There are several types of arthritis. Osteoarthritis is the most common type and it generally develops as we age. It is thought that this condition is caused by “wear and tear” on a joint, but this has not been established. The cartilage which normally cushions the joint, may wear away, so that the two bones involved rub together. Many older people have symptoms of arthritis, most commonly in the spine, hips, knees, or hands.
Pain is the usual symptom. The pain is intensified by moving the joint or putting stress on the joint. The area may be stiff, especially in the morning. There may be limitation of movement. There may be bone spurs — small lumps of bone growing near the edge of the joint. Bone spurs are visible in arthritis of the hands. The joints at the ends of the fingers are swollen and tender. Other types of arthritis, such as rheumatoid arthritis, cause different abnormalities of the hands.
Risk factors for osteoarthritis include being overweight, previous injury, and family history of arthritis. It is more common in women than men. Diagnosis is generally made by an orthopedist, who examines the area around the joint for swelling or tenderness. The doctor may suspect osteoarthritis. X-ray will show the loss of cartilage (cartilage does not show up on x-ray, so the two bone ends are close together.) Other causes of arthritis include rheumatoid arthritis, gout, and infection. These causes need to be ruled out. An MRI may be used to look at cartilage and muscle or to identify other problems.
Medical treatment begins with acetaminophen or NSAIDs, such as ibuprofen. Your doctor may suggest other medications.
Along with medications, you should consider losing weight. Even if your weight is only slightly elevated, that puts stress on the affected joints. Many overweight people who succeed in losing as little as 20 pounds feel less joint pain and also decrease their risk of heart disease, stroke, and diabetes.
It is surprising that exercise can help the pain, even though it may hurt to move. Ask your doctor to refer you to a physical or occupational therapist for guidance with exercises that you can do on your own. Walking is always healthy. Gradually increase the length of your daily walk and you will find it easier to lose weight and you may have pain relief.
Joint replacement is a surgical procedure that generally relieves pain. Most of us want to avoid surgery, so other approaches should be tried first.
Joint replacement is valuable for osteoarthritis of the hip and knee, but not useful for the spine.
Back pain can best be treated with weight loss (if overweight) and gradual increasing exercise. Yoga or Tai Chi may be helpful. Seeing a chiropractor may be helpful.
Older people with arthritis should try other health-related changes. Prevent falls by getting rid of clutter and putting railings on all stairs, inside and out. Explore the use of a cane, or even a walker, to make it easier to move about. The more you can move, the better you are able to remain independent and participate in activities with your relatives and friends.