As we age, one of the most common health problems that we all face is chronic joint pain and stiffness due to arthritis. The most common type of arthritis is osteoarthritis.
About 32 million people have osteoarthritis or OA, according to the Centers for Disease Control and Prevention (CDC). The disease most often affects the hands, hips, knees and spine. Women are more likely than men to get it, especially after age 50. Symptoms may range from mild discomfort to disabling pain, swelling and stiffness.
Getting diagnosed is important. Early intervention may help to make the condition easier to manage and prevent symptoms from getting worse over time.
“There is no cure for OA, but there are a number of treatments to manage your symptoms and improve your function,” says Adam Rosen, DO, an orthopedic surgeon at Scripps Clinic Torrey Pines. “Early intervention is the key to slowing the progression of pain and disability.”
Treatments can range from weight loss to medications for pain relief to physical therapy and finally joint replacement surgery. Treatment will depend largely on the severity of the condition.
Osteoarthritis has also been called the “wear and tear” arthritis, but many factors may lead to destruction of the joint. It occurs when the cartilage in the joint wears away due to age, trauma and overuse. When that happens, it leaves bone exposed resulting in bone rubbing against bone, which causes pain and limited mobility.
People often confuse osteoporosis with osteoarthritis. They’re different. Osteoarthritis is a degeneration of a joint. Osteoporosis is the loss of bone mass.
Osteoporosis is a bone disease that affects more than 10 million Americans age 50 and over. It can occur in both men and women, but tends to occur earlier in women, which is one reason more women suffer from fragility fractures.
Avoiding smoking, participating in weight-bearing exercise and keeping a healthy diet rich in vitamin D and calcium are ways to combat osteoporosis. Checking with your health care provider to assess your vitamin D levels and bone density allow you to get treatment if needed.
Osteoarthritis usually develops during late adulthood. But the disease is increasing among young people due to the obesity epidemic as well as overuse and trauma from high-impact activities.
“Osteoarthritis is often thought of as an ‘old person’s disease', but with obesity on the rise, this is no longer the case,” Dr. Rosen says. “While most patients with OA are over the age of 60, we see many patients in their 30s developing the disease for a variety of reasons, including obesity, injury or other conditions.”
The main treatments for osteoarthritis include weight loss, strengthening, medication and supportive therapies. In some cases, surgery to repair or replace damaged joints may be considered.
Maintaining a healthy body weight by eating well and exercising can decrease the progression of osteoarthritis.
Losing a single pound removes the equivalent load of three to five pounds on your joints. Losing 10 pounds can eliminate 30 to 50 pounds of pressure on your joints. This not only decreases pain but slows the progression of the disease.
“Exercise is helpful for people with OA, but certain exercises should be modified if they provoke pain,” Dr. Rosen says. “Consider switching from high-impact activities, such as running, to low-impact exercises, such as swimming or using a stationary bike.”
Many physicians will prescribe acetaminophen or non-steroidal anti-inflammatory drugs to reduce stiffness and pain symptoms.
Some patients benefit from cortisone injections given directly into affected joints by a physician.
Your doctor may refer you to a physical therapist to help you with muscle strengthening exercises and advice.
You may need to use a walking aid, such as a cane, if your hip or knee are affected. A brace can reduce symptoms in certain patients, so it's worth trying a simple over-the-counter knee brace. Most people find it helps with swelling or gives the knee the sense of support.
If early treatments and therapies don’t work, surgery may be an option for people with advanced osteoarthritis. Joint replacement is a common surgical treatment. Hips and knees are the joints most commonly replaced.
“Treatment with surgery depends on a person’s age, activity level, health condition and the severity of their osteoarthritis,” says Dr. Rosen, who specializes in knee and hip replacement.
“Surgery is usually the last resort when other approaches have failed,” he says. “Fortunately, advances in surgery, pain management and rehabilitation have made it safer and more effective.”