Osteoarthritis is the most common disabling condition in older adults, but it can be treated and diagnosed by a physician.
The condition is an inflammation of the cartilage in joints and damage to the bone underneath. It causes a progressive breakdown of cartilage that only worsens over time, never having a remission period. Bones once separated by cartilage rub against each other resulting in damage, which causes painful joint symptoms.
According to Marshall Hale, a family practice physician in Jacksonville, Ill., osteoarthritis is very common.
“In some studies of people 90 years old, 90 percent have this condition,” Hale says. “In people 60 years old, it’s about 30 percent.”
Hale outlines symptoms as the following:
• Pain in the joints, often at the conclusion of activities
• Swelling
• The joint might feel warm
• Mild stiffness that eventually becomes worse over the years
While the symptoms can be lessened with treatment, complete prevention is impossible. Injuries and obesity increase a patient’s risk. Hale recommends slowing the progression through the following steps:
• Avoid repetitive damage by changing activities, such as runners switching to bicycle riding.
• Keep weight under control. A person within ideal weight range does not put excessive pressure on joints.
• Avoid chemicals that inhibit healing, such as those in alcoholic drinks and cigarettes.
If these behavioral changes do not improve the patient’s condition, treatment might include low-dose over-the-counter painkillers like acetaminophen, aspirin or ibuprofen.
Or the doctor might recommend over-the-counter or prescription nonsteroidal anti-inflammatory drugs, also called NSAIDs. But Hale notes that these drugs carry the risk of ulcer formation in the stomach. And he adds that in patients older than 60, arthritis medicine is the most common cause of ulcers.
“Newer drugs have a beneficial effect on joints, with less risk for irritation of stomach,” Hale says. “But on the downside, they can be very expensive.”
In serious cases, physicians inject steroids directly into the joint.
“[Steroid injections] control pain for up to one year,” Hale says. “But this increases the risk of infection and can produce a little damage, so this is used only occasionally.”
And in severe cases, patients might turn to joint-replacement surgery. Hale estimates that 20 to 25 percent of patients eventually have to undergo surgery.
Other forms of arthritis exist, so Hale says osteoarthritis is a “diagnosis of exclusion.” To get such a diagnosis, the patient must show symptoms of osteoarthritis without signs of other conditions such as gout or rheumatoid arthritis.
Self-management techniques suggested by the Arthritis Foundation include weight control, learning to protect your joints and getting exercise.
According to the foundation, those with osteoarthritis should commit themselves to regular exercise that includes three types of activity — flexibility (stretching, range-of-motion), strengthening (resistance) and cardiovascular (aerobic). Just be sure to consult your doctor before you begin, as you may need to be assessed by a physical therapist who will help you start your new exercise routine.