Those Aches And Pains

Arthritis is a condition most of us associate with old age, but the real story is much more complicated. Arthritis can affect anyone of any age, race or gender, and two-thirds of people diagnosed with arthritis are under the age of 65, according to the Arthritis Foundation. Additionally, arthritis is the leading cause of disability in the United States, according to the Foundation, accounting for 44 million outpatient doctor visits and more than 900,000 hospitalizations each year.

“It can really impact your life and can be pretty devastating on your livelihood,” says Dr. Bret Frey, orthopedic surgeon with Mercy Hospital in Oklahoma City.

The term “arthritis” refers to hundreds of conditions ranging from rheumatoid arthritis and gout to degenerative forms of the disease, such as osteoarthritis, says Dr. Amy B. Dedeke, rheumatologist with Integris Physicians.

Degenerative arthritis is the most common form of arthritis. The Arthritis Foundation reports an estimated 27 million Americans live with degenerative arthritis. Degenerative arthritis is a chronic condition characterized by the breakdown of the joint’s cartilage, which is quite different than other forms where the membranes lining the joint become inflamed. With degenerative arthritis, the breakdown of cartilage between the bones causes the bones to rub against each other.

“Once the joint’s cartilage rubs off the bone, it’s permanent,” says Frey. “Patients are often left with joint stiffness, activity-related pain and loss of movement in the joint,” says Dedeke.

While the natural aging process is a key contributor to arthritis, a number of factors may cause the condition to develop in younger patients.

“Arthritis can form after an injury or post-traumatic event,” explains Dedeke. “The joint wears down faster, leading to arthritis.”

Abnormal forces like injury speed up the body’s natural degeneration process, explains Frey.

“Degenerative arthritis can occur from direct contact to a joint, like falling on an outstretched wrist, resulting in a fracture to the joint, or even with a less traumatic strain or sprain to the tendon or ligament surrounding the joint,” says Dedeke. “Disruptions of the natural architecture of the joint leads to a change in the mechanics of the joint, even the joint surface can become affected.”

“Old injuries, like sport injuries, also cause joints to not function properly,” adds Frey.

The Arthritis Foundation says symptoms of arthritis from an injury often start as soreness or stiffness that seems more a nuisance than a medical concern. Some will never progress past this early stage while others will have arthritis progress to a point where it interferes with daily activities; the pain and stiffness may make it difficult to walk, climb stairs or sleep. The Foundation outlines common symptoms of osteoarthritis as joint soreness after periods of overuse or inactivity; stiffness after periods of rest that goes away quickly when activity resumes; morning stiffness, which usually lasts no more than 30 minutes; pain caused by the weakening of muscles surrounding the joint due to inactivity; joint pain is usually less in the morning and worse in the evening after a day’s activity; and deterioration of coordination, posture and walking due to pain and stiffness.

It is important to remember that all of these changes can be permanent. There is no cure, so the best course to prevent arthritis from developing in the future is protecting the body from injury.

“You can’t really prevent post-traumatic arthritis other than preventing the injury in the first place,” says Frey. “Use common sense and be safe. Practice basic safety at home and at work.”

Be sure to take extra care when playing sports or exercising, cautions Dedeke. Use proper equipment and proper form. “Wear the correct shoes, stretch and properly warm up prior to activity and exercise,” she says. 

Protect joints by strengthening the muscle groups that surround the joint and provide support, offers Dedeke. Both endurance and resistance types of exercise provide considerable disease-specific benefits. Variety in a routine will help to build strength while reducing the risk of overuse.

“Approach exercise and sports using cross-training techniques,” advises Dedeke. “Participate in different activities like biking and running or walking.”

Also, be extremely cautious with knees. The knee joint is as a very commonly injured joint, says Dedeke.

“The lower extremities are more prone to post traumatic arthritis because they are load-bearing,” explains Frey.

Excessive weight also increases the risk of developing arthritis. The extra weight puts additional strain on load-bearing joints. For every pound gained, four pounds of pressure is added onto knees and six times’ the pressure onto hips, the Arthritis Foundation warns.

“Lose weight safely with low-impact activities,” recommends Frey.

Water sports, walking, biking, yoga and Pilates are a few good options, but there are plenty others to incorporate into a daily routine. Just remember to start slowly.

Even with all the care possible, injuries still happen. Lessen the damage done by using the RICE method after an injury: rest, ice, compression and elevation.

“Immediately after an injury, rest the joint, ice the area 15 minutes at a time, compress with a bandage and elevate the injured area,” advises Dedeke. “(This method) can reduce swelling.”

Then, visit a doctor. Dedeke and Frey both agree that proper treatment of injuries is critical to preventing further complications from an injury as well as reducing the risk for developing arthritis.

“The most important thing to remember is to seek medical evaluation after an injury so that concerning injuries can be identified and treated, which may lessen the possibility of arthritis,” explains Dedeke. “No injury should be ignored, and most injuries should be evaluated by a medical provider, especially those that have symptoms lasting more than one or two days.”

If there are any lingering issues related to an injury, especially pain, it should not be ignored. Follow up on them.

“Make sure you talk with your primary care physician if you still experience problems,” adds Frey. “It is important to keep an eye on it.”

While there is no cure for arthritis, treatments are available to lessen the symptoms of the condition.

“Post-traumatic arthritis is treated in the same manner as other types of degenerative arthritis,” says Dedeke.

There are medications, surgeries, physical therapies and other natural or alternative treatments available. Medical therapies might include non-steroidal inflammatory agents, analgesics, topical rubs and injections, says Dedeke. “Most patients with arthritis feel better with warmth,” says Dedeke. “Whether with a heating pad or electric blanket, keeping warm can help reduce some pain.” 

Frey suggests starting with simple treatments. Over-the-counter medications like acetaminophen, ibuprofen and naproxen are commonly recommended, as well as other similar prescription medications.  Over-the-counter topical creams can also be used, including capsaicin- and menthol-based analgesic creams.

There are also supplements and herbs commonly used to relieve arthritic symptoms. Cinnamon, ginger, glucosamine/chondroitin and fish oil are common supplements that have been reported to provide some benefit.  

Splints and braces can sometimes provide benefit by providing stability depending on the joint involved.