Osteoarthritis (OA) is the most common type of arthritis, affecting up to 70 million Americans, and 1 out of 2 people over the age of 50. Osteoarthritis has fast become the most common cause of disability, and by 2050 will outpace cancer and heart disease combined. Osteoarthritis is usually caused by either wear and tear on the joints or follows several years after an injury to the joint. Despite how common OA is, people often know relatively little about the disease and how it can be treated effectively.
- Osteoarthritis affects more people than all of the over 100 types of arthritis combined. Rheumatoid Arthritis, which is much more familiar to people, affects about 1.5 million Americans and is the second most common type.
- Osteoarthritis is very different than Osteoporosis. Osteoporosis is loss of bone strength and density which can lead to increased risk of bone fractures. Osteoarthritis affects the joints. Osteo, latin for bone, is a misnomer in osteoarthritis in that the problem is in the cartilage, not the bone. The bone is underneath the cartilage and when the arthritis is most severe, the cartilage can wear away all the way down to the bone.
- Bone spurs are most common in Osteoarthritis when compared to other forms, although they are usually not the main cause of the symptoms.
- Although commonly called wear and tear arthritis, inflammation plays a significant role in Osteoarthritis. Calcium crystals can get into the joint and cause it to swell. The inflammation may be why “cortisone” shots can help relieve symptoms in some patients.
- No medication has been shown to modify or change the course of the disease. They all provide symptomatic relief, however often with significant side effects. NSAIDs (naproxen, diclofenac, ibuprofen) the most common class of medications used to treat Osteoarthritis can be particularly problematic in older patients. Acetaminophen, commonly known as Tylenol, is usually used as first line therapy, but studies indicate that a patient often needs 4 grams, or 8 extra strength (2 pills 4 times a day) to get some relief. It is important to avoid alcohol when taking acetaminophen and many other pain and over the counter medications contain acetaminophen, so you need to be careful not to accidentally overdose.
- Glucosamine and Chondroitin were thought to potentially change the course of the disease, but a large study done by the NIH showed no benefit. Other small studies have shown benefit, but the data is mixed.
- Appropriate strengthening exercises can provide significant symptomatic relief. Many studies have shown that a 6 to 12 week quadriceps strengthening regimen can decrease osteoarthritis pain in the knee by up to 50%.
- Look for options that provide relief without significant side effects. Since medications don’t change the disease, just help the symptoms, find something that is safe and effective. There are some natural anti-inflammatory pain relievers that help with few side effects, including Boswellia, Bromelain, Curcumin, and possibly ever ginger. Try these options, along with appropriate exercise before going on more dangerous medications or surgery.