Arthritis For Dummies. Barry Fox
osteoarthritis: various types of trauma to the joints or an autoimmune arthritis (like RA or gout). That includes sudden, high-velocity trauma (the kind you’d experience in a car accident), as well as little insults to your joints that occur time and again, like repeated poor posture or running on a concrete surface every day for years. The causes of secondary osteoarthritis can be further broken down as follows:
Joint injury: Weekend warriors beware! Once a joint has been injured, be it through a sports mishap, car accident, household slippage, or anything else, it is much more likely to develop osteoarthritis.
Repetitive motion injury: Joints that are stressed over and over again in the same way (for example, a ballerina’s ankles, a football player’s knees, or a data processor’s wrists) are more likely to experience a cartilage breakdown than joints subjected to normal use.
Damage to the bone end: Usually due to trauma or continual stress, a bone may chip or sustain small fractures. In the body’s zeal to repair the damage, it may cause an overgrowth of bone in the injured area. The result is a bone end that’s bumpy, not smooth, and joint problems can ensue.
Bone disease: A bone disease, such as Paget’s disease, weakens the bone structure, making it more likely to fracture and develop bony overgrowth.
Carrying too much body weight: The heavier you are, the more stress your knees, hips, and ankles must bear. Osteoarthritis of the knee has been clearly linked to excess body weight. That’s not surprising considering that every time you take a step the stress on your knee is roughly equivalent to three times your body weight. Increase that figure to ten times your body weight when you run!
Regarding the repair problem
To make matters worse, once your cartilage is damaged, your body can compound the problem if it repairs itself in certain ways. Like injured bone, injured cartilage can overdo the repair process, piling too much new cartilage into a crack or tear. The result is a lumpy, bumpy surface that doesn’t glide smoothly against the cartilage on the opposing bone end. On the other hand, sometimes the cartilage doesn’t repair itself at all, and remains in its damaged state — cracked, pitted, frayed, and even worn-through. Pieces of loose cartilage and/or bone may break off and float freely through the joint fluid. The bone ends, no longer well cushioned, start to rub against each other and can develop bony spurs (osteophytes) that further interfere with smooth joint movement. The joint space narrows, and the entire shape of the joint can change. All this from a little damaged cartilage!
Recognizing Risk Factors for Osteoarthritis
Although osteoarthritis affects more than 30 million Americans, not everybody suffers from it. Some people actually sail into their golden years with joints unaffected by pain, stiffness, or other symptoms, while others are hobbling around by the time they’re 35. So how come one person gets osteoarthritis while another gets away scot-free? And how can you tell if you happen to be particularly susceptible to it?
Your chances of developing osteoarthritis are increased if:
You’re past age 45: Cartilage and other joint structures, like most bodily tissues, tend to degrade and become weaker over time. After decades of use, they start to wear out. Luckily, research has shown that osteoarthritis isn’t inevitable as we age. The odds just go up.
You’ve had a joint injury: If you’ve been in a car accident, have played rough-and-tumble sports, or have injured any of your joints in any way, you are more likely to develop osteoarthritis in the joints that were affected by those activities.
Your joints have been repeatedly stressed: Ballet dancers, assembly line workers, baseball pitchers, grocery checkers, and anyone else who overuses and stresses a joint or joints can suffer from cartilage breakdown in those joints.
You’re a woman: Women are three times more likely than men to develop osteoarthritis. This may be due to smaller joint structures or some link to estrogen; nothing has yet been proven.
Your parents had it: There appears to be a genetic component to osteoarthritis; in fact, one study concluded that genes were responsible for 50 percent of hip osteoarthritis cases. Osteoarthritis in the hands is also believed to be at least partially due to genetics. An inherited tendency toward defective cartilage or poorly structured joints can certainly put you on the road to osteoarthritis, although you won’t necessarily develop it.
You’re overweight: Excess weight puts a great deal of strain on the weight-bearing joints — the hips, knees, and ankles. For every ten pounds of excess weight you carry, you increase the force exerted on these joints anywhere from four to ten times, depending upon the type of activity. Researchers have found a definite link between being overweight and osteoarthritis, especially involving the knee joints.
Determining Whether It Really Is Osteoarthritis
Nearly 50 percent of those suffering from osteoarthritis don’t know what kind of arthritis they have and therefore can’t make good decisions about their treatment.
Say your knee hurts. The first time that you visit your doctor complaining of the pain, they put you through the standard round of interviews, examinations, and tests. They review your medical history and makes a detailed list of the injuries you have sustained, especially to your knees. They may palpate your knee to see if it’s painful to the touch, carefully bend your knee and straighten it several times (it may hurt a little and seem stiff), and listen for cracking or popping in the joint. If your arthritis appears to be inflammatory, your doctor may send you to the lab to get some blood drawn to rule out other forms of the disease. At this point, all your doctor has to go on is a history of knee injuries, some pain and stiffness upon movement, and a little cracking in the joint. Your symptoms may sound like osteoarthritis, but may not yet be a sure thing.
The next step would be to order an X-ray of your knee to see if one or more of the following signs are present:
Cartilage degradation
Cartilage overgrowth
Narrowing of the joint space
Bone spurs
Bits of cartilage or bone floating in the joint fluid
Joint deformity
Treating Osteoarthritis
After a diagnosis of osteoarthritis is confirmed, you and your doctor can begin to devise a treatment program — confident that you’re headed in the right direction. Although the symptoms may not disappear completely, you still have a good chance that, with proper treatment, your pain will diminish significantly and joint degradation can be kept to a minimum. (Check out “Keeping OA at bay: Mark’s Story” at the end of the chapter to see how a 35-year-old man successfully took charge of his arthritis.)
A good treatment plan for osteoarthritis should include the following elements to help you manage pain and discomfort on a daily basis.
Muting the pain with