Arthritis: Common and treatable
HealthWorks’ editorial staff spoke
with Alan Marks,MD,
a rheumatologist at
Emerson Hospital,
about osteoarthritis, the
most common form of
arthritis, which affects
more than 20 million
Americans.
What is the underlying process that
causes osteoarthritis?
Regardless of the cause, all cases of osteoarthritis
have one thing in common: change in the cartilage
followed by its gradual deterioration—usually a slow
process.The disease typically spreads beyond the
cartilage to involve the joint lining and ultimately
the bone itself.The most commonly affected joints
are the neck, back, hip, knee, knuckles and large toe.
What are the most common symptoms
of osteoarthritis?
The most common symptom is pain, which may
vary from mild to severe, may affect only weightbearing
joints and might occur only when the
individual is physically active. Joint stiffness, which
can affect one’s range of motion, is another symptom
and indicates inflammation in the joint lining.
Many people with osteoarthritis feel a weakness
in the affected joint, and some describe hearing a
noise, which indicates that the joint is starting to
grind as a result of worn cartilage.
What factors contribute to the
development of osteoarthritis?
The three major risk factors are advanced age,
female gender and obesity. After menopause,
obese women are especially at risk for developing
osteoarthritis, particularly of the knee or hip.
Trauma in the form of a fracture, in or near a
joint, may cause arthritis decades later. Repetitive
trauma, which may occur in individuals whose
work involves standing or walking on hardwood
floors, is another risk factor. Finally, we know that
genetic factors are sometimes involved though they
are not well understood.
What are the standard treatments for someone with osteoarthritis?
Successful treatment begins with clarifying the type
of arthritis—osteoarthritis or rheumatoid arthritis—
and determining which joints are affected. Many
patients will experience relief of their symptomsthrough a combination of appropriate exercise,weight
control and medication. Exercise might include
riding a stationary bike, swimming and weight
training to build the muscles, strengthen the joints
and increase the range of motion.Available
medications include over-the-counter painkillers
such as acetaminophen (Tylenol) and ibuprofen and
prescribed anti-inflammatory drugs. Some patients
report good results from taking glucosamine-chondroitin;
others benefit from cortisone injections,
which may provide pain relief in the short
term. Supportive devices—canes, orthotic devices
or elastic braces—can be helpful.When someone’s
quality of life is seriously affected due to pain or
an inability to get around and obtain a good night’s
sleep, we evaluate them for possible joint replacement
surgery.
Is rheumatoid arthritis a completely
different disease?
Yes. Rheumatoid arthritis (RA) is a chronic
autoimmune disease that develops when someone’s
immune system attacks the joint lining, causing
inflammation and swelling. If RA is not diagnosed
and treated early, it can cause structural damage— permanent deformity of the affected joints.
Fortunately, major breakthroughs have occurred in
the past five years.We now have medications that
literally can shut down the disease, prevent future
joint damage and, at times, repair joint damage.
Is osteoarthritis inevitable as we age?
Most people will develop some degree of
osteoarthritis. Although we cannot control our age,
there are things we can do to prevent osteoarthritis,
such as maintaining a healthy weight and getting
exercise throughout our lives, which keeps our
muscles strong and helps keep our joints in good
working order.
For more information on diagnosis or treatment of arthritis at Emerson Hospital, visit our Find a Doctor section or call the Physician Referral Line at 978-287-3456.
