As spring approaches and we emerge from winter hibernation, there’s a good chance some new aches and pains will also pop up along with the return to more activities. According to the Centers for Disease Control and Prevention, arthritis affects about one in four adults, with more than half of them in the working years ages of 18 to 64. With such a far-reaching impact, we interviewed two of our orthopedic surgeons to hear their perspectives and answers to some common questions about arthritis.
Q: There are actually several kinds of arthritis. What are the most common types you see and treat?
Dr. Jason Glynn: By far the most common type of arthritis that we see is the very typical osteoarthritis, which is the arthritis that comes from aging and use and abuse of your joints. Very similar to putting miles on a car and eventually needing a new set of tires, the more miles you put on, and the higher stress those miles are, the quicker your joints tend to wear out.
Dr. Chris Rott:The osteoarthritis Dr. Glynn mentioned is considered degenerative arthritis. The other main category or type would be inflammatory arthritis. This includes things like rheumatoid arthritis or psoriatic arthritis. Those are a lot less common and quite different from osteoarthritis.
Q: Are there other causes of osteoarthritis besides “wear and tear” such as genetics?
Rott: Well, there may be a small genetic component. We certainly hear of plenty of people whose grandma had arthritis and their mom had arthritis and now they have arthritis. But generally, the biggest thing that causes arthritis is wear and tear, like Dr. Glynn had mentioned. It usually affects people who are later in life, people with sports injuries or other types of injuries to the joint, or people who have carried extra weight for many years. These are the factors that most commonly lead to the breakdown of your joints and cause osteoarthritis.
Q: How is arthritis diagnosed?
Glynn: Typically, the first and easiest step is simple x-rays. This shows us the space in-between the bones, which essentially makes up the cartilage. The lack of cartilage is what gives you typical osteoarthritis. So when we see narrowing of the space that used to be there, it’s a good diagnostic tool. If it isn’t obvious with an x-ray, we can move on to further imaging tests, oftentimes MRIs, or sometimes CT scans. It depends a little bit on the joint, and it depends a little bit on the person, their age, and their injury history. Knowing this background helps to determine what the next best step is if plain x-rays don’t tell us what we’re looking for.
Rott: Also, while imaging tests are typically the diagnostic path for degenerative arthritis, it’s different for inflammatory arthritis. In those cases, there are blood tests and other lab testing that’s involved.
Q: What do typical treatment options look like and how do you explore those with patients?
Rott: Usually, treatment for arthritis starts conservatively with simple things like trying to modify your activities and to decrease the load on your joint. Exercise can really be quite helpful, and weight loss can also go a long way toward improving symptoms. Heat and ice can also help. There are also anti-inflammatory medicines like Tylenol, ibuprofen, or Aleve that can help. From there we start getting into a bit more invasive options like cortisone injections and ultimately oftentimes total joint replacement for certain advanced stages of arthritis.
Q: Is there any risk to ignoring or bearing with your arthritis and not addressing it?
Rott: As a general rule, you’re just going to have more pain and more disability. There are certain times where people have let their arthritis go so far that they’ve now caused severe deformities of their joint. This is rare, but it can definitely make things more complicated. A bigger risk would be your loss of function and activity which can then lead to other medical problems. We know that being active and eating right can have an effect on diabetes, cholesterol and blood pressure and other health issues. Indirectly, the results of limited mobility and loss of activity is probably the biggest risk to not having your arthritis treated.
Q: Will exercising make arthritis worse, or cause further damage to affected bones and joints?
Glynn: The problem with arthritis is that with the loss of cartilage you lose some shock absorption for your daily activities. However, with the help of personal trainers or physical therapists, there are ways to safely exercise a troublesome joint to regain some strength and mobility. It’s not a cure for arthritis but it can certainly make the symptoms a lot less bothersome, allow you to be more active and maintain as much of your activity as you can, despite the fact that you do have arthritis. The benefits of exercising and moving safely through arthritic discomfort generally outweigh the risk of further harm. Maintaining your flexibility and maintaining or improving your strength puts you in a better place to be able to deal with it and certainly outweighs the possible downside of worsening the arthritis.
Rott: There are actually some good studies that have shown that people with more moderate arthritis actually feel better if they can go out for a 20 or 30 minute walk most days of the week. It does hurt a little bit more when you get started, but after a sustained 20 or 30 minute walk or swim or a bike ride, symptoms can actually improve. Like Dr. Glynn said, the high-impact activities are problematic, but simply going for a walk around the block with your dog or your significant other can actually make your arthritis hurt a little bit less.
Also, if ultimately you need to have a surgery for your arthritis, having strong muscles and good flexibility makes you heal much faster after surgery.
Q: Can diet impact either the worsening or the improvement of arthritis symptoms?
Glynn: I think it certainly can and it works in a couple of ways. There are types of foods that tend to be more inflammatory to our systems and foods that have been shown to have an anti-inflammatory effect. But the other thing is simply the amount of food you consume. If you’re carrying around 10 or 20 or 50 extra pounds, think about going out to the local grocery store or fleet farm and picking up a 50 pound bag of something and carrying it around all day. You feel dramatically better when you set that down and take that pressure off those joints.
Q: Is there anything that a person can do to prevent or at least delay the onset arthritis?
Rott: Like we said before, the biggest thing you can do is keep your weight down. The other things that can cause arthritis are injuries to your joint, but those are kind of hard to prevent. I certainly wouldn’t suggest avoiding participation in sports because we know that sports are good for you.
Glynn: There are sports that are higher risk for injuries to bones and joints and sports that are less risky. But even within those sports that are higher risk, there are a lot of interesting studies on injury prevention programs. They call them pre-hab or pre-rehab programs that can, according to those studies, make a person dramatically less likely to sustain injury on the soccer field, on the football field, or on the basketball court. Injury prevention can lead to lesser chances of arthritis as the result of that injury further down the road.
Q: What is your best advice for someone who’s suffering from some joint they suspect may be arthritis and is starting to interfere with their daily activities?
Rott: First I would say try to get a little more active, if you can, and see if you might feel some better. I think the next thing is come and talk to an orthopedic specialist like Dr. Glynn or myself. We will tell you what we can do to help you, from the least invasive to the most invasive and where you fall on that continuum. We have a great team of physical therapists and athletic trainers and physicians and advanced practice providers here who will walk you through your options and answer your questions.
Glynn: I agree. Each person will have a very individualized treatment plan and what’s good for one person isn’t necessarily good for another. What makes sense for you is not always what makes sense for your neighbor. Just don’t let arthritis pain keep you from living your fullest life. That’s really why we’re here, to help enrich your life through health.