Make no bones about osteoarthritis
October 19, 2001 | 12:00am
"I don’t deserve this, but I have arthritis, and I don’t deserve that either." said Jack Benny(1894-1974) US actor when accepting an award.
In this physical life, wear and tear is the name of the game. We wear out anything where use involves friction. That means brake pads, toothbrushes, shoes, and tires. Unfortunately, our very own joints, especially the weight-bearing ones such as the hips and knees are subject to similar abrasive forces. In fact, osteoarthritis or degenerative arthritis is also known as the "wear and tear" disease. Anytime you’re through with the meat of that fried chicken, take a close look at the bone ends. You will see that it is smooth and white. That’s how joints should be. That’s how they are not in arthritis.
When diseased, the joint’s white part wears thin. That’s bound to hurt because then you’ll have bone rubbing bone each time you move. Joint diseases account for half of all chronic conditions of persons over 65 worldwide. Think about it. There will always be two or three aunts in the Christmas reunion with aching joints.
If no cause can be found, OA is primary. That’s just your doctor’s clever way of saying that you have arthritis but he doesn’t know where it came from! Sometimes a cause can be found. The usual suspects include infection, a bad accident involving the joint, or gout.
Will a person with osteoarthritis become a cripple overnight? By the way it is described medically – degenerative, there is a hint that it is a slow, insidious process. The cardinal symptom of OA is joint pain that can be described as constant, made worse by moving, but made tolerable by rest.
The patient with arthritis will complain "I feel as stiff as a corpse in the morning," or "My body feels like a diesel engine. It takes time to get it running."
Risk factors. Does it then mean that there is no escape from shot joints? A good answer to this demands the awareness of risk factors. As mentioned, major accident to the joints can lead to OA. Obesity will increase the chances of destroying the knees. Even if you are not sumo wrestler-heavy, remember that half your weight goes through one knee and the other half on the other. When the load is just too much, the joints go early. Age is the most powerful risk factor. Simply put, as age increases, so does the prevalence of OA. Women are twice as likely as men to be affected, making gender a related variable.
Prevention. Are there ways of avoiding osteoarthritis? Obviously, if there are underlying causes that are in themselves controllable, there is hope. Losing weight is one, avoiding contact sports as we get older is another. An exciting supplement in the market right now is glucosamine sulfate. By stopping the white part of the bone ends from wearing out, glucosamine prevents or delays OA. It is also used to relieve pain.
Diagnosis. When does your doctor (preferably a rheumatologist, a physiatrist or rehabilitation medicine doctor, or an orthopedic surgeon) say you have osteoarthritis? He will rely initially on physical findings and x-rays. Suspicions of other forms of arthritis will be confirmed by the specific lab exam result (for example, high uric acid in gouty arthritis).
Treatment. Your doctor will first try to lessen arthritic pain through tablets or capsules. Available drugs include acetaminophen and NSAIDs (non-steroidal anti-inflammatory drugs). Common NSAIDs are ibuprofen, mefenamic acid, piroxicam, diclofenac, and tenoxicam. These are effective but long term use may cause stomach bleeding. More recently, a new anti-arthritic drug rofecoxib (Vioxx) has been shown not to cause gastric irritation. Your doctor, having staged your osteoarthritis may instruct you to lose weight. He may also show exercises that strengthen muscles around the affected joint, prescribe a cane or walker to unload the arthritic joint, or even ask the physical therapist to apply heat.
Surgery. Burned out joints are very painful. The patient will be forced to move less and will want to stay at home and sit down. So there goes the golf and ballroom dancing. At this point, much of the joint’s protective white has worn out and raw bone is now raking through adjacent bone. To this problem, your doctor will now most likely recommend joint replacement. The old joint will be removed surgically and replaced with an artificial one made of metal and plastic. There are three goals in joint replacement: to relieve pain, to restore function, and to achieve stability. Because joint replacement is a major operation, you must know if these will be gained.
Osteoarthritis is one of those conditions that people do not die of but live with. It is for this reason that as a medical menace, its impact must be lessened and its consequences prevented. Life is movement. Stiffness and stasis lead to death.
Fact/Factoid. Drinking green tea, popularly known as Japanese tea, may be good for you. It contains an antioxidant compound 100 times more effective than Vitamin C and 25 times better than Vitamin E in preventing cell damage.
In this physical life, wear and tear is the name of the game. We wear out anything where use involves friction. That means brake pads, toothbrushes, shoes, and tires. Unfortunately, our very own joints, especially the weight-bearing ones such as the hips and knees are subject to similar abrasive forces. In fact, osteoarthritis or degenerative arthritis is also known as the "wear and tear" disease. Anytime you’re through with the meat of that fried chicken, take a close look at the bone ends. You will see that it is smooth and white. That’s how joints should be. That’s how they are not in arthritis.
When diseased, the joint’s white part wears thin. That’s bound to hurt because then you’ll have bone rubbing bone each time you move. Joint diseases account for half of all chronic conditions of persons over 65 worldwide. Think about it. There will always be two or three aunts in the Christmas reunion with aching joints.
If no cause can be found, OA is primary. That’s just your doctor’s clever way of saying that you have arthritis but he doesn’t know where it came from! Sometimes a cause can be found. The usual suspects include infection, a bad accident involving the joint, or gout.
Will a person with osteoarthritis become a cripple overnight? By the way it is described medically – degenerative, there is a hint that it is a slow, insidious process. The cardinal symptom of OA is joint pain that can be described as constant, made worse by moving, but made tolerable by rest.
The patient with arthritis will complain "I feel as stiff as a corpse in the morning," or "My body feels like a diesel engine. It takes time to get it running."
Risk factors. Does it then mean that there is no escape from shot joints? A good answer to this demands the awareness of risk factors. As mentioned, major accident to the joints can lead to OA. Obesity will increase the chances of destroying the knees. Even if you are not sumo wrestler-heavy, remember that half your weight goes through one knee and the other half on the other. When the load is just too much, the joints go early. Age is the most powerful risk factor. Simply put, as age increases, so does the prevalence of OA. Women are twice as likely as men to be affected, making gender a related variable.
Prevention. Are there ways of avoiding osteoarthritis? Obviously, if there are underlying causes that are in themselves controllable, there is hope. Losing weight is one, avoiding contact sports as we get older is another. An exciting supplement in the market right now is glucosamine sulfate. By stopping the white part of the bone ends from wearing out, glucosamine prevents or delays OA. It is also used to relieve pain.
Diagnosis. When does your doctor (preferably a rheumatologist, a physiatrist or rehabilitation medicine doctor, or an orthopedic surgeon) say you have osteoarthritis? He will rely initially on physical findings and x-rays. Suspicions of other forms of arthritis will be confirmed by the specific lab exam result (for example, high uric acid in gouty arthritis).
Treatment. Your doctor will first try to lessen arthritic pain through tablets or capsules. Available drugs include acetaminophen and NSAIDs (non-steroidal anti-inflammatory drugs). Common NSAIDs are ibuprofen, mefenamic acid, piroxicam, diclofenac, and tenoxicam. These are effective but long term use may cause stomach bleeding. More recently, a new anti-arthritic drug rofecoxib (Vioxx) has been shown not to cause gastric irritation. Your doctor, having staged your osteoarthritis may instruct you to lose weight. He may also show exercises that strengthen muscles around the affected joint, prescribe a cane or walker to unload the arthritic joint, or even ask the physical therapist to apply heat.
Surgery. Burned out joints are very painful. The patient will be forced to move less and will want to stay at home and sit down. So there goes the golf and ballroom dancing. At this point, much of the joint’s protective white has worn out and raw bone is now raking through adjacent bone. To this problem, your doctor will now most likely recommend joint replacement. The old joint will be removed surgically and replaced with an artificial one made of metal and plastic. There are three goals in joint replacement: to relieve pain, to restore function, and to achieve stability. Because joint replacement is a major operation, you must know if these will be gained.
Osteoarthritis is one of those conditions that people do not die of but live with. It is for this reason that as a medical menace, its impact must be lessened and its consequences prevented. Life is movement. Stiffness and stasis lead to death.
Fact/Factoid. Drinking green tea, popularly known as Japanese tea, may be good for you. It contains an antioxidant compound 100 times more effective than Vitamin C and 25 times better than Vitamin E in preventing cell damage.
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