Arthritis

It’s not unusual to occasionally experience pain in your joints, especially if you’re an active person. But if you experience pain, aching and stiffness on a regular basis — especially if those symptoms are right at a joint — you may be developing arthritis.

Arthritis is a Greek word applied to over 100 different diseases that affect our joints. It literally means “joint (arthros) inflammation (itis).” These diseases attack our joint cartilage, breaking it down. The most common arthritis diagnoses are osteoarthritis and rheumatoid arthritis. Treatment is focused on reducing the inflammation in the joint.

Though there is no cure for arthritis, there are treatment options that can help alleviate your symptoms and slow the progression of joint damage. With the right treatment, many people can manage their symptoms and remain active. Contact the Orthopaedic Institute of Ohio office closest to you to schedule an appointment.

Joint Anatomy

A joint is a place where the ends of two or more bones meet. The hip joint, for example, is located where the top of the thigh bone (femur) meets the cup-shaped depression of the pelvis (acetabulum).

Our joints move freely and painlessly due to a specialized coating called articular cartilage. A smooth layer of cartilage covers the ends of our bones, cushioning the joints and lowering friction during movement. Additionally, our joints are encased in a fibrous capsule lined with a tissue called synovium. Synovium produces a fluid that also helps reduce the stress of motion in a joint.

Damage or loss of articular cartilage increases friction in a joint, leading to arthritis. This can happen due to natural wear and tear on the cartilage over time, an injury or a systemic disease throughout the body. The affected joint becomes inflamed, causing pain and stiffness that worsen over time. Arthritis makes it difficult to do daily activities and can cause long-lasting or permanent disability.

Commonly Affected Areas

Arthritis primarily affects weight-bearing joints. However, non-weight-bearing joints can also be affected.

• Elbow
• Wrist
• Thumb and fingers
• Hip
• Knee
• Ankle
• Foot
• Neck
• Shoulder
• Lower back

Arthritis Symptoms

Pain, stiffness and swelling are the primary symptoms of arthritis. These symptoms may range from mild to disabling. Additional symptoms of arthritis may include:

• Tenderness to touch
• Limited joint mobility
• Weakened muscles around the joint
• Feeling of warmth around the joint
• Deformity of the joint
• A grating feeling with movement
• Creaking, clicking, snapping or grinding noise with movement
• Pain flairs up with vigorous activity
• Pain may be worse in the morning
• Bump develops over the joint

Knee and Hip Arthritis & Arthroplasty

Millions of people suffer from pain and loss of mobility due to hip and knee arthritis, and hundreds of thousands undergo hip and knee arthroplasty every year. Although advances in surgical techniques and devices, as well as surgeons’ expertise, have improved outcomes over the past several decades, many patients with arthritis still experience anxiety about the diagnosis and the prospect of having a hip or knee replaced. Read More.

Osteoarthritis

Over 10% of our population suffers from osteoarthritis (OA). Usually, OA presents itself as localized pain to a joint that is aggravated with activity. As the disease progresses in the joint, the pain can be more global. Swelling can become common after activity. As OA enters its final stages, stiffness and deformities develop, escalating the pain.

Early treatment for OA includes activity modification, weight reduction and stretching exercises to maintain joint motion. As the disease progresses, so does the pain. Early pain remedies include aspirin, Tylenol and ibuprofen. These are later substituted with more powerful anti-inflammatory drugs or even oral steroids for short courses. Joint injections of steroids or “lubricants” can also relieve pain. 

Surgery is the last option for OA treatment. Arthroscopy or “scoping” the diseased joint can ease pain and return function for a short period of time. Ultimately, joint replacement is necessary to eradicate the disease and provide long-term pain relief.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is the second leading cause of arthritis. This is an autoimmune disease where your body recognizes its own cartilage as “bad” and starts to digest it. It is familial in nature and can attack early on (juvenile) or later in life (adult-onset). RA affects 1% of Americans and can be severely debilitating. 

Usually, RA presents itself as early swelling with global joint involvement and multiple joint involvements. It can be detected by laboratory blood tests. Progression can be rapid depending on the aggressive nature of the patient’s RA and the treatment.

Early treatments for RA are the same as for OA. These include rest, over-the-counter medications and activity modification. More powerful anti-inflammatories and steroid medications are introduced early on in the treatment of RA. Ultimately, specific RA medications including plaquenil, methotrexate or embril are necessary to slow the RA progression and treat the symptoms. Injections are commonplace and are used judiciously to lessen the amount of medications taken. Joint irrigation with arthroscopy can help prolong the course, but eventually joint replacement is necessary to relieve suffering and correct deformity.

Can Arthritis Be Prevented?

Arthritis is virtually inevitable as our population continues to age. The fastest-growing segment of the population in America is people over the age of 80. Unfortunately, this translates to higher rates of arthritis. Treatments have improved over the years, but they have not kept pace with the growing demands of our more active octogenarians. Prevention will likely decrease this epidemic in the future. 

You can lower your risk of developing arthritis by:

• Maintaining a healthy body weight
• Losing weight if recommended
• Avoiding tobacco products
• Controlling your blood sugar
• Engaging in continued low-impact physical activity, such as walking, swimming and biking, to keep your muscles and tendons strong and supportive
• Stretching to keep your joints mobile 
• Avoiding injury
• Getting routine preventive care

Nonsurgical Treatments for Arthritis

Early diagnosis and treatment of arthritis can help relieve pain, maintain joint mobility and improve function. Most treatment programs begin with nonsurgical approaches, including medication, lifestyle modifications and physical therapy.

Medication

Various non-steroidal anti-inflammatory drugs (NSAIDs) available over the counter can help control pain and inflammation in the joints. These include ibuprofen, aspirin and naproxen. Acetaminophen can also be effective in reducing pain. For some patients, prescription medications are an option.

Steroid Injection

Injections of a corticosteroid medication into the joint may temporarily help relieve pain and inflammation. The potential side effects of cortisone shots increase with repeated use and larger doses. Therefore, the number of shots an individual can receive in a year generally is limited.

Lifestyle Changes

Making changes in your daily life can help reduce the pain of arthritis and slow the disease’s progression. These changes may include losing weight to reduce stress on your joints, limiting or stopping activities that inflame the condition, and switching from high-impact exercise to low-impact fitness styles.

Assistive Devices

Depending on which joint is affected, wearing a device for immobilization (e.g., a wrist splint or an ankle-foot orthosis) may be recommended. A brace helps support the joint and reduces the stress placed on it by frequent use. Patients with arthritis in the lower extremities may also benefit from using a walking device like a cane and/or wearing shock-absorbing shoes or orthotic inserts.

Physical Therapy

A physical therapy program is often recommended to increase range of motion, improve flexibility, reduce pain, and strengthen the weakened muscles surrounding the joint. A physical therapist can also recommend exercises to perform at home and demonstrate ways to perform daily activities that are less stressful on the affected joint.

Other Remedies

To reduce swelling, a doctor may recommend applying ice and heat packs or using “contrast soaks” of warm and cold water for short periods, several times per day. Some patients explore alternative therapies such as acupuncture or stem cell injections.

Surgical Treatments for Arthritis

If nonsurgical approaches do not relieve the pain and inflammation, or if they lose their effectiveness, surgery may be considered. The goal of surgery for arthritis is to reduce pain while preserving or improving joint function. Typically, this is done by minimizing or ending bone-on-bone contact. 

The decision to treat arthritis surgically depends upon the patient’s age and activity level, the condition of the affected joint and the extent of the disease’s progression. Surgical options for arthritis include:

• Arthroscopy
• Osteotomy
• Synovectomy
• Cartilage grafting
• Joint fusion
• Partial joint replacement
• Total joint replacement

Your orthopaedic surgeon will talk with you about which procedure will work best in your case.

Long-Term Management of Arthritis

Because there is no cure for arthritis, most people need to manage the condition for the rest of their lives. 

Changing your daily routine can make living with arthritis easier. If certain activities aggravate your symptoms, reduce or eliminate these activities. It may help to consult an occupational therapist (OT). OTs specialize in helping people with illnesses, injuries and disabilities lead full, active lives through the therapeutic use of everyday activities.

Your healthcare team can help you find an effective combination of treatments to manage your symptoms. If your symptoms worsen or you struggle to find a routine that works for you, ask your doctor to review your treatment plan and determine whether changes are needed.

Ohio Arthritis Care — Contact Us Today to Schedule Your Appointment

At the Orthopaedic Institute of Ohio, our experienced physicians commit to giving patients an early diagnosis and a personalized arthritis treatment plan to help them get back to living a normal life. We offer a comprehensive range of arthritis treatment options, from nonsurgical therapies to surgical joint replacement. We tailor each treatment plan to the individual patient and their personal goals.

For appointments and inquiries, please contact the Orthopaedic Institute of Ohio here or at 419-222-6622.