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Coping With Osteoarthritis

If you live long enough, chances are good you’ll develop osteoarthritis in one or more joints.

 

An estimated 33 million Americans now have the disorder, according to the Arthritis Foundation. And the U.S. Centers for Disease Control and Prevention predicts the number will rise to 67 million by 2030.

 

The term arthritis encompasses a variety of diseases that attack the joints. Osteoarthritis—also called degenerative joint disease and “wear and tear” arthritis—is the most common form. It primarily affects those over age 40. However younger people may also develop it as a result of joint injuries or hereditary defects.

 

The disease occurs when the slippery protective cartilage that cushions the inner surfaces of your joints begins to wear away. The result may be pain, stiffness and limited movement in the joint.

 

Osteoarthritis can affect any joint, but the most frequently afflicted ones are those of the hands, hips, knees and spine.

 

There is no cure for degenerative joint disease, but you can take steps to prevent it—or to slow its progression. This report shows you how.

 

Who Is At Risk?

Osteoarthritis often develops as a result of the aging process. X-rays of people over age 70 indicate that 70 percent show signs of the disease, although only about half experience symptoms.

 

People who have had a significant joint injury—fracture, severe sprain or other trauma—are more likely to become arthritic. Even previous joint surgery may increase the odds of osteoarthritis.

 

Those born with genetic bone deformities or defective cartilage are at greater risk. People who are double-jointed, or have lax joints, are also more susceptible. More women than men are diagnosed with osteoarthritis, especially in the fingers and knees.

 

The obese are more likely to develop arthritic hips and knees because of increased mechanical stress on joints. Gaining one pound of body weight increases knee stress by three pounds and hip stress by six pounds. Obesity is second only to aging as a risk factor.

 

Warning Signs

Osteoarthritis is sneaky. By the time you begin to experience symptoms, significant joint damage may have occurred.

 

Early signs include joint pain during or after activity. You may feel pain or stiffness first thing in the morning or after a period of inactivity. The affected joint may be tender to the touch.

 

The joint may be less flexible than before. You might feel a grating sensation when you move. Or you could feel lumps in the area caused by bone spurs. Also, arthritic joints may swell or appear deformed.

 

If any of these signs persist for more than two weeks, see your physician.

 

Can Supplements Help?

The jury’s still out about how effective glucosamine and chondroitin supplements are in relieving osteoarthritis symptoms.

 

According to the Mayo Clinic, the consensus of expert opinion supports taking them “for improving symptoms and stopping (or possibly reversing) the degenerative process of osteoarthritis.”

 

But the supplements don’t work equally well for everyone. Some people report significant pain relief; others are not helped. The Arthritis Foundation recommends giving them a try for six months, then discontinuing them if you feel no better.

 

People who are allergic to shellfish should not take chondroitin supplements.

 

Fish oil supplements have been shown to have anti-inflammatory properties as well as other health benefits. Eating fish several times a week has the same effect.

 

Non-Drug Remedies

If your pain is mild to moderate, you may be able to manage degenerative joint disease without drugs. Try the following tips:

 

  • Take regular breaks to reduce the load on hips, knees, ankles or feet. Get plenty of sleep.
  • Wear comfortable, supportive shoes.
  • Use heat or cold—or alternate the two—to reduce pain and inflammation. Apply heat with a hot-water bottle or heating pad. Gel-filled packs available at any drugstore can be frozen when you need cool relief, or microwave them for warmth.
  • Soak in a Jacuzzi or hot tub to reduce stress and joint pain.
  • Try a pain-relieving cream that includes capsaicin, menthol or methyl salicylate. Brand names include ArthriCare, Aspercreme, Ben-Gay, Icy Hot and Flexall.
  • Ask your doctor about using a brace or splint to stabilize the joint and relieve discomfort.
  • Learn a relaxation method such as meditation, deep breathing, guided imagery or progressive relaxation. It may relieve stress and pain.

 

Drugs For Osteoarthritis Relief

A number of effective prescription and over-the-counter (OTC) drugs are available to relieve symptoms. Here are some of the options:

 

  • Acetaminophen lessens pain but has no effect on inflammation. High doses can cause liver damage, particularly in those who have three or more alcoholic drinks daily. 
  • Nonsteroidal anti-inflammatory drugs (NSAIDS) treat both pain and inflammation. Brand-name OTC medications include Ecotrin, Advil, Motrin and Aleve. Prescription choices include Celebrex, which belongs to a class of drugs called COX-2 inhibitors. All NSAIDS have potential side effects such as gastrointestinal bleeding, high blood pressure, heart problems and damage to the liver and kidneys. The dangers increase with alcohol consumption.
  • Medicines containing narcotics (e.g., codeine, hydrocodone and oxycodone) may be prescribed to those with severe pain who are not helped by other medications. They too can have serious side effects, including drug dependence.
  • In some cases your doctor may wish to use injectables such as cortisone or hyaluronic acid for pain relief. Cortisone is used sparingly because overuse can increase damage to the joint. In the U. S. hyaluronic acid is approved only for osteoarthritis of the knee.

Making Lifestyle Changes

You might think exercise would damage your joints further, but the opposite is true.

 

Physical activity is “the most effective non-drug treatment for reducing pain and improving movement,” says the Arthritis Foundation. Most foundation chapters offer exercise classes for people with joint disease.

 

The foundation recommends a program that enhances flexibility with gentle stretching exercises and includes aerobic as well as muscle-strengthening moves. Ideal forms of aerobic exercise include biking, walking, pool exercises and swimming. Weight training can strengthen the muscles surrounding an injured joint, thus reducing shock and stress.

 

In addition, yoga and tai chi can improve flexibility while building strength.

 

If exercise causes new or intensified joint pain, talk to your doctor about alternatives.

 

One of the most significant lifestyle changes you make to help your joints is losing weight. A 2004 study conducted by Wake Forest University in Winston-Salem, N.C., found that patients with knee osteoarthritis who exercised and dieted for 18 months enjoyed a 24-percent improvement in physical function. They also had a 30-percent-plus reduction in knee pain.

 

When To See A Doctor

If you suspect osteoarthritis, see your general practitioner. In some cases she may recommend consulting a rheumatologist, a specialist in arthritic diseases.

 

There’s no one-shot method of diagnosing degenerative joint disease. Your physician may take X-rays to examine your joint. The images can indicate deformation, bone spurs and a narrowing of the joint space, which is a sign of cartilage destruction.

 

She may wish to remove and test fluid from the joint, a process called arthrocentesis, to rule out infection or gout. Blood tests may also be used to determine whether the pain is a result of rheumatoid arthritis, an autoimmune disorder.

 

Your doctor may wish to order an arthroscopic examination of your joint. In this procedure incisions are made, and a tiny camera is used to show precisely what changes have occurred in the joint.

 

Surgical Options

In some cases surgery can eliminate or reduce joint pain.

 

The most widely publicized option is joint replacement, which can be an excellent solution for severe osteoarthritis of the knee, hip or shoulder.

 

In these surgeries, the joint is removed and replaced with a metal and plastic prosthesis. The rehab process afterward is extensive, usually lasting several months. Once healing is complete, the reward is a pain-free joint and nearly complete range of motion. Joint replacements can last up to 20 years.

 

Some people may qualify for partial knee replacement if the damage is restricted to a single area of the joint.

 

Unfortunately, there’s no quick fix for more complex joints such as the ankle. Joint-replacement surgeries for them can be performed, but the success rate is lower than that for replacing a knee or hip. If you’re a candidate, talk to your doctor about all the options.

 

Other possible surgical interventions include:

 

  • Debridement, or clean-up of loose cartilage and bone around the joint.
  • Realigning the bones of the leg to reduce pain and stress on the knee joint.
  • Arthrodesis, or fusing the bones in joints such as the ankle, wrist, spine or toes. Fusion eliminates pain but results in a permanently inflexible joint.

Ways To Help Employees

Anything you do to encourage workers’ overall health will benefit those who already have osteoarthritis—and could help prevent the disease in others.

 

  • Promote employee fitness with tips from the Arthritis Foundation’s Let’s Move Together Web site (http://lmt.arthritis.org).
  • Invite your staff to take part in an Arthritis Foundation activity such as an Arthritis Walk or the annual Jingle Bell Run/Walk. The events raise money for arthritis research and give workers an opportunity to learn more about the disease.
  • Contact the American Cancer Society (www.acsworkplacesolutions.com) to learn about its Workplace Solutions consulting program. It helps employers of all sizes implement cost-effective disease-prevention strategies such as healthy eating habits, physical activity and smoking cessation.

For More Information

Learn more about osteoarthritis by visiting these Web sites.

 

The Arthritis Foundation

www.arthritis.org

 

National Institute of Arthritis and Musculoskeletal and Skin Diseases

www.niams.nih.gov/Health_Info/Osteoarthritis/default.asp

 

Medline Plus guide to arthritis

www.nlm.nih.gov/medlineplus/arthritis.html