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Understanding
Osteoarthritis
The Basics
Osteoarthritis occurs when the cartilage (the smooth material that covers bone ends and helps them slide easily across each other) wears down, and the bone ends rub against each other, causing pain. Bits of the cartilage may even break off, causing even more pain and swelling in the joint area. Over time, the cartilage may wear away entirely.
Osteoarthritis usually involves weight-bearing joints such as the hips, knees, feet, and spine, although the finger and thumb joints may also be affected. The condition doesn’t usually show up in other joints except when they have been injured or put under unusual stress. |
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What are the symptoms?
The degree of osteoarthritis can range from mild to severe and usually starts slowly and progresses over time.
The symptoms include:
- Pain, stiffness, and swelling around a joint that lasts longer than two weeks.
- Joint that doesn’t move as easily or as far as it once did.
- Grating sound when moving a joint.
- Bumps or swelling, especially on the joints of the fingers and feet.
Who is likely to get osteoarthritis?
Although anyone of any age can develop osteoarthritis, there are certain factors that increase a person’s risk.
These risk factors include:
- Aging: The likelihood of developing it increases with age.
- Being overweight: Extra pounds on your frame put you at higher risk of osteoarthritis of the knee.
- Family history: There are certain hereditary conditions that put you at higher risk, including defective cartilage and malformed joints.
- Past injuries: Past injuries or repeated overuse put a joint at increased risk of developing osteoarthritis.
Diagnosing the Problem
Your doctor will use a variety of methods to determine whether your symptoms are due to osteoarthritis. A physical examination is the first step. The doctor may also take fluid samples from the joint to study and may do blood tests to rule out things such as other forms of arthritis.
There are also imaging techniques available that will help the doctor see inside the joint. These techniques include x-rays, bone scan, computerized tomography (CT) scan, magnetic resonance imaging (MRI), and arthrography. These tests may reveal bone spurs, worn-down cartilage, and loss of joint space, all indicators of osteoarthritis.
Osteoarthritis Treatments
There are many treatments available to help reduce pain and maintain joint mobility, including medication, self-care techniques, physical therapy, and occupational therapy. In very serious cases, surgery may be required to repair or replace a joint.
Many medications treat both pain and mild inflammation. In mild cases, over-the-counter drugs may be all that are necessary; however, stronger prescription medicines are available for use when needed.
Common osteoarthritis treatments include:
- Topical pain relievers: These are gels, creams, ointments, and sprays applied to the skin that temporarily relieve pain. Some of these products contain capsaicin, the active ingredient in hot chili peppers. Others contain acetylsalicylic acid, the active ingredient in ASA, which is absorbed through the skin and should be factored into your total daily dose if you take ASA or ibuprofen orally.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs relieve pain and reduce inflammation; however, if used at high dosages for long periods of time, they may cause side effects such as ringing in the ears, gastric ulcers, gastrointestinal bleeding, and liver or kidney damage.
- COX-2 inhibitors: These prescription medications are newer NSAIDs that are believed to have a lower risk of producing stomach-damaging side effects than older NSAID drugs. However, they have their own side effects, including fluid retention, which may raise blood pressure.
- Other pain relievers: Sometimes other pain relievers (such as acetaminophen) may be prescribed for joint pain, but not all medicines that ease pain also reduce inflammation.
- Antidepressants: In addition to their ability to relieve depression, these medicines are also used to treat chronic pain and the sleep disturbances that often accompany arthritis.
- Cortisone: In cases of severe inflammation, a doctor may inject the joint space with a corticosteroid. An injection can provide almost immediate relief, but the treatment cannot be used too often, because cortisone can weaken cartilage and remove minerals from bone.
- Viscosupplementation: In this treatment a clear gel-like substance is injected into the knee to lubricate the cartilage, reducing pain and permitting greater movement of the knee.
- Surgery: If a joint is badly damaged, or if the pain becomes unbearable, your doctor may recommend surgery. There are several different kinds of surgery that are done for osteoarthritis. Some operations remove bits of cartilage from the joint. Others repair or rebuild parts of the bone, or replace a joint with an artificial joint.
Supplements
Many people treat their arthritis symptoms with supplements. There are some supplements that have been tested scientifically and have been shown to be of some value; others showed little or no value when tested. It is extremely important to tell your doctor about all of the supplements you take, because some can interact with other medications you take and others shouldn’t be taken by people with certain medical conditions. The amount you take is important, too, because large quantities of some supplements can be toxic.
While supplements can be very helpful for some people under certain circumstances, they can also be harmful if misused. Don’t make the mistake of thinking that something that is labeled “natural” is automatically safe; that simply isn’t true. Need convincing? Think about poison ivy—a “natural” plant that is well known for causing misery.
With these cautions in mind, using supplements wisely may provide relief of your osteoarthritis symptoms. After discussing the subject with your doctor or pharmacist, you may want to consider the following supplements. While many other supplements have also been studied, the evidence for possible benefit seems strongest from these.
- Glucosamine may reduce pain and joint tenderness and may promote long-term improvement in mobility.
- Chondroitin may reduce pain over time. When used in conjunction with NSAIDs, it can improve hip and knee function.
- SAM-e (s-adenosylmethionine) may reduce pain and improve flexibility of the knee, hip, neck, lower back, and fingers.
Helping Yourself
Some simple self-care techniques can relieve much of the discomfort of osteoarthritis.
These tips may help:
- Exercise regularly: Before starting an exercise program, check with your doctor to make sure the activity you are planning is right for you. The wrong kind of exercise can put stress on the joints and make the condition worse.
Muscle strengthening exercises are often recommended, because stronger muscles are better able to support an arthritic joint. For example, building up your thigh muscles helps support your knees. But avoid exercising tender, injured, or severely inflamed joints. If you feel new joint pain, stop immediately. If the new pain lasts two hours after you exercise, you have probably overdone it. Either lower the intensity of your workout or reduce the amount of time you exercise.
- Control your weight: Extra weight puts added stress on the joints in your back, hips, knees, and feet.
- Eat well: A healthy diet that emphasizes fruit, vegetables, and whole grains can help you control your weight and maintain your overall health.
- Apply heat to tense muscles: Heat can ease your pain while relaxing tense, painful muscles. You may find it especially helpful to apply heat before exercising.
- Apply cold for flare-ups: Cold can help dull pain during the first day or two of a flare-up. Always check with your doctor first to find out if there is any reason you shouldn’t use hot or cold applications. Avoid using cold if you have poor circulation or numbness. Be sure you don’t fall asleep with a heating pad on a sore joint, or you could end up with a severe burn. Placing a towel between your skin and the hot or cold pack will help you avoid burning or freezing your skin.
- Put your best foot forward: Wear comfortable shoes that support your weight.This is particularly important for people with arthritis in the weight-bearing joints or back.
- Practice relaxation techniques: Meditation, hypnosis, guided imagery, deep breathing, and muscle relaxation can all be useful in controlling pain.
- Take your medications exactly as your doctor prescribes: By taking your medications regularly instead of waiting for the pain to build, you can prevent the pain from becoming intense.
Although there is no cure for osteoarthritis, there are a number of steps you can take to manage your pain and lead an active life. Coping effectively with osteoarthritis is a daily commitment. You need to be kind to your body. After doing heavy work, or repeating the same task over and over, take a rest. Use your back, arms, and legs in safe ways to avoid putting stress on joints. For example, use your thigh muscles when lifting objects; never bend over to pick something up and use your back muscles to lift it. Carry heavy loads close to your body. Use helpful devices such as a cart to carry your grocery bags. There are also devices that can make daily tasks easier, such as special handles for doors and cupboards and enlarged handles for cutlery that make them easier to grasp.
If you have any questions about osteoarthritis or ways to manage it, speak with your doctor or pharmacist.
The material in this pamphlet has been supplied by a professional medical writer. It is intended for information purposes only and should not be used in place of consultation with a health care professional. Axis Pharmacy is not responsible for errors, omissions, or inconsistencies with respect to the information contained in this pamphlet and does not accept any liability whatsoever for reliance by the reader on the information contained herein.
© Promo-Ad & Associates Inc., 2005
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