Ache happens: What you should know about osteoarthritis
Osteoarthritis is something many people experience. It can start as a twinge of pain when you bend down to grab something off the floor or maybe a stiffness in your knee when you first wake up in the morning, but what exactly causes this type of arthritis? What can you do to prevent it? How can you treat it? We asked Dr. Paul Paily, associate professor in the H. Ben Taub Department of Physical Medicine and Rehabilitation, about osteoarthritis and what patients should know.
Question: What causes arthritis?
Answer: Primary osteoarthritis is the cumulative degradation of both the protective cartilage cushioning at the end of your bones as well as the degradation of the chemical environment of the joint that occurs with aging and with use of the joint, along with an interplay of genetic, inflammatory and even possibly environmental factors. Genetically mediated factors may protect against or promote this process.
This is different from secondary osteoarthritis, which is a similar process but often is caused by trauma/injury or infection.
Q. What are some typical symptoms?
A. Typical symptoms of primary osteoarthritis include pain, stiffness, palpable crepitus (the cracking and creaking sound in the joint), swelling around the joint, mild warmth around the joint and even range of motion limitations, which could be caused by the pain, but also could happen due to loss of mechanical space in the joint.
Q. How do you know when you need to see a doctor?
A. You should see the doctor when the symptoms persist and become intrusive to your daily function. For some patients, it may be even earlier than that.
If you have symptoms that are not mentioned above and not typical of primary osteoarthritis, such as fever, chills, redness around the joint or pain that is disproportionate to any injury, you should seek medical advice from your physician immediately.
Q. Does arthritis affect certain joints (like knees, elbows, shoulders) or can it be found other places?
A. Primary osteoarthritis can affect any joint, but most commonly affects the hips, knees, shoulders and hands.
Q. What are treatment options?
A. Treatment options for primary osteoarthritis include acetaminophen and oral anti-inflammatory medications. Topical creams are also commonly used. Physical therapy can improve joint range of motion and mobility and help stretch the surrounding muscles and tendons. Interventional options include injections with steroids or hyaluronic acid (FDA-approved only for the knees in the United States) and platelet-rich plasma injections, which are part of a regenerative strategy. More often than not, a multifaceted approach, including a combination of these strategies, will provide a more robust treatment effect than one strategy alone.
Some patients, if they fail conservative, non-surgical measures, may need surgical intervention like a total joint replacement.
Q. Can it ever be cured?
A. At this stage of our science, primary osteoarthritis does not have a cure. Still, the above treatment strategies can be used to reduce symptoms and improve the patient’s quality of life.
Q. Is it true that weather changes (heat/cold/rain) can make arthritis more painful?
A. Some patients have reported that changes in weather toward more moist and rainy environments or colder environments can increase their symptom experience. However, the science is still inconclusive about the exact relationship.
Q. What are some common misconceptions about arthritis?
A. One of the most common misconceptions about primary osteoarthritis is that everyone will develop this condition eventually. However, for a variety of reasons, we know this is not the case. Some patients well into their 70s and 80s show no radiographic or clinical evidence of primary osteoarthritis. Another misconception is that impact exercises will always worsen arthritis, but this is not true. Exercise can actually help alleviate osteoarthritis.
Learn more about Baylor Medicine Physical Medicine and Rehabilitation.
By Anna Kiappes
