No doubt, you are referring to osteoarthritis, the leading cause of disability in the U.S., with more than 20 million sufferers. It most often affects the hips, knees, spine and hands. The cause of osteoarthritis is usually unknown, though it is mainly related to aging. About half of those over 65 have some degree of osteoarthritis, reflecting a lifetime of wear and tear on cartilage.
However, osteoarthritis can be inherited, and injuries or certain diseases can lead to the condition. Being overweight is known to increase the risk of osteoarthritis in the hip, knee, ankle and foot joints. It is also important to rule out other types of arthritis that at times resemble osteoarthritis, such as chronic gout, pseudogout or rheumatoid arthritis. It is important to consider these other causes of arthritis because the treatment can be quite different.
Osteoarthritis is usually recognized by the onset of pain and stiffness in the affected joints, more commonly seen after exercise or when placing weight or pressure on the joint. The affected joint or joints may be tender at times and lose some of their flexibility. Morning stiffness lasting up to 30 minutes can be noted and followed by relief with mild activity.
Osteoarthritis occurs when the cartilage that cushions the ends of bones, allowing the bones to glide over one another, deteriorates over time, breaking down and wearing away. This lets the bones rub together, causing pain, swelling and stiffness. This in turn results in the ligaments and muscles around the joint becoming weaker.
There is no cure for osteoarthritis and it will most likely get worse over time. However, there is much that can be done to slow its progression, control its symptoms and maintain or even improve joint function. Exercise helps maintain joint and overall movement, and results in less pain. Swimming and biking are especially good. Walking can be effective — a padded heel can cut in half the force with which your foot hits the ground with each step. Weight loss, if overweight, can be of great help for lower extremity osteoarthritis. Resting a particularly sore, swollen joint should also be considered. Applying heat or cold to the joint may help. A physician or physical therapist can outline an exercise program that strengthens the ligaments and muscles around a joint, leading to significant symptom improvement.
Unlike in rheumatoid arthritis, there are no disease-modifying osteoarthritis drugs yet, but the search goes on. Over-the-counter pain-relieving medicines can help osteoarthritis symptoms — acetaminophen (Tylenol) is usually tried first, then non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen and naproxen can be helpful. For more severely involved joints, steroid injections into larger joints (knee) can reduce swelling and pain. Capsaicin (Zostrix) skin cream can help relieve pain in smaller joints. Artificial joint fluid (Synvisc, Hyalgan) may be effective for a few months for knee joints, but not in cases of severe, bone-on-bone arthritis.
Of even more concern is the large number of expensive, ineffective and unproven preparations and treatments that are touted on the Internet, magazines, TV and radio, which may have no more than a short-term placebo effect. These include: glucosamine and chondroitin combinations, SAMe, Instaflex and collagen supplements (Genacol), to name a few. There is no convincing evidence that supplements do anything for joints. Acupuncture, magnets and copper bracelets have no more than a placebo effect. Procedures such as microfractures in bone to induce cartilage growth or cartilage implants are not there yet. When conservative therapies no longer work, excellent surgical procedures and joint replacements are effective, especially for pain relief.
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