A Joint Effort
Easing the pain and limitations associated with osteoarthritis
Holiday gatherings provide a wonderful opportunity to reconnect with loved ones, and spending one-on-one time with older relatives can make us more aware of their health issues. Maybe we have to speak a little more clearly and slowly to be understood. Perhaps we need to provide an arm for someone to descend some steps. Even offering to twist the lid of a jar that’s hard to open can sometimes be a great help.
Complaints of joint pain and mobility limitations could be a sign of osteoarthritis. Approximately 27 million Americans suffer with OA, the most common chronic condition affecting the joints. While this form of degenerative arthritis can affect any joint, it’s most common in the knees, hips, cervical and lumbar spine, fingers, and base of the big toe.
“Osteoarthritis is a disease of the cartilage, thought to be associated with mechanical stress,” says Ho Bing Patrick Oei, M.D., who is dual board certified in rheumatology and internal medicine. “Over time, the cartilage thins out, and eventually we see bone-on-bone in the affected joints.” While there’s evidence of a genetic association of OA that’s not clearly defined, you’ll often hear the term “familial” when talking about most forms of arthritis.
Early signs of OA can be pain in the knee or hip—particularly during weight-bearing activities—complaints of difficulty opening jars or stiffness in the fingers, a bony feeling in the joints, “crunchy” feeling in the knees, and early morning stiffness. “Activity or movement tends to make people feel worse,” Dr. Oei says, “and yet the less active you are, the harder it is to regain mobility.”
Living with Arthritis
Unfortunately, OA is a degenerative condition without a current cure. But living with the disease can be made more comfortable if you are diligent in seeking care and take necessary steps to improve your quality of life.
Help stave off joint pain
While certain populations are more prone to joint injuries—athletes, military members, police officers—and therefore cartilage deterioration, you can also cause injury to your joints simply by being overweight. According to Arthritis.org, each pound you gain adds nearly four pounds of stress to your knees and increases pressure on your hips six-fold. Over time, the extra strain breaks down the cartilage that cushions these joints. Losing weight can be helpful in preventing joint damage.
You should also protect your joints during physical activities. Seek treatment immediately for any joint injury, and always use your strongest joints for lifting or carrying heavy objects.
Even though arthritis is a painful condition that’s aggravated by movement, it is helpful to stay as active as possible to prevent any atrophy of the joint’s support structures. Therefore, Dr. Oei advises patients of his Irving, Texas, clinic to try low impact exercises. “Walking or swimming is better than jogging,” he says. And if you have loved ones with arthritis, “Encourage them to strengthen their muscles around the joint to offer support to the degenerating joint,” Dr. Oei suggests.
To help with pain, patients can take an over-the-counter anti-inflammatory or, when necessary, a physician can prescribe a prescription-strength one. Other medications that can help with pain include Tylenol and prescription pain meds, in more advanced cases. Home physical therapy is warranted for some patients, and group exercise classes such as chair yoga or tai chi can be helpful for retaining flexibility. A slow gentle stretching of the joints can manage stiffness.
Occupational therapy can also be advantageous, especially when OA affects the hands. Warm paraffin hand treatments can feel particularly soothing, and topical creams such as Biofreeze or topical capsaicin can also reduce pain.
For an added measure of support, consider fall proofing the home by installing grab bars in the bathroom and handrails near any steps. Remove any objects, such as loose throw rugs, that could potentially cause a fall. Assistive devices including knee braces, grips, and canes can also encourage mobility.
On the Horizon
Medical research today includes perfecting a gelatinous material to replace missing cartilage that doctors can inject into the joint to improve patients’ symptoms. “If we can determine what initiates the cause of cartilage degeneration, we can get ahead of it,” Dr. Oei explains. While there’s no known method for regenerating cartilage today, small studies are trying to determine how to slow the progression.
“There are some studies working to develop medications to block the chemical mediators that signal pain,” says Dr. Oei. And while there are conflicting opinions regarding supplements or diets to help with the symptoms or progression of osteoarthritis, “It does help to avoid high fat, high calorie foods because you want to keep from gaining weight,” Dr. Oei adds.
Because the disease can cause pain and decreased mobility, compliance with any treatment plan is significant. That’s when getting a family member involved can be helpful. If possible, attend a doctor visit with your relative with OA to ask questions and relay concerns. Be supportive when it comes to following up with medications or therapies. Most of all, encourage anyone who has OA to be active and involved. Interacting with friends and family members can help them focus less on their pain and more on their quality of life.
A Woman’s Lifetime of Living with Rheumatoid Arthritis
Laura D. noticed pain in her pinky finger when she was barely a teen. Then that pain spread to her wrist. Before long, both of her ankles hurt and then more of her joints were affected. With the exception of her spine, nearly everything hurt. At age 13, she was diagnosed with juvenile rheumatoid arthritis.
Laura has lived through treatments and medication regimes as varied as gold salt injections and joint replacements. “By my early 20s, I had a lot of joint damage,” Laura says, which led to having both hips and knees replaced. Now in her 50s, she experiences little pain thanks to annual infusions plus anti-inflammatories as needed, “Which help me function pretty well for the rest of the year, and my blood work is normal, as though I’m in remission.”
Laura stopped all treatments for rheumatoid arthritis twice in her life so she could become a mother. “The moment my first son was born, I wanted to nurse him, but I was in so much pain, I had to stop so I could take medication,” she says. With her second son, she didn’t even attempt to nurse. “I think having had a mother with this disease has taught them so much,” Laura says of her boys. “It’s made them more empathetic to people who are having a hard time, more willing to offer to help. I notice their keeping an eye out to see when someone needs assistance opening a door or lifting something. My older son helped me a lot with his younger brother, even buckling the car seat. He was always helpful.” This same boy is now a college graduate with his eye on medical school.
What Laura has learned during her lifetime of living with RA is this: “Seek treatment early before you have too much joint damage, and weigh the benefits of medications against the side effects. If a doctor monitors your condition, you can be alert to problems with drugs.” Also, she stays active and maintains her weight. “People with severe RA are in pain and don’t feel like exercising, but I swim and use the elliptical which allows me to keep flexibility without putting stress on my joints,” Laura adds. “I also find it helps to keep my mind busy by working, volunteering, and being a part of my community. It helps me emotionally to be useful and productive.”
Did you know?
According to Arthritis.org, there’s a newly discovered link between osteoarthritis and diabetes, as high glucose levels speed the formation of certain molecules that make cartilage stiffer and more sensitive to mechanical stress. Diabetes can also trigger systemic inflammation that leads to cartilage loss. This may help explain why more than half of Americans diagnosed with diabetes also have arthritis.
By Pamela Hammonds