Arthritis is not just a single disease. It is a term used to describe more than 100 different conditions that affect the joints in the body. The word arthritis actually means inflammation of a joint. Almost every animal that can walk is susceptible to this inflammation.
Although many types of arthritis have some common aspects, each type has its own pattern of symptoms and affects different people in different ways.
Two major forms of arthritis are rheumatoid arthritis and osteoarthritis. In cases of rheumatoid arthritis, the body’s immune system appears to go awry and attacks healthy parts of the body, particularly the joints. In severe rheumatoid arthritis, the joints become deformed and internal organs are adversely affected.
What is osteoarthritis?
Osteoarthritis, the most common form of arthritis, is also called degenerative joint disease or “wear and tear” arthritis. Almost everyone is affected by it to some extent as they grow older. It most frequently occurs in weight-bearing joints, mainly knees, hips and ankles.
This form of arthritis slowly and gradually breaks down the cartilage that covers the ends of each bone in a joint. Normally, cartilage acts as a shock absorber, providing a smooth surface between the bones. But with osteoarthritis, the smooth surface becomes rough and pitted. In advanced stages, it may wear away completely. Without their normal gliding surfaces, the bones grind against one another, causing inflammation, pain and restricted movement. Bone spurs may form.
In osteoarthritis of the knee, the shape of the bone and appearance of the leg may change over the years. Many people become bow-legged or knock-kneed. In osteoarthritis of the hip, the affected leg may appear shorter.
What are the symptoms of osteoarthritis?
The number-one symptom of osteoarthritis is pain. Irritation and pressure on nerve endings, as well as muscle tension and fatigue, cause the pain. The pain can progress from mild soreness and aching with movement to severe pain, even when resting.
The second symptom is loss of easy movement, such as bending or rising normally. Morning stiffness is a problem for many people. This lack of mobility, in turn, often causes the muscles serving the knee or hip to weaken, and overall body coordination suffers.
How is osteoarthritis diagnosed?
A simple weight-bearing X-ray and examination by a skilled orthopedic physician will determine if you have osteoarthritis. Time consuming and costly diagnostic procedures are not required.
How is osteoarthritis treated?
There is no cure for arthritis, but there are ways to manage the pain, lack of mobility and fatigue that are among the most disabling symptoms.
Hyaluronate: This treatment lubricates the knees and can reduce pain for 9–12 months. Three to five injections are given into the knee, one week apart.
Medicines: Coated aspirin helps relieve pain and has few side effects. Nonsteroidal, anti- inflammatory drugs, (NSAIDS), such as Voltaren, Feldene, Naprosyn and Clinoril, are prescription drugs for pain and inflammation. Cox2 NSAIDS have a lower risk of stomach ulceration and may be prescribed by your doctor. Do not take aspirin if you are taking NSAIDS.
Cortisone shots: Cortisone shots are given for inflammation. For many people, joint arthritis is often made symptom-free for months or even years after cortisone shots. Two to three shots a year can be given without any side effects.
Ice treatments: Ice packs on the knee (three times daily, 1–20 minutes at a time) are helpful for inflammation and temporary relief of pain and soreness. Heat applications in either the knee or hip make the joint feel less stiff.
Diet: There is no evidence that any specific foods will prevent or relieve arthritis symptoms. It’s important to keep excess weight off, however, because it aggravates arthritis by putting added pressure on the knee.
Exercise and rest: Prolonged rest and days of inactivity will increase stiffness and make it harder to move around. At the same time, excessive or improper exercise can overwork your arthritic joint and cause further damage. A balanced routine of rest and exercise is best. Exercise in a swimming pool can be very helpful.
Arthroscopy: Arthroscopic procedures may be helpful for arthritis. In some cases, a “flap” of torn knee cartilage can aggravate arthritis and cause additional pain. The cartilage flap can be removed by arthroscopy.
Knee or hip Replacement: Knee or hip replacement is a very effective solution to the pain and disability of advanced osteoarthritis. The rough, worn surfaces of the joint are relined with smooth-surfaced metal and plastic components, thereby resurfacing the joint.
Is Joint Replacement Surgery Right for You?
“I wish I had done it sooner.”
This sentiment is expressed over and over again by people who have undergone hip- or knee-replacement surgery. Joint replacement is often indicated as a “last resort,” but that doesn’t mean you need to suffer needlessly. Ask yourself the following questions:
Does the pain in your hip or knee make it difficult for you to sleep at night?
Have you tried medications to ease the pain but they are no longer helping?
Is the pain from your arthritis affecting your ability to do the things you enjoy?
Do you have a hard time keeping up with friends or family at the mall, at the theater, or on outings?
Are you doing less of the things you enjoy because of your arthritis pain?
Does the pain make it difficult to enjoy time with your grandchildren?
Is it difficult to get out of a chair, go up stairs, get off the toilet or pick something up from the floor?
If you answered “yes” to any of these questions, then your next step should be to arrange for a consultation with one of our experienced orthopedic surgeons. This is your opportunity to learn more about surgical options to relieve your pain and get you back to the life you want to live. You won’t be pressured to opt for surgery. Instead, you will be given a personal evaluation and the advice of an experienced doctor that will empower you to make an informed decision. Your surgeon may recommend non-surgical options as well, such as medically supervised weight management or physical therapy.
Questions to Ask Your Doctor
Print out these questions and bring them with you when you meet with an orthopedic surgeon:
Am I a good candidate for joint replacement surgery?
What makes a good candidate? What alternatives to surgery should I consider?
How effective might they be?
How will surgery help my particular problem?
What are the risks involved? How likely are they?
What can I expect if I delay or choose not to have surgery?
What types of physical activity would I be able to engage in after the surgery?
How long is the recovery process? What is involved in the recovery process?
Will more surgery be necessary? If so, when? Can you give me the name of someone else who has undergone this surgery who would be willing to discuss it with me? Are you board-certified?
How many times have you performed this operation?