Aging with Osteoarthritis

By Ann Pierce

Osteoarthritis doesn’t have to hobble your golden years! Knowing the risk factors and the symptoms can help slow this disease down or prevent it entirely. Understand what causes it, how you can take steps to avoid it, and how to treat it should it rear its painful head.

Dr. Michael Veale Orthopedic Surgeon, Center for Sports Medicine & Orthopaedics

If you want to maintain your mobility and your quality of life as you age, now’s the time to start preventing osteoarthritis, the most common cause of disability in seniors. Over 30 million Americans – including more than half the adults over 65 – currently have osteoarthritis, and that number is expected to explode to 70 million by 2030, as the last of the Baby Boomers reach retirement age.

What Causes Osteoarthritis?

“Osteoarthritis is the ‘wear and tear’ in the weight-bearing joints that occurs as people age,” says Dr. Michael Veale, a specialist in general orthopedics and arthroscopic surgery at the Center for Sports Medicine & Orthopaedics. “There are two forms: primary OA, which tends to be strictly a product of aging, and secondary OA, which develops as a result of another cause like injury or disease.”

OA is also known as degenerative joint disease, and it causes a host of painful symptoms that can limit your range of motion. “The most commonly affected joints are the hips, knees, spine, and hands,” explains Amy Jones, a physical therapist and geriatric specialist with HealthSouth Chattanooga Rehabilitation Hospital.

Osteoarthritis begins when the cartilage in your joints, which acts as a cushion between the ends of your bones, slowly wears away. Jones explains, “Cartilage is a flexible tissue that acts as a shock absorber and a smooth surface for bones to interact in the joints. When it wears away, you get pain, stiffness, swelling, and crepitus, which is the creaking sound you may hear with movement.”



 


 


Amy Jones Physical Therapist and Geriatric Specialist, Healthsouth Chattanooga Rehabilitation Hospital

What Are the Risk Factors?

Your age is one of the biggest risk factors, since your likelihood of developing the disease increases with each passing year. Another is gender, as women are more likely to develop OA, though there’s no clear reason why. Obesity is linked to OA too, as added weight puts more stress on joints such as the hips and knees, and the proteins produced by fatty tissue can cause inflammation around joints. The more excess weight, the greater the risk.

Additional risk factors include joint injuries from accidents or sports, certain occupations that require repetitive stress on a joint, bone deformities, or defective cartilage. Finally, genetics can make you more susceptible to OA. If any of your family members had or currently struggle with the disease, your chances increase. Be sure to compile a complete family medical history before visiting your doctor.

Living with OA

If you are diagnosed with OA, there are steps you can take to reduce your pain and improve your range of motion. Low-impact exercise – think swimming, walking, or biking – is the best way to build muscle to support the joint without putting additional stress on it, and it helps reduce pain. Yoga, too, is excellent for lessening pain and increasing mobility.

The challenge with exercise is not to be put off by mild discomfort in the beginning. Avoiding exercise due to stiffness or a little discomfort means more pain and immobility later. Plus, sticking with a measured exercise regimen will release endorphins, which will alleviate pain, and may also help reduce excess weight, which eases stress on the joints.

To set yourself up for success, try alternating heat and cold on the affected joint. Use a heating pad first thing in the morning to relieve stiffness and warm up joints, then exercise after. Following your walk or workout, use cold – a frozen gel pack works great – to reduce pain or swelling. You can repeat the alternating treatments as often as you need.

In addition to exercise, over-the-counter anti-inflammatory medications such as acetaminophen and ibuprofen, or even topical gels that reduce inflammation, should ease pain. Dr. Veale also recommends glucosamine, a supplement that helps stabilize remaining cartilage. Ambulatory aids such as canes or walkers can also unload pressure on the joints.



The challenge with exercise is not to be put off by mild discomfort in the beginning. Avoiding exercise due to stiffness or a little discomfort means more pain and immobility later.


 


Beyond that, Jones recommends planning your steps in advance and adapting your home. “If bringing in groceries increases osteoarthritic hand pain, decrease the loads you carry per trip or use a wheeled bag. If stairs aggravate knee pain, try to limit trips up and down and use ramps. Elevated toilets can reduce strain on knees and hips, while dumbwaiters and laundry chutes can reduce the number of items you have to carry.”

Treatment Options

If your OA is affecting your quality of life to the point that at-home remedies aren’t enough, there are numerous options available depending on the specifics of your condition. “The goal of treatment is to start with the least invasive options and work toward more invasive options only if necessary,” says Dr. Veale.

Physical therapy works to improve mobility, which is key to remaining independent. Your therapist will create a specific treatment schedule to help you strengthen the muscles around the affected joint and eliminate stress.

In some cases, your physician may suggest cortisone injections. They can reduce pain for six weeks to six months and are traditionally used in combination with physical therapy. Another injection available is viscosupplementation, also called hyaluronic acid injection. “Hyaluronic acid is a protein that produces a viscous (thick, sticky consistency) substance that lubricates the joint,” says Dr. Veale. “People with OA don’t make enough of that protein, so we’re trying to stimulate their bodies to restore it.” These injections, which are currently only used in osteoarthritic knees, add cushioning to the knee to protect it from weight-bearing activities.

When you’ve exhausted non-surgical treatments to no avail, surgery will likely be the answer. “Total joint arthroplasty is one of the most successful surgeries we can do to improve quality of life and remove pain,” says Dr. Veale. Joint arthroplasty involves resurfacing the damaged bones to restore function to the joint or replacing the joint with a prosthesis made of metal, plastic, or ceramic. The prosthesis will mimic the function and shape of the natural joint. Movement soon after surgery is encouraged, and most patients are able to perform daily activities more easily within just a few months.

You have a good chance of never developing OA, and a better chance, if you pay attention to the risk factors. Walk. Swim. Do yoga. Keep (or get yourself to) a healthy weight. Pay attention to aches and pains – are some temporary while others are constant? Then visit a medical professional and find out the best course for remaining healthy, mobile, and independent.

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