Credit: nia.nih.gov (the National Institute on Aging)
Do you hear a crack when your knees bend, or feel stiff when you get out of bed? You may be one of the 30 million Americans with osteoarthritis. There are over 100 varieties of arthritis, including rheumatoid, gout and Lyme, but osteoarthritis (OA) is by far the most common. Age alone is the most frequent cause of OA: 60% of sufferers are over 65. The rest are over 50, their osteoarthritis stemming from earlier injuries or trauma incurred by repetitive joint motion from sports, carpentry, farming or landscaping.
Also called degenerative joint disease or “wear and tear arthritis,” OA primarily affects fingers, thumbs, big toes, knees, hips and lower back. Over time, the shock-absorbing cartilage that lines our joints begins to deteriorate, resulting in inflammation of the surrounding tendons and ligaments. The classic symptoms include morning stiffness, pain, decreased flexibility and deformity. Joints may swell, and bumps (bone spurs) can form on fingers and toes. Muscles then weaken due to inactivity, because it hurts to move.
Daily tasks become challenging—opening jars, getting in and out of the bathtub, rising from a chair, even bending over. Quality of life can worsen and physically demanding jobs can become impossible.
Obesity stresses joints and is a risk factor for osteoarthritis, as is diabetes, high cholesterol and a family history of OA. The estrogen depletion of menopause can lead to osteoarthritis in women.
There is no cure for OA, but there are many ways to minimize pain and improve mobility and strength.
Begin with a visit to your primary care provider (PCP), who may order X-rays and blood work. Your PCP can recommend or prescribe medicines that ease symptoms and slow the progression of osteoarthritis: over-the-counter (OTC) acetaminophen (Tylenol) for pain alone; nonsteroidal anti-inflammatories (NSAIDs), such as ibuprofen (Advil), for pain and inflammation; and the mood disorder drug duloxetine (Cymbalta) for chronic pain. Full-strength topical NSAIDs are available in gel or patch by prescription, or half strength over the counter.
Other OTC topical creams and patches contain menthol, camphor, capsaicin (derived from chili peppers) or salicylates (the chemical in aspirin). They work by mildly irritating the skin to distract the brain from focusing on joint pain. Among the many choices are Bengay, Salonpas, Tiger Balm and Aspercreme. Lidocaine OTC anesthetic patches may also help.
Try alternating ice and heat packs on the affected joint. Losing weight can help your knees, hips and back. Low-impact exercise reduces pain and improves joint function: swimming, water aerobics, stationary bike, walking. Stronger muscles will help support joints and improve mobility, so start light weightlifting with 2- to 5-pound barbells or weight cuffs.
Gentle yoga and Tai Chi (both available, at no cost, at the Pine Plains Free Library), physical therapy, massage, meditation and acupuncture have all been shown to decrease pain and enhance flexibility.
Consider visiting a podiatrist for foot OA, as orthotics may help. Adaptive tools, like a reacher grabber or cap snaffler, can make life easier.
Supplements, with your PCP’s approval, have been safely used for treatment and prevention of OA with some success. Glucosamine and chondroitin (both proteins found in cartilage) are available as tablets, capsules or powders. Turmeric and cat’s claw have an anti-inflammatory effect, as does fish or flaxseed oil.
If your symptoms don’t improve, see an orthopedist, who may recommend injections of steroids to reduce inflammation or hyaluronic acid to cushion the joint. Surgical intervention should be the last resort, ranging from minimally invasive procedures like arthroscopy, to remove problematic cartilage, to joint replacement.
More helpful ideas and tools for osteoarthritis management can be found here.
Mary Jenkins is recently retired after nearly 40 years as a family practice physician in New York state.