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My parents used to be so active in the community -- dancing, BINGO, the Elks' Club. But now they have arthritis and they seem to be going downhill. The doctor says their condition isn't as bad as they make out. What could account for this disconnect between symptoms and activities?

It's not always clear what the true reason is for disability or loss of function in patients with osteoarthritis (OA). Sometimes their symptoms are much greater than might be expected for the degenerative changes seen on the X-rays. In other cases, just the opposite happens: the X-rays show severe joint degeneration and the person is out kicking up his or her heels. Certainly, pain and loss of strength or decreased joint motion can keep some folks off the dance floor. But studies show that it's more than just the physical problems that lead to disability. Psychosocial, emotional, and mental factors play a role, too. But how these factors contribute to disability exactly remains a mystery. Research shows that it's likely a combination of factors and not a single issue at all. It's always true that perceptions outweigh reality. It's not so much what's really happening as it is how the process is perceived by the person. Psychologic well-being, coping strategies, and quality of life are all important factors as well.

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