Arthritis: What is it and what can you do about it?

By Dr Andrew Brooks

More than 21 million Americans have arthritis. It is one of the most common reasons people seek medical care and advice. As baby boomers continue to age, we expect to see more patients who have the debilitating effects of arthritis.
But, what exactly is arthritis and what can people do to treat it?
Arthritis is quite simply the loss of the smooth cushion or cartilage lining our joints. There are two forms; the most common is osteoarthritis. This is classically referred to as “wear and tear” arthritis. It usually develops in adulthood and can be the result of a prior major injury or multiple minor injuries. This form of arthritis has a genetic component as well and can be passed on from generation to generation.
Many of my patients will have had a parent who struggled with arthritis as well. There is no blood test available to diagnose this form of arthritis. The diagnosis is made by your doctor after taking a history, performing an exam and reviewing X-rays.
There is a blood test to diagnose the second most common type of arthritis, called inflammatory or rheumatoid arthritis. It can strike in childhood or adulthood. It can be crippling and affect many different joints in the same patient.
Regardless of the type of arthritis, the result is loss or damage to the cartilage, which leaves the surface of our joints (most commonly affecting hands, knees, spine and hips) rough and irregular – similar to a street badly in need of resurfacing. Weight-bearing activities can put additional stress across these damaged surfaces, leading to pain, stiffness, swelling and deformity.
Treatment depends on the severity of the disease.
For mild arthritis with mild limitations, physicians recommend low-impact exercises such as biking, yoga, swimming or water aerobics along with occasional acetaminophen (Tylenol) and possibly ibuprofen (Motrin, Advil) or naproxen (Aleve). Occasionally, topical creams such as Ben Gay, Icy Hot or Capsaicin may be helpful.
For moderate arthritis, all of the aforementioned treatments may be used, plus physical therapy and prescription-strength arthritis medication. If unsuccessful, injections may be considered.
Some patients try acupuncture or chiropractic treatments. Weight loss can be important in overweight patients as this may alleviate some of the damaging forces across the joint, resulting not only in less pain but slower progression of the disease.
For severe arthritis, once other treatments have failed, it may be time to consider surgery such as joint replacement with metal and plastic implants. These are common and highly successful procedures, and recent innovations have made this a popular option for many people. But there are risks.
There are approximately 7 million Americans walking around with artificial hips and/or knees. You do not know if this is a reasonable option unless you have met with an orthopedic surgeon who has examined you and reviewed your X-rays.
Patients often ask me if stem cell injections or other procedures to grow new cartilage are available. At this time these procedures are considered experimental and there is limited scientific evidence to support their use. Insurance will not pay for these, but a lot of research is being done in this field and one day they may be a reasonable option.
If you have painful, swollen and stiff joints, consult a physician for an evaluation. Your physician should be able to direct you to appropriate treatment options for your level and type of arthritis.

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