Living with Arthritis: How to Lessen its Effects

Just like wrinkles, arthritis is a natural result of adding more candles to our birthday cakes, says Dr. Alireza Meysami, rheumatologist at Henry Ford Health System. In most cases, we can postpone the most common form, osteoarthritis, with healthy living choices such as weight loss and regular physical activity. Without proper care, though, arthritis can be debilitating. “It is the most common cause of disability among older adults,” Dr. Meysami says.

Some 27 million Americans have osteoarthritis, which includes half of all those over 65, according to the Arthritis Foundation. Also called degenerative arthritis, the disease is a slowly progressive, noninflammatory joint disorder. “It usually affects the joints we use on a daily basis – the hands, knees, hips, feet and spine,” Dr. Meysami says.

Bone on bone

As we get older, Dr. Meysami says, we start losing cartilage, which is the cushion between the bones. The less cartilage, the more the bones rub against one another. Eventually, that friction causes bone spurs. Those are abnormal bone growths, which add to the pain and difficulty of movement.

Symptoms include the cracking noise your bones make when you stand up (which has a medical name – crepitus – and is caused by the friction of bone on bone). Other signs are joint pain with activity, stiffness of the joints, if you’ve been immobile for a while, and limitation of movements.

Your health care provider can usually diagnose osteoarthritis from these signs. X-rays can verify the diagnosis, showing joint space narrowing, loss of cartilage and bone spurs.

Twenty-somethings get it too

Although age is the primary risk factor for osteoarthritis, it can affect younger people who put excessive stress on the joints, Dr. Meysami says: “A 20-year-old ballet dancer can get arthritis in their feet, or a 30-year-old carpenter in their elbows and shoulders.”

More than 65 percent of those with osteoarthritis have a family history of the disease, he says. In the United States, osteoarthritis is most common in the knees and more likely to affect:

  • Women over age 50, which is associated with the effects of menopause;
  • Men who have had previous joint injuries such as former football or basketball players;
  • Those who are overweight, with a body mass index above 25;
  • Smokers because smoking can weaken bones; and
  • Competitive athletes, including runners. (Dr. Meysami emphasizes, though, that normal recreational running, such as jogging at a slow pace, does not increase risk.)

First, lose weight

Weight loss can be an important first step in managing – and avoiding – osteoarthritis. In fact, the risk of osteoarthritis in the knee increases 30 percent for every 11 pounds of weight gain, Dr. Meysami says. By contrast, if you lose 11 pounds, you cut your risk by half.

Other nondrug treatments include:

  • Walking at least 30 minutes a day on a flat surface;
  • Physical therapy to help improve range of motion and reduce pain;
  • Occupational therapy to teach patients how to make daily tasks easier and safer such as getting into and out of a car, lifting objects, and, if needed, using a walker;
  • Muscle-strengthening exercises; and
  • Braces and proper footwear for osteoarthritis in the knees.

Get ahead of the pain

You can manage osteoarthritis pain at home with warm wax for osteoarthritis in the hands; capsaicin or lidocaine cream; hot and cold patches; and acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen. Stronger drugs are available, Dr. Meysami says, but because osteoarthritis is progressive, those are usually saved for later stages of the disease. And make sure to talk to your doctor about any medications you’re taking, even if over-the-counter.

Medical intervention

For more serious cases, corticosteroids or hyaluronic acids can be injected into the joints to reduce inflammation and pain. If those do not work, your doctor may consider a referral to a surgeon for possible joint replacement.


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