|
Living with Osteoarthritis Joint aches, pain and stiffness make everyday life trying for the more than 43 million Americans suffering from Arthritis.While the term Arthritis actually refers to more than 100 different diseases that cause joint pain and sufferring, by far the most common form is Osteoarthritis. Often known as a degenerative joint disease, osteoarthritis is caused by a breakdown of the joint's cartilage, the spongy cushion that separates the bones and helps to absorb the normal impacts of life. While any joint in the body be affected, this condition occurs most frequently in the hips, knees, fingers, neck and lower back. "For the vast majority of people, osteoarthritis occurs without previous injury," says Elliot Rosenstein, M.D., attending rheumatologist and Medical Director of the Arthritis and Rheumatic Disease Center at the Saint Barnabas Ambulatory Care Center. "It can cause a range of problems including pain, aches, joint tenderness, stiffness, limited motion and even distorted joint appearance. Symptoms may be sporadic, perhaps after particular activities, or the individual may experience pain all or most of the time." According to the National Council on Aging, several risk factors have been identified for the development of osteoarthritis. They are the following: age (usually beginning after age 45), being overweight, previous joint injury, muscle weakness and heredity (defective cartilage or flaws in joint fit). DIAGNOSIS AND LIFESTYLE MODIFICATION The first step for those in pain is to be properly diagnosed. At the Arthritis and Rheumatic Disease Center, attending rheumatologists perform physical evaluations to exclude other possible conditions and x-rays may or may not be necessary. If the patient is found to have osteoarthritis, Dr. Rosenstein first recommends several lifestyle measures to treat the condition:
PHARMACEUTICAL TREATMENT If, after adopting these lifestyle modifications, patients continue to feel pain, the next line of treatment is medication. For mild symptoms, Dr. Rosenstein has found that acetaminophen is often adequate for pain relief. In addition, patients can use cold therapy for treatment of swelling and heat therapy for relief of muscle spasms and stiffness, especially in the lower back. Topical creams and ointments, particularly those containing salicylates (aspirin-related compounds) and capsaicin, derived from hot peppers, can also address pain relief. If the pain persists, then anti-inflammatory medication may be prescribed. "The newer anti-inflammatory drugs are less toxic to the stomach than in the past, and are generally well tolerated," says the physician. Many patients also take a combination of over-the-counter herbal products or vitamin supplements. One that seems to "have some pain relieving properties and may slow the progress of the condition" is glucosamine sulfate, says Dr. Rosenstein. However, the physician cautions that many of the materials advertised as arthritis treatments by health food stores are often "untested and ineffective." A new medical treatment currently approved for osteoarthritis of the knees is injectible hyaluronates. This viscous fluid, which naturally occurs in cartilage, is injected into the knee joints by a physician and has a positive effect that can last up to six months. Hyaluronates may help to heal cartilage defects that occur in osteoarthritis. Some patients confuse these injectibles with other injectible treatments that use methotrexate or "gold injection." While these are common treatments for rheumatoid arthritis, an autoimmune disease, they are not appropriate or helpful for osteoarthritis. SURGICAL INTERVENTION Dr. Rosenstein refers patients to an orthopedic surgeon when their osteoarthritis has not been treated successfully and when the effect of the condition makes life unsatisfactory. Patients are also referred for surgery when the osteoarthritis impacts other structures in their body, such as a problem knee that now affects gait or aggravates an otherwise mild back condition. Surgery can range from cleaning the soft tissue and smoothing the cartilage to partial or total joint replacement. The use of surgery is more of a reflection of the duration and severity of the condition," says Dr. Rosenstein. In his practice, he has found that the percentage of people who end up needing surgery because of osteoarthritis is "a small minority." While osteoarthritis is not curable, it is a very treatable condition," relates Dr. Rosenstein. "Treatment generally controls the condition and helps the individual to maintain function for life." THE JOINT REPLACEMENT INSTITUTE The Joint Replacement Institute is comprehensive treatment unit specifically designed for the diagnosis, treatment and rehabilitation of joint disorders. The Institute's staff of expert physicians, anesthesiologists, nurses, physical therapists, case managers social service personnel is dedicated to reducing the pain and immobility associated with arthritis. Specialized care is offered for individuals with knee, hip and shoulder disorders, well as osteoarthritis. Services include total hip and knee replacement using minimally invasive surgical techniques. Free educational public seminars about hip and knee pain are also available. For information or an appointment, please call The Joint Replacement Institute at (973) 322-BONE. For information about the Arthritis and Rheumatic Disease Center, please call (973) 322-7400. For information about The Center for Health and Wellness, please call (973) 322-7444. [ top ] |
|
||||||||
