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December 15th, 2016

Ask the Doc: What you should know about osteoarthritis

What is osteoarthritis?

Osteoarthritis is a degenerative joint disease. Basically, it’s wear-and-tear on your joints. It affects approximately 27 million Americans in some form. The disease can happen at any joint in the body, with weight-bearing joints such as the knees and ankles being the most commonly affected. Meniscus tears, torn ACLs and other injuries to the joints can also lead to osteoarthritis. It can also affect the hands since we used them so much.

How can you tell that a patient has osteoarthritis?

Arthritis means joint inflammation, so the main symptoms we hear from patients are pain, swelling, stiffness or limited range of motion in their joints. Sometimes they’ll describe the pain as an ache or a sharp pain. We’ll then do a pain scale with the patient, and have them describe how severe the pain is, on a scale of 0 to 10, while they’re at rest and then when they’re making use of the joint in pain.

What are some of the risk factors for osteoarthritis?

Age is a big risk factor. Most people with osteoarthritis are over the age of 65. Weight is another risk factor as it puts extra stress on the joints. As I mentioned earlier, previous injuries to the joints are also risk factors.

What kind of treatment is available for a patient?

The simplest treatment is rest, ice, compression and elevation, which can help reduce the pain. Think of the acronym RICE to remember this remedy. Ice is a natural anti-inflammatory so putting ice where the pain is after an activity will help. Ace bandages and knee sleeves are examples of compression options. Compression helps stop the pressure from the swelling, which causes the pain. Assisted devices like a cane or a walker also help reduce the weight put on the affected extremities.

Another way to reduce pain is to lose weight to reduce stress on the joints. Riding an exercise bike or doing pool exercises can help a person lose weight while not putting pressure on the joints.

Over-the-counter medication like acetaminophen can help with the pain while ibuprofen reduces inflammation. An anti-inflammatory gel also can be rubbed on the joints to help reduce pain.

If the previous options don’t work, then we look into steroid injections. This will put a potent anti-inflammatory right into the joint space to calm down the inflammation. Another kind of injection is hyaluronic acid, which is found in the joints. By injecting hyaluronic acid into the affected joints, it’ll help stimulate growth of the material that acts as a cushion for the joints.

If left unchecked, what could happen to someone with osteoarthritis aside from constant pain?

Osteophytes, bony growth better known at bone spurs, can grow around the joint and eventually break off causing more havoc to the joint. For some people, because the joint has no cartilage and is bone-on-one, the joint will lock up where it can’t be moved.

Is there any permanent solution for osteoarthritis?

Since osteoarthritis can affect any joint, replacing the bone will stop it. Certain surgeries for joints can replace the bone with metal therefore eliminating osteoarthritis for that joint.

What should adults nearing the age of 65 due to help avoid osteoarthritis?

Some risk factors you can’t avoid like being genetically predisposed to osteoarthritis. Repetitive activities that put stress on the joints over the course of
several years like running or working on your knees, such as laying tile, can also lead to osteoarthritis.

The best things you can do are to manage your weight and avoid injuries to the joints. A good diet, staying hydrated, exercising and getting enough sleep also will help. Having a good attitude has also been proven to help reduce pain. Finally, if you are smoker, stop! Smoking causes tissue damage to joints.

Dr. Leigh Romero, Board Certified in Family Medicine and Primary Care Sports Medicine, is a primary care physician at WellMed at Midtown in Austin, TX.