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Ways to treat and prevent progression of osteoarthritis: Part 3 of 3

Antonio Adiletta, MD3

Antonio Adiletta, MD3

Ways to Treat and Prevent Progression of Osteoarthritis: Part 3 of 3

Special Feature “ Health & Exercise Forum” with Geisinger Commonwealth School of Medicine the 3rd Monday of every month!

Guest Columnist: Antonio Adiletta, MD3

Antonio Adiletta, MD3 is a third year medical student at Geisinger Commonwealth School of Medicine from Lancaster, PA. During his first two years, he served as President of his class and helped create a General Surgery Interest Group. He is currently interested in Orthopedic Surgery.

Two weeks ago, in Health & Exercise Forum, Antonio Adilettta, MD3, GCSOM presented Osteoarthritis Part I and discussed the most common causes and areas of the body affected by osteoarthritis. Last week in part two, he discussed 3 of the 5 most effective methods of prevention and treatment and this week, part three we will present the last two of the most effective methods.

You may not realize, but osteoarthritis (OA) is more common than you think, affecting people like President George. W. Bush and First Lady Barbara Bush, who got hip replacements at age 76 and 72, respectively. Moreover, the Piano Man, Billy Joel had double hip replacements at age 61 and joked afterward saying, “I got a double hip replacement, and now I’m twice as hip as I used to be.”

Osteoarthritis, also known as degenerative joint disease and wear and tear arthritis, is the most common type of arthritis affecting approximately 27 million Americans. Osteo refers to bone, while arth comes from the Greek word arthron, which means articulation, or joint. Finally, itis, a commonly used medical term, refers to inflammation. OA is caused by damage to the cartilage, the rubber-like padding that protects the ends of bones at the joints.

As previously discussed, prevention and management of OA includes exercise, weight loss and protection of your joints. However, it is also important to manage your occupational risks and, in some cases, consider medications and surgical procedures.

Manage Occupational Risks

Certain jobs may predispose you to the development of OA. This includes jobs that require repetitive motion like kneeling, lifting, twisting, or walking every day. It has been shown that there is an increased risk of OA of the knee, hip, and fingers in workers who carry heavy loads as part of their daily job. Some common jobs include construction working or lumbar working. Lifting heavy objects improperly and without the correct assistance can lead to joint damage. Osteoarthritis can develop over years, slowly day by day, if constant damage is being done to your joints.

There are ways this day to day joint damage can be prevented. It’s recommended that you attempt to rotate different work jobs to prevent the repetitive insult to your joints. If possible take breaks when you feel like you are injuring your joints, use assistive devices, or ask for help. In summary, it is important to practice safe ways of working to prevent the repetitive damage that occurs. Here’s a short list of things you can do.

  • Learn how to lift correctly
  • Talk to your doctor about stabilizing joint braces
  • Rotate work assignments to prevent aggravation of existing injuries
  • Be familiar with good practices of postures and actions at work. Shifting position often, and using devices such as dollies to do the lifting and moving of goods can all help with arthritis prevention.
  • It is important to combat excess weight and abdominal obesity.
  • Some professions offer assistive lifting devices that should be used to prevent injury. Health care workers should use rolling gurneys, wheelchairs, and ask for help when trying to lift or transport a patient.

Medications and Procedures

There are a variety of anti-inflammatory medications that can be prescribed by your doctor to help with joint pain. Talk with your doctor about the use of acetaminophen, NSAIDs, COX-2 inhibitors and other analgesics that can help relieve your joint pain. Tell your doctor if you’ve ever had GI upset or have kidney or liver problems before taking these medications. Another option is glucocorticoid (steroid) injections. This injection is most beneficial to OA patients with one or a few joints that continue to cause pain despite oral medication therapy. With proper injection technique and medication intervals, side effects are minimal. Tell your doctor if you have diabetes before getting a steroid injection as it can raise your blood sugar.

Surgery is considered in patients who continue to have debilitating pain despite treatments with nonpharmacological and pharmacological therapies. In many cases, surgery is considered a last resort when the patient cannot tolerate the joint pain any longer and all other treatment modalities have been exhausted. All patients are different and have unique injuries and circumstances, so it’s important to talk with your doctor about what kind of treatment is best for your situation and goals in life. Partial and total joint replacements are surgical options to repair a damaged joint. Patients who undergo surgery often experience substantial improvements in pain and physical ability. According to the literature patients usually experience maximal improvement in the first 3 to 6 months after surgery. Talk with your doctor about your goals and concerns in finding the appropriate surgical treatment that best fits your wishes.

Medical Contributor: John Doherty, MD, Geisinger Orthopedics, Scranton, PA

Read Dr. Mackarey’s Health & Exercise Forum – every Monday. This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.