What Doesn't Kill You ... Can Make You Weaker
In 2009, at least 1.7 million people will have died from chronic diseases in the U.S., and a majority of those will have suffered from some form of arthritis as either the primary cause, but more likely, as an ancillary debilitating and degenerative affliction.

In 2014, when every baby boomer will be over 50 years of age and the oldest will be staring down 70, arthritis is projected to affect up to 60 percent of that demographic. That is in addition to having a pervasive effect on as much as 76 percent of the Greatest Generation. With more than 80 percent of all baby boomers already past 50 and resisting the natural tendency to slow down and "act their ages," a hefty proportion of that demographic is still hiking, dancing, climbing, jogging, biking, weightlifting and engaging in all manner of activities and lifestyles that conversely build bodies and minds, but ravage joints and bones. Worldwide growth in the elderly population, costly novel therapies, escalating diagnosis rates and an emergent trend toward more aggressive treatment are prepared to drive substantial gains in drug and device revenue throughout a 25-year growth model.

Darn, I believe I feel a sneeze coming. While that seemingly unrelated action seems harmless enough and has nothing to do with the Great Disabler disease, a sneeze by an arthritic requires preparation akin to hurricane preparedness. "Hold on to something ... tighten sacral vertebra muscles ... bite down on an ink pen ... let her rip! Oh my spine, such pain! It's not over yet ... Category 5 consequent back muscle spasm warning ... PREPARE TO CRY!"

Who Wants to Live To Be 100 Years Old with This?
No one seems to be able to escape its scourge of scraping bones, worn-out useless appendages, scalding joints, detaching tissues, lifeless muscles, filched mobility and 24-7 pain. Although the elderly still represent the leading demographic for the disease, arthritis is no longer your grandparents' disease, as no population class is exempt from its symptoms:

• Newborns are susceptible to hereditary and infectious arthritis.
• Juvenile arthritis afflicts 500,000 children 18 years and younger.
• Young adult arthritis diagnoses have increased 38 percent in the last 25 years.
• Middle-aged adults are now the arthritis onset gateway demographic.
• The elderly, in majority proportions, have arthritis.

The good news is, arthritis patients can expect to live very long lives with the affliction. The bad news is, they most often live that existence with unrelenting excruciating pain. Arthritis can pervade every aspect of each day for the rest of a life, covering everything from morning stiffness to terminal immobility. It also is an unpleasant reality that some of the therapeutics patients take to treat arthritis, especially the corticosteroids, inflict destructive consequences on their bones.

Aging Boomers, WWII Class Combine to Create a Mature Market
Recent statistics from the Centers for Disease Control and Prevention revealed that approximately 47 million adults suffer from some form of arthritis. That is one in nearly five people living in the U.S. Arthritis is the No. 1 cause of disability in the country, costing more than $86 billion dollars annually to address the disease.

As ominous as those numbers are, prevailing projections based on relative trends such as obesity, aging, prevalence and therapeutic application imply that the pervasiveness of arthritis is on course to affect at least 33 percent of the U.S. population by 2025. Society's powerlessness to control the natural process of growing old opens the door for the disease to largely continue to proliferate at its own raging rate of affliction, abetted by what will soon be the largest senior citizen demographic in U.S. history, as the entire baby boomer generation crowds into what promises to be a standing-room-only retirement-age sector of society.

The last-born baby boomer denizens will collectively reach 60 around the quarter-century mark and will bring with them a lifetime of enough physical wear-and-tear, mental stress, bad dietary habits and disregarded symptoms to make arthritis a market accountable for more than $200 billion in total costs, including medical technology, therapeutics and health care. Health care will include the wide-ranging, increasing need for assisted care, rehabilitation, surgery and hospitalization.

Editor's note: For more in-depth analysis on arthritis, check out  BioWorld's Arthritis Report 2009: Drug and Med-Tech Innovation and Economics.

Published: June 25, 2009