Managing OsteoarthritisNov 10, 2013 09:00AM ● By Traci Osuna
Osteoarthritis, also known as degenerative arthritis, can and will eventually affect everyone. That sounds rather ominous. “Degenerative arthritis is a term that is generally used and obviously differs from rheumatoid arthritis, which is an auto-immune disease,” explains Dr. Michael Morrison of Omaha Orthopedic Clinic and Sports Medicine. “But degenerative arthritis is the same as wear and tear and is associated, just simply, with the aging process.”
Dr. Morrison says that, generally, people in their 50s and 60s will start to feel the aggravating pains and experience the swelling of joints, though these symptoms can occur much later. He shares that some people may experience an accelerated condition due to genetics.
While the aging process as a whole leads to the aches and pains we experience, how we choose to exercise can affect the condition as well. High-impact activities, such as running and jumping, are hard on the joints. “Most people believe that if they start to get some aches in their joints, they can just exercise through them, but that probably irritates it more,” says Dr. Morrision. While exercise is always recommended for good health, he suggests lower to no-impact activities, such as swimming, bicycling, or even using elliptical machines.
To combat the pain that you already may be feeling, Dr. Randall Neumann of OrthoWest recommends starting out with over-the-counter anti-inflammatory remedies, such as ibuprofen or acetaminophen, to lessen the pain. Dr. Morrison also recommends herbal supplements as a good addition to the OTC regimen: “I’m a big believer in it.” He suggests trying glucosamine MSM. Glucosamine is found naturally in the body and helps with keeping joints healthy. He also recommends SAM-e and drinking cherry juice.
“I’ve seen them help many patients,” Dr. Morrison says. “But what works for one person might not work for another, so you are going to have to experiment with those and see what can give you the most relief.”
If OTC medicines are not providing enough relief, your physician can prescribe an anti-inflammatory that has a somewhat stronger dosage. However, Dr. Neumann cautions against medicating too liberally. “You can take pain pills, but we like the non-narcotic pain medication, such as Tramadol,” he says. “Most physicians are going to shy away from anything as far as narcotic for pain because they all have addicting potential.”
Physician-administered injections into the problem joint are also an option: Cortizone shots work as an anti-inflammatory and hyaluronic acid injected into the joint acts as a lubricant.
Finally, joint replacement surgery is an option for those who have end-stage disease, says Dr. Neumann. “These people are hurting, they have pain everyday, and their function is down. They have a hard time working, walking, going up and down stairs, and just having a miserable time in life.” The joint replacement procedure involves replacing the natural joint with a metal and plastic device. “You could still have some soft-tissue pain around there, but usually the pain from wear and tear arthritis is because bone is rubbing on bone there, and it causes an inflammatory response.”
Generally, says Dr. Morrison, the time frame for surgery, healing, and rehab is between four to six weeks. Knee replacements tend to involve a little more intensive rehab than hip replacements.
Osteoarthritis can affect joints in the upper extremities (such as shoulders, wrists, elbows) as well, but “is not usually brought on as quickly as in the weight-bearing joints,” Dr. Morrison clarifies.
“The decision to progress with anything surgical is strictly based on the patient’s inability to manage their pain, despite all conservative measure, and their quality of life is significantly hindered,” adds Dr. Morrison. “It is not based on what an x-ray looks like; it is based on the symptoms presented by the patient.”