Caring For Aching Joints And Osteoarthritis

Do you have aching joints? Do your knees or hips hurt constantly? If so, you could have osteoarthritis, the most common type of arthritis.

Found in nearly 33 million Americans — most over age 45 — osteoarthritis, or OA, is described as “wear and tear” on your joints. It’s caused by the breakdown of cartilage between the bones of the joints and tendons, as well as the ligaments around the joints. The culprit can be routine daily activities or sudden injuries.

Osteoarthritis, or OA, typically affects your knees and hips, but it may impact your hands, lower back and neck. Severe osteoarthritis can make daily tasks, including walking and standing straight, difficult.

“When you can't do the daily activities of life that make you happy and allow you to enjoy your life, whether that's your retirement years, just doing your job, or playing with your kids, whatever it is, I think that's the risk,” said Nikhil Pandhi, DO, orthopedic surgeon at Franciscan Physician Network Orthopedics & Podiatry Munster in northwest Indiana. “And that's really has a overall detrimental toll on your health when you can't be active.”

Key Takeaways: Osteoarthritis

• Persistent knee, hip or hand pain may be a sign of osteoarthritis.
• Regular low-impact exercise can help reduce pain and stiffness in your joints.
• Losing even a modest amount of weight can ease joint stress.
• Physical therapy, medications and joint replacement can all play a role in treatment.
• See a provider if joint pain is limiting your daily activities.

Why Do My Joints Hurt?

“Osteoarthritis is the most common cause of arthritis and affects many millions of adults in the United States,” said Sandeep Bhave, MD, a radiation oncologist who chooses to practice at Franciscan Health. “It occurs when the articular cartilage, which is the smooth protective tissue that covers the ends of the bones in a joint, gradually breaks down over time. As the condition progresses, changes happen in the underlying bone, including development of spurs and cysts. This leads to joint pain, stiffness, swelling, difficulty moving, and making activities of daily living more challenging.”

OA is different from rheumatoid arthritis, a common autoimmune disorder that causes inflammation and swelling in the lining around your joints (called the synovium).

What Causes Osteoarthritis And Who Is At Risk?

Nearly everyone has some risk of developing osteoarthritis, said James Hartson, MD, DPM, FAAOS, a Michigan City orthopedic surgeon with Franciscan Physician Network Coolspring Health Center.

“The lifetime risk of developing osteoarthritis is fairly high in men and women,” he said.

Factors that can put you at higher risk of OA include:

• Getting older: Your likelihood of osteoarthritis increases with age.
• Family history: Arthritis runs in families. If your parents or siblings have osteoarthritis, your risk is higher.
• Sex: Before age 45, osteoarthritis is more common in men. Women are more affected after age 45.
• Obesity: Being overweight adds pressure to your joints, mainly your knees, hips and spine.
• Previous joint injury: Prior joint injuries, typically from sports, increase your risk for osteoarthritis in those joints.
• Joint deformity: Joint misalignments, such as bowlegs, make osteoarthritis more likely.

What Can I Do If I Think I Have Osteoarthritis?

• Stay active with low-impact exercise
• Maintain a healthy weight
• Avoid smoking

Don’t expect major changes overnight, however, said Gina Saylor, NP, with Franciscan Physician Network Rheumatology & Osteoporosis Specialists in Indianapolis. Symptom improvement takes time.

“I always stress the importance of leading an active lifestyle, exercise, eating right and sleeping well,” she said.

Schedule an evaluation with your primary care doctor or an orthopedic or rheumatology specialist if your symptoms limit daily activities

How Can I Reduce Osteoarthritis Pain?

You can reduce the pain from your aching joints. People living with osteoarthritis have several strategies for reducing pain and inflammation.

Set small, realistic goals. Incorporate healthy habits, such as quitting smoking, individually rather than taking on multiple changes simultaneously.

Regular activity

Staying active is one of the best things you can do to slow osteoarthritis, Dr. Hartson said.

“Activity is one of the great components of treatment, especially for the hips and knees — joints that are meant to move,” he said.

If you have osteoarthritis, low-impact exercises that keep your joints comfortable are best:

• Walking: This exercise improves your balance and flexibility.
• Swimming/water exercises: These activities are easier on your joints.
• Cycling: Raising the bike seat for better leg extension is more comfortable for your joints.
• Elliptical machine: This machine mimics the treadmill but puts less strain on your joints.

If needed, a physical therapist can prescribe therapeutic exercises based on your strengths and limitations.

Exercise also contributes to another tactic for reducing your pain and stiffness and for slowing osteoarthritis — maintaining a healthy weight.

Weight loss

“It’s not uncommon for patients preparing for joint replacement surgery to find that losing as little as 20 pounds reduces their symptoms of pain and swelling, enough so that they feel comfortable delaying surgery for a few more years,” Dr. Hartson said.

Stop smoking

Smoking adds to inflammation in your body, among other negative health effects. Researchers at Clemson University have reported a link between smoking and accelerated osteoarthritis progression.

What Osteoarthritis Treatments Are Available?

Sometimes aching joints stop you from being active. If so, don’t lose hope. Several treatment options for osteoarthritis exist, including medication, injections, therapy and surgery.

Medications for osteoarthritis

As a first step, your doctor may suggest medication for arthritis pain, such as:

• Pain-relieving medications (analgesics): These medications, including acetaminophen (Tylenol), tramadol (Ultram), and narcotics that contain oxycodone or hydrocodone, can reduce joint pain but not inflammation.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): These medications, which are available over the counter as ibuprofen (Advil, Motrin) or naproxen sodium (Aleve), can reduce both pain and inflammation.
• Counterirritants: Rubbing a cream that contains menthol or capsaicin, the spicy component in hot peppers, onto your aching joints may disrupt pain signals, providing some relief.
• Corticosteroids: These drugs, including prednisone, are typically delivered via injection. They reduce inflammation in and around joints.

Non-medication options for osteoarthritis management

You also have non-medication options for your osteoarthritis. Knee braces may reduce pressure on your knees, increasing support and stability. Physical therapy also can improve your range of motion and strengthen the muscles around your joints.

“People are very familiar with things such as physical therapy to strengthen the muscles,” Dr. Pandhi said. “That's always a good first start. There are activity modifications.”

Low-dose radiation for osteoarthritis is a new treatment option at Franciscan Health.

“At low doses used for musculoskeletal conditions, radiation acts less like cancer treatment and more like a powerful anti-inflammatory therapy,” Dr. Bhave said. “It helps calm inflammation by reducing the amount of inflammatory white blood cells that enter the joint. Low-dose radiation also decreases the release of inflammatory signals called cytokines and helps eliminate activated inflammatory cells. This results in less inflammation, which causes reduced pain and hopefully improved mobility.”

Surgery for most advanced cases

Eventually, osteoporosis will wear away your remaining cartilage, and your joints will grind “bone-on-bone.” Your bones may become deformed, or you could develop bone spurs. If so, your doctor may recommend surgery or joint replacement, an operation that replaces your knee or hip joint with an artificial one. Based on your X-rays, your doctor will decide if you’re a good candidate.

“Joint replacement is an excellent option, and it’s life-changing for many patients who have limited mobility and pain,” Saylor said. “But it’s a final step in treating osteoarthritis, and that’s why it’s important for patients to actively seek treatment for the disease as early as possible.”

When Should I See A Doctor For Joint Pain?

See an orthopedic specialist or rheumatology provider if:

• Your joint pain interferes with walking, sleeping or daily activities.
• You notice swelling, stiffness, redness or reduced range of motion.
• Over-the-counter treatments are no longer helping.

Can You Cure Osteoarthritis?

You may be able to slow down your osteoarthritis progression, but there is no cure for OA.

Frequently Asked Questions: Osteoarthritis And Joint Pain

Does having osteoarthritis mean my joints will hurt?

Some adults have osteoarthritis without any pain, Dr. Pandhi said.

What kinds of injections might I be offered for joint pain?           

Depending on the source of your pain, amount of joint space and your medical history, your doctor may offer platelet-rich plasma injections, cortisone injections or viscosupplementation injections (gel injections) as part of your treatment plan.

If I have arthritis, how can I protect my joints?

Dr. Pandhi recommends steps to protect your joints:

• Maintaining bone strength. Talk to your doctor about whether supplements like Vitamin D, vitamin K2 and magnesium, would be appropriate to support bone density.
• Keeping weight within a reasonable body mass index. Staying at a healthier weight reduces pressure on load-bearing joints
• Protecting muscle mass by eating enough protein. Dr. Pandhi recommends discussing protein needs with your doctor if you have kidney issues or other medical concerns that impact how much protein you eat.
• Keeping your abs, hip abductors, quadriceps and hamstrings strong. “You don't need to have a fancy gym, but that keeps your knee strong, and that helps keep the health of the joint intact,” Dr. Pandhi said. “Even if one day you need a knee replacement, you still need that lever of the quadriceps and your extensors and your extensor mechanism of your leg to do well when you have a knee replacement.”