Have you recently been to your doctor’s office for a regular check up? Did you complain about some pain in your thumbs when you opened a jar or pain in your knees when you went downstairs? The doctor then said “you have arthritis”. But they were more concerned about your blood pressure, so there was no chance to discuss the issue further.
Now you are home feeling the joint pains again and are wondering “What type of arthritis do I have? Is it going to get worse? Are my hands going to look like my mother’s? What can I do about it?” Chances are you are developing osteoarthritis.
What is osteoarthritis?
Osteoarthritis is the most common type of arthritis. More than 20 million people in the United States have the disease and it is one of the leading causes of disability. Osteoarthritis is also called degenerative joint disease because it involves degeneration of the cartilage.
Cartilage is the firm, rubbery material that covers the surface of bones and allows for joint movement. Osteoarthritis occurs when the cartilage breaks down and reaches a point that cannot repair itself. It gets thinner and thinner until “bone is rubbing bone”. At this point the joint loses mobility.
Another problem is the joint fluid in patients with osteoarthritis has poor quality and is less effective for lubrication, and that accelerates the degeneration of the cartilage. The joints affected tend to get bigger because the bone grows around it. That is why the knuckles in the fingers get bigger and you cannot wear your rings anymore.
What causes osteoarthritis?
A certain degree of cartilage break down is part of the aging process. Most people over the age of 60 have osteoarthritis to some degree, but its severity varies. However, getting old is not the only cause of osteoarthritis. Heredity is a very important factor. Some people inherit a defect in one of the genes responsible for making cartilage. This causes defective cartilage, which leads to more rapid deterioration of joints. In these people, osteoarthritis usually starts at a younger age and tends to be more severe. Other factors that can trigger early osteoarthritis are obesity, which increases the risk of arthritis in the knees and possibly the hips; injuries due to an accident or related to sports activities; and overuse, such as with jobs that require a repetitive motion.
What are the symptoms of osteoarthritis?
Osteoarthritis occurs more often in knees, hips, small joints of the fingers, the base of the thumb, the big toes, and the neck and lower back. Typical symptoms are pain with certain activities and stiffness when arising in the morning lasting no longer then 30 minutes. Sitting for a while or driving some distance can also cause stiffness and pain which disappears as you begin to move.
As osteoarthritis advances it causes limitation of motion of the joint. Your doctor can determine what type of arthritis you have by your description of the pain and a physical exam. Sometimes x-rays, blood tests, or analysis of the fluid in the joint may be needed to rule out other conditions. If there is any doubt, you may be referred to an “arthritis doctor” or rheumatologist for further evaluation.
What can I do to prevent it from getting worse?
Maintaining ideal weight or losing excess weight may prevent osteoarthritis of the knee and hip or decrease the rate of progression once the arthritis is established. Regular exercise helps control your weight and strengthens the muscles around the joints. Water exercises are very good for patients with arthritis because they are less stressful to your joints. Try to avoid as much as possible overuse of the joints that are starting to show some symptoms. There may be a role for certain nutritional supplements to slow down the progression of the disease.
What is the treatment of osteoarthritis?
There is a lot of research trying to find a way to stop the degeneration of the cartilage or to help repair it better. However, at the present time the main goals of treatment are relief of the pain and improvement in quality of life. There are several medications that can be used to treat the pain. It is better to talk to your doctor before you decide to take any medicines because he/she knows your other medical problems and can give you better recommendations.
First line treatments are acetaminophen (Tylenol) and anti-inflammatory drugs (some available over-the counter, others with prescription). If these medicines do not work or are contraindicated, your doctor can recommend other alternatives.
Glucosamine and chondroitin are over-the-counter nutritional supplements. Some studies suggest that these supplements slow down the degeneration of the cartilage. They also have a mild anti-inflammatory effect and some people report pain relief and improvement in joint function.
Viscosupplementation therapy can be used for arthritis of the knee. This consists of a series of injections that help rebuild the lubricant fluid in the joint. This usually results in reduction of pain for several months.
Other measures can help in certain occasions, such as topical analgesics; use of assistive devices, braces, splints; and local steroid injections. Physical and occupational therapy are useful to learn muscle strengthening exercises and improve the ability to perform certain daily activities such as bathing or doing household chores.
Surgery is usually the last resort when osteoarthritis is causing severe pain and is affecting your quality of life. Knees and hips can be replaced successfully.
Finally, if you think you may be suffering from osteoarthritis, talk to your doctor to see what can be done in your particular case.
The Arthritis Alliance of Louisiana is another good resource to find more information and support for people suffering with arthritis. Osteoarthritis will not go away, but there are many things that can help you deal with it.