Friday, October 28, 2011

How to Treat Arthritis Joint Pain

Your knees ache and hips creak. Did you do too much over the weekend? Or is it age? If you’re a woman in your 40s, you may have osteoarthritis, the most common form of arthritis. Find out what causes this painful joint disease and how to ease the aches and stiffness. Plus, how much do you know about osteoarthritis? Take our quiz and find out…

You feel great after that six-mile hike, those rousing sets of tennis, that morning jog. But lately, there’s an ache in your step. Some days walking feels more like hobbling.

You may be paying for living a longer, more active life than Mom or Grandma. Hobbies like hiking, tennis and gardening keep us fit and youthful into our senior years, but they also conspire against us.

The result of the wear and tear?

Osteoarthritis, a degenerative joint disease that causes pain and stiffness.

Arthritis has many forms, but osteoarthritis is the most common: More than 27 million Americans suffer from it, and women over age 45 are 10 times more likely to have osteoarthritis than men. Researchers don't know why, but it could be blamed on women's bone structure, or even the high heels women sometimes wear.

Former competitive athletes – from runners to divers to gymnasts – are particularly vulnerable.

Aging, excess weight and having a joint injury also increase risk. The disease usually targets weight-bearing joints, such as the hips, knees and lower back, but also the neck, fingers and big toe.

Osteoarthritis’ most common symptoms include:

Joint soreness after overuse or inactivity

Morning stiffness that improves with activity

Changes in posture or walking because of stiffness
What Causes the Pain?
Osteoarthritis breaks down cartilage, the primary shock absorber covering the joint ends. The subsequent damage occurs in several stages:

First, the cartilage cushion loses elasticity and is more easily damaged from injury or use.

As the cartilage wears down, the underlying bone thickens and develops growths or spurs. At this stage, bits of bone and cartilage float in the joint.

The joint lining then becomes inflamed and releases irritants that damage cartilage even more. The normal lubricant also deteriorates, further exposing the joint surfaces to injury.

Eventually, the joint becomes so painful and stiff that replacement may be the only option. The procedures are hugely successful: A study published in the journal Arthritis and Rheumatism showed that 77% of 112 knee replacement patients were satisfied or very satisfied with the results; 80% said they would have the surgery again.

Where You Feel It Most
Hips: If you have osteoarthritis of the hips, you may feel pain in the groin, inner thigh or buttocks. The discomfort may radiate to the thigh or knee and force you to limp when walking.

Hands: It’s common in the fingers too, causing joints to ache and swell. They may develop boney outgrowths and your hand may lose its grip strength or fine motor skills that help you pick up small items or hold a pencil.

Back: Repetitive stress on the spinal discs that cushion the vertebrae can cause them to break down. Again, boney spurs may develop, placing pressure on the nerves exiting the spinal canal.

Osteoarthritis of the back can lead to stiffness and pain in the neck, shoulder, arm, lower back and legs. It can also cause pinched nerves, which leads to weakness in arms and legs.

Knees: Osteoarthritis of the knees usually causes pain, grating or catching at the joint as you move, especially on stairs.

Women tend to wear out their knees differently than men. First, women are more likely to tear one of their key knee ligaments, the anterior cruciate ligament, or ACL. (Female college basketball players, for example, are up to eight times more likely to sustain an ACL injury than their male counterparts.) The resulting knee instability increases the risk for developing arthritis.

Women also are more likely to wear down the outer knees. Our broader pelvis force the legs to angle inward at the knee instead of straight down. Researchers have developed gender-specific joint replacements for a more comfortable fit.

High-heel shoes also increase osteoarthritis risk. Shoes with three-inch heels, whether stilettos or platform, put at least 22% more pressure on knee joints than low-heeled shoes because they strain muscles and tendons.

Treating Joint Pain
So how do you get rid of the pain?

Step 1: See a physician for tests, such as a blood count, joint X-rays and possibly a joint MRI.

Sometimes the doctor will remove some joint fluid to look for deterioration and to rule out other forms of arthritis, which are treated differently than osteoarthritis.

Early diagnosis and treatment are key to managing the disease. You can’t reverse the clock, but you can minimize joint damage and maintain range of motion.

You can also control pain and swelling, improve function and slow osteoarthritis' progression. Often treatment includes weight management (the less weight, the less stress on the joint), exercise, physical therapy and medication.

Traditional medications include:

Non-steroidal anti-inflammatories (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin) and naproxen (Aleve)

Pain relievers such as acetaminophen (Tylenol)

Topical pain relievers, such as creams and rubs containing wintergreen oil or camphor

Steroids and viscosupplements, such as Synvisc, that a doctor can inject into the knee to supplement its normal lubricating fluid.

Fitted braces can also relieve some stress and reduce damage over time. Arthroscopic surgery may be necessary to clean up the joint, trim worn or torn cartilage and remove debris.

For advanced osteoarthritis, you may need a total joint replacement. Partial replacements (often called joint resurfacing) repair only the damaged area, allowing you to retain more of the original joint.

Relief, Naturally
Alternative treatments like glucosamine with chondroitin sulfate and methylsulfonylmethane (MSM) can help, often in combination with conventional methods.

Among the most popular:

Glucosamine: This sugar seems to play a role in cartilage formation and repair. One study showed that 50% of osteoarthritis patients had less pain when taking glucosamine supplements, particularly among those with mild to moderate symptoms.

But watch out: Glucosamine may upset your stomach and raise blood sugar levels. Also, don’t take it if you are allergic to shellfish.

Chondroitin sulfate: This protein part gives cartilage its elasticity. It may improve its shock-absorbing properties and help it retain water. Like glucosamine, chondroitin can upset your stomach.

Glucosamine and chondroitin: They've been used in combination for years in Europe to manage joint pain.

A study published in the New England Journal of Medicine in 2006 showed that the supplements were more effective together. They had little effect on mild pain, but showed a significant benefit in people with moderate to severe pain.

Methylsulfonylmethane or MSM: This naturally occurring sulfur compound found in fruits, vegetables and grains may also reduce pain and inflammation.

A pilot study of 50 men and women with osteoarthritis showed that MSM reduced pain and improved physical function without major side effects, but no controlled trials substantiate the claim.

Before you add a nutritional supplement to your treatment regimen, check with your doctor.

For more information and expert advice, visit our Arthritis Health Center.

Are You Bad to the Bone?
For years, you’ve been the first one on the tennis courts, the weekend hiker, the intrepid gardener on your knees for hours. While all those activities are great for you, they can also be hard on your joints.

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