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Living Well with Osteoarthritis

8/14/2014 Rich Maloof
© Jason Merritt-Getty Images: Photo © Microsoft Photo

You would never know it by his prowess on the basketball court, but NBA superstar Shaquille O'Neal suffered from osteoarthritis for over a decade. Interestingly, both the 7-foot-1-inch center and 5-foot-tall actor Danny DeVito, who has osteoarthritis in his knees, are at higher risk for this painful joint disease than other people because they are at the far ends of the height spectrum.

Osteoarthritis (OA) is caused by wear and tear on our joints, which can be more intense for very tall or very short people. It can be aggravated by activity -- like sports -- and cause swelling and deformity of affected joints. Shaq had successful surgery for the OA in his big toe in 2002, and as a result was able to keep tearing up the boards until his retirement in 2011.

What Is Osteoarthritis?

Arthritis is a catch-all term for joint inflammation. OA, which is also characterized as a degenerative joint disease, is the most common form of arthritis. It can occur anywhere in the body, but most commonly shows up in weight-bearing joints in the hips, knees, feet and spine.

OA is associated with a breakdown of joint cartilage, the cushiony layer of firm tissue that covers the ends of our bones and reduces friction between them. OA can cause cartilage to become stiff and lose its rubbery quality. Over time and with overuse, cartilage can wear down and lose its ability to act as a shock absorber.

Who Gets Osteoarthritis?

Osteoarthritis affects millions worldwide, including nearly 21 million Americans. The chance of developing the disease increases with age. Because OA is caused by cartilage wearing down over time, most people over age 60 have it to some degree, but even people in their 20s and 30s can get osteoarthritis. Women are generally at higher risk for OA than men.

In addition to extremes in height, weight can be a factor because carrying extra pounds puts pressure on joints. Other risk factors include a sedentary lifestyle, prior joint injuries from sports or accidents, congenital bone deformities and occupations that place repetitive stress on joints. Certain diseases, including diabetes, gout, hypothyroidism and Paget's disease can increase the risk of developing OA.

What Are the Symptoms?

OA tends to develop slowly and worsen over time. Signs and symptoms of osteoarthritis include:

  • Pain in the affected joint
  • Tenderness in response to light pressure
  • Stiffness, especially in the morning or after periods of inactivity
  • Loss of range of motion
  • A crunchy or grating sensation when the joint is used
  • Bone spurs -- bits of bone which may form around affected joints
How is Osteoarthritis Diagnosed?

If you have symptoms of OA, see your doctor, who will examine your affected joints for tenderness and swelling and will check your range of motion. Cartilage doesn't show on X-rays, but cartilage loss may be revealed by a narrowing of the space between the bones. Bone spurs can be spotted on an X-ray.

MRI tests are able to provide detailed images of bone as well as softer tissues like cartilage. Your doctor may order an MRI as well as certain blood tests to rule out other potential causes of joint pain such as rheumatoid arthritis, gout or an injury. A joint fluid analysis test may be performed if your doctor suspects gout or an infection.

Treatment

The most common over-the-counter drugs used to treat OA are familiar pain reducers such as acetaminophen (Tylenol), naproxen (Aleve), and ibuprofen (Advil, Motrin). Codeine-containing narcotics may be prescribed for more severe pain. Cortisone shots can reduce inflammation and pain, and lubrication injections such as hyaluronic acid can provide some cushioning around joints.

Physical therapy can help the strengthen muscles around painful joints, reducing pain and increasing mobility, while occupational therapy can help a patient manage daily tasks without increasing joint stress or discomfort. Additionally, shoe inserts, braces and other medical devices can help support joints and reduce pressure. Chronic pain classes are often recommended for teaching coping techniques and providing support.

When joint pain becomes severe enough to interfere with quality of life or with work, doctors may recommend joint replacement or other surgeries. Shaquille O'Neal had surgery to alleviate the pain from osteoarthritis in his stiff right toe. He also used anti-inflammatory medications and physical therapy. With help from his coaches, O'Neal changed his jumping technique and focused on building core strength and flexibility.

Joint replacement surgery is a last resort, but it can be very effective. Artificial hips and knees have become very sophisticated, and new surgical techniques have been developed to make the procedure less invasive.

Lifestyle Changes That Can Help
  • Exercise -- Although excessive exercise can damage joints, moderate exercise naturally lubricates joints and strengthens the muscles around them. If you have OA, stick to gentle, low-impact exercises like walking, biking, yoga, or swimming as advised by your doctor.
  • Lose Weight -- Lighten the load on your joints by maintaining a healthy body weight. Being just ten pounds overweight increases the stress on your knee joints by the equivalent of 30 to 60 pounds with each step you take.
  • Acupuncture -- Some studies suggest that this ancient art can relieve pain and improve joint function.
  • Glucosamine and chondroitin -- Some OA sufferers find relief from these supplements. Warning: Don't take glucosamine if you're allergic to shellfish, and talk to your doctor before trying either supplement, especially if you take blood-thinning medications.
  • Eat fish oils -- Fish oil is rich in omega-3 fatty acids, which have been shown to help reduce inflammation in the body. Add salmon, mackerel, and sardines to your diet, or try fish oil supplements.
Living Well With Osteoarthritis

If you have osteoarthritis, the first step to living well is to realize that there are many avenues available for managing the disease and the discomfort that comes with it. To some degree, OA sufferers choose how severely this disease will affect them.

Work with your doctor to develop a treatment plan. Studies show that people who take control of their treatment and actively manage their arthritis experience less pain and function better without sacrificing the fulfilling activities of daily life.

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