Arthritis is a condition which affects nearly 1 in 4 of us. Arthritis is the name for a number of conditions that cause wear and tear on the joints of your body. The most common type of arthritis is degenerative joint disease, which occurs when the cartilage that cushions joints such as the hip, knee or fingers wears out over time from overuse or injury, but arthritis may be caused by inflammation or infection as well. When the underlying bone begins to rub together, pain, swelling, and stiffness result. Obesity and being overweight place extra strain on joints and are big risk factors for developing the condition. Other risk factors include previous joint injury, aging, family history of arthritis, and female gender. Common symptoms of arthritis include swollen, painful, stiff joints that are difficult to move, especially upon waking. Fever, bright red joints or drainage from aching joints are not common symptoms of osteoarthritis and should be brought to the attention of your medical provider immediately.

Diagnosis and Treatment

Arthritis is a chronic condition that often progresses with time. Diagnosis of arthritis often consists of a thorough history and exam, but sometimes bloodwork or x-rays may be needed to confirm the condition. There are many therapies available to reduce inflammation and joint pain once the diagnosis is confirmed. Anti-inflammatory medications such as naproxen and ibuprofen are long-standing and effective treatments for joint pain, but can have serious side effects such as gastrointestinal bleeding if taken improperly. Topical remedies such as anti-inflammatory creams, capsaicin and menthol often have fewer side effects and can block pain and decrease joint stiffness. Many herbal remedies have been shown to have pain-reducing characteristics as well. Turmeric, ginger, SAM-e and boswellia all have documented anti-inflammatory properties. Please consult a knowledgeable practitioner prior to using these and all alternative therapies to determine proper dosage and to prevent harmful interactions between these substances and prescription medications. 

Dietary changes have been noted to prevent worsening of joint damage and decrease pain. Adding essential fatty acids such as GLA (gamma-linolenic acid) and omega 3 fatty acids, preferably by consuming a diet rich in fruits, vegetables and whole grain foods and moderate amounts of fatty fish such as salmon has been noted to slow the progression of joint damage. A plant-based diet as described above may help with weight loss and has many other beneficial side effects such as decreased risk of high blood pressure, osteoporosis, diabetes and heart disease. Just a 15 lb. weight loss has been shown to decrease arthritis symptoms by 50%. Exercise is also known to decrease pain, increase joint range of motion and assist with weight loss. Aim for 20-30 minutes of moderate exercise such as swimming or walking in order to improve arthritis symptoms. Physical therapy can be useful to reduce pain, improve joint mobility and decrease risk of falls. Sometimes a therapist may recommend assistive devices such as a cane or walker for additional support if joint function is severely affected. Your physician can refer you to physical therapy for further evaluation if necessary. 

Surgery is a last resort with good long-term outcomes for patients with severe debilitating arthritis. You may be a candidate for joint replacement surgery if pain and loss of joint function restrict the performance of your daily activities, if medication and lifestyle modification fail to decrease pain and/or improve joint function and if severe damage is noted on x-rays or other studies such as CT or MRI. “Most current data suggests that both hip and knee replacements have an annual failure rate between 0.5-1.0%. This means that if you have your total joint replaced today, you have a 90-95% chance that your joint will last 10 years, and a 80-85% that it will last 20 years” (American Association of Hip and Knee Surgeons). If you have had long-standing arthritis unimproved with a trial of conservative therapy such as weight loss, exercise and medication, please discuss further therapeutic options with your doctor.

By BitMED Provider: Traci L French MD

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