A look at Osteoarthritis

Dr. Norman B. Gaylis

What is Osteoarthritis? How does it happen? Why you? How will it affect your daily life?…

…If you recently learned that you have Osteoarthritis, these are probably some of the questions you have been asking. In this column I will try to help you understand Osteoarthritis and learn to live with it. The most important thing for you to understand is that while Osteoarthritis is not curable, it is very treatable and, in most cases, there is no reason for the condition to significantly lower your quality of life.

Osteoarthritis is a condition that results when the smooth lining that covers the bones and joints, the cartilage, starts to wear out. When this happens, bones rub against bones. This friction can also cause small spurs to form within the joints. As a result of this process, cartilage, our body’s shock absorber, is destroyed and pain and discomfort occur when moving joints. The natural reaction to this pain is to protect one’s joints by not moving them. This, in turn, weakens the muscles that support the joints.
Osteoarthritis is prevalent among people over the age of 60 because of the wear the body is subjected to over the years. The condition can also occur in younger people. Between 30 and 40 million people in the U.S. today suffer, from Osteoarthritis.

Osteoarthritis and its symptoms vary for each individual. The pain can be mild or very severe. It may come and go. Some people may be disabled by it, while others may feel only a few twinges during damp, humid or cold weather. The joints most commonly effected by Osteoarthritis are those subject to the most wear and tear during our lives. This includes all weight bearing joints, particularly the hips, knees and feet. Osteoarthritis often effects the thumb, the most actively used joint in the body. The spine, especially the back and the neck are also commonly affected by the condition. Osteoarthritis of the spine is usually a result of bad body mechanics and bad habits, including watching television in bed, sleeping on one’s stomach, wearing the wrong prescription lenses, being overweight and lifting or bending over without first bending at the knees.

There is a hereditary form of Osteoarthritis which effects the joints at the ends of the fingers causing swelling and deformities of the knuckles. These deformities are called Heberden’s Nodes.

Osteoarthritis develops slowly and worsens over time. Therefore, it is important to diagnose and treat the condition early, to eradicate causitive factors and to begin therapy to prevent long-term problems.

Diagnosis begins with a physical examination by a specialist in the field of Arthritis. At times certain blood tests are ordered to rule out other Arthritic conditions. X-rays of the involved joints are usually suggested and fluid from the joints is examined. Once the diagnosis is established, the treatment goals are to ease pain and discomfort, reduce or prevent disability and help the patient to continue his or her routine activities as independently as possible. It is important for the patient to recognize that treatment of Osteoarthritis does not rely on drugs alone. Anti-inflammatory medications and aspirin-like drugs can be very helpful in reducing symptoms, but they do not correct the problem, nor do they prevent long-term disability. When I see a patient for the first time my primary goal is to educate him/ her as to why Osteoarthritis developed and how to eradicate those reasons. For example, someone who has osteoarthritis of the hips and knees cannot walk five miles per day. That is not to say that exercise is no good. Once the inflammation is reduced with the aid of medication, exercise is very important to strengthen the muscles that support the joints. In general, non-weight bearing or non-active exercises are suggested. The ideal exercises are swimming, riding a bicycle or range-of-movement exercises without any need to prevent overuse of painful joints. Therapies such as hit, ultrasound and massage may also help to reduce the pain and disability of Osteoarthritis. While all of these therapies can provide symptomatic relief, it is important to remember that they will not cure Osteoarthritis.

There is no “magic formula” which a physician can prescribe to suit all Osteoarthritis patients. A blend of rest, exercise, therapy and medication must be tailored for each individual patient according to his or her own special needs and lifestyle. I strongly emphasize the need to sit down with your doctor and explain your personal circumstances and needs. Together you will develop the best therapeutic program for you.

In most instances, if you are getting good medical advise, taking your medications as directed and following your rest and exercise program, you will be able to enjoy a fairly comfortable lifestyle and slow the progressive destruction of the disease. Of course, if you seek a physician’s help after you have had Osteoarthritis for many years there may be irreversible damage done to the joint. At that point, one must consider other medical options, such as joint replacement surgery. Total joint replacement has been performed with grit success on the hip and to a lesser extent on the knee, shoulder and small joints of the hand and foot. I generally recommend that surgery be performed only after all other forms of therapy have been exhausted. This is not because that surgery will not be successful, but simply, because the replacement joint has a limited life span.

I want to make a plea to you to avoid using unproven drugs or following the advise of untrained friends and neighbors who recommend various miracle cures such as D. 4. S. D.. (v hr*+^ 4e .. devil’-, claw.-.snake venom and the like. Such “cures” can actually do more harm than good simply because they delay participation in more valid forms of therapy.

Despite claims to the contrary, there is no known diet that will cause, prevent or cure Osteoarthritis. The best dietary advice I can offer is that a well-balanced diet is important for all physical fitness and that one can eat basically anything in moderation. Remember, excess weight puts stress on the joints and that stress can accelerate pain and Osteoarthritis.

While Osteoarthritis is a painful and sometimes crippling disorder, most individuals should be able to live fairly normally and comfortably with some form of therapy. The condition may slow you down once in a while, you may even need to change the way you do certain things, but by working hard and being properly motivated, you should be able to keep up with what is important to you. With medication, rest and exercise, most of my patients are able to control their symptoms and continue with most, if not all of their daily activities and live full and productive lives.

If you have any questions about Osteoarthritis, feel free to contact me through this column. Until next time, when I will discuss Rheumatoid Arthritis, try to stay as “loose” as possible!