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Dear
Doctor:
I
am a woman in my fifties and recently, I have been experiencing pain in the
joints of my hands and knees. A friend of mine told me I might have
arthritis and I was wondering if you had any information you could share
with me about this. B.B., Laurel.
Osteoarthritis, also known as
degenerative joint disease, is a progressive disease of the joints.
Osteoarthritis is the most common form of arthritis, affecting more than 20
million American adults. This condition is associated with a breakdown and
advancing loss of cartilage in joints. Cartilage is a tough, resilient
elastic material comprised of collagen and water molecules. This tissue is
present on the joint surfaces and provides a cushion between the bones of
the joints. Healthy cartilage permits bones to glide over one another. When
we move our joints, fluid and waste products are expressed out of cartilage
cells, and oxygen and nutrients are diffused into the cells. Thus, the
health of cartilage is greatly dependent on joint movement. Over time,
cartilage can break down, becoming injured, torn and may even wear away
entirely. As this occurs, the bone surfaces under the cartilage begin to
rub against each other, causing pain, swelling and loss of motion of the
joint. Additionally, as the cartilage deteriorates, the tendons and
ligaments stretch, contributing added pain.
What
causes osteoarthritis?
Most cases of osteoarthritis have no
known cause, as this disease spares no race, age or geographic region.
However, due to the gradual degeneration of cartilage through repetitive
use or misuse, age seems to be the primary perpetrator. Other risk factors
include certain hereditary conditions, joint injuries, repeated trauma,
fracture or surgery around a joint surface and obesity.
Signs
and Symptoms of osteoarthritis
The symptoms of osteoarthritis tend to
develop gradually. Initially, one might experience joint aching and
stiffness, typically following activity. In the early stages of
osteoarthritis, this pain and discomfort may fade and return over time,
particularly with overuse of a joint. As this condition progresses,
symptoms may include:
*joint
aching and soreness
*loss
of mobility of the affected joint(s)
*swelling
and tenderness in the joints
*pain
after overuse or after long periods of inactivity
*stiffness
upon arising in the mornings
*a
crackling noise (called “crepitus”) when the
affected joint is in motion
*patients
may also experience muscle spasm or contraction
Osteoarthritis can occur in any joint
however it most often occurs in the spine,
hips, hands and knees. In
the spine, bony growths known as “osteophytes”
can form and are associated with degeneration of cartilage in the disc
spaces. As these spaces narrow, greater compressive forces are imposed on
the bones, consequently leading to osteophyte
formation. Osteoarthritis involving the hips often involves both sides of
the body. Hips are major weight-bearing joints and degeneration here may
limit movement and is usually activity related. In advanced cases,
performing simple activities of daily living such as walking may become
difficult or even impossible. In osteoarthritis of the hands, the end
joints of the fingers can form bony enlargements. These joints can become
painful, swollen and red. Though all fingers can become affected, the base
of the thumb joint is the most frequently encountered site in the hand.
Knees affected by osteoarthritis can become stiff, swollen and painful. As
the knees are major weight-bearing joints, there may be a sense of
unsteadiness, making it difficult to walk or climb stairs.
When diagnosing osteoarthritis, most
doctors rely on a combination of factors, including history, physical
examination and testing. X-rays can be helpful in confirming this diagnosis
in determining bone damage and cartilage loss.
Treatment
Treatment for osteoarthritis is
dependent on multiple factors, including patient age, progression of
disease, activity level and medical condition. The overall goal of
treatment is to reduce joint pain and inflammation while improving and
maintaining joint function. People with moderate osteoarthritis of
weight-bearing joints (hips and knees) may benefit from exercise to help
mitigate pain and improve motion. Losing weight and walking aids may also
lessen the compressive loads imposed on these joints. People suffering from
osteoarthritis in the spine may benefit from an exercise program designed
to strengthen the muscles in the back and abdomen. Exercise strengthens
muscular support around the joints and maintains joint mobility, and can
stimulate cartilage growth. Many people find relief sleeping on a firm
mattress or using cervical and back support pillows. Paraffin wax dips,
warm water soaks and finger splints can help with osteoarthritis found in
the hands. Though medication is often used in cases of severe
osteoarthritis, other non-drug treatments providing pain relief include
hot/cold therapy, prolotherapy, acupuncture, and
herbal remedies. Vitamin D deficiency has been reported in patients with
osteoarthritis, so supplementation is advised, as well as antioxidant
vitamins C and E. Diets should include calcium for bone growth and omega-3
fatty acids from fish oil to reduce the inflammatory affects of chondrocyte metabolism. Both glucosamine
and chondroitin sulfate may reduce pain and replenish nutrition to
unhealthy cartilage cells.
If you are suffering from
osteoarthritis, you have options. You can enjoy a healthy lifestyle
notwithstanding this condition.
Education is the first step. If you are experiencing any of the
symptoms listed above, see your health care professional. Taking care of
yourself and adopting healthy lifestyle choices is empowering. The quality
of the life you lead is in your hands.
Yellowstone Naturopathic
Clinic
720 N. 30th St.
Billings, MT 59101
PHONE 406·259·5096/FAX 406·248·5655
ync@180com.net
Dispensary
406·254·9682
dispensary@yncnaturally.com
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