Are joint pain and stiffness keeping you from all the things you’d like to do? In this month’s blog, we present the basics of osteoarthritis (OA) and provide some self-care strategies for living with this very common chronic disease.
What is osteoarthritis?
Arthritis is a general term referring to more than one hundred joint pain or joint diseases. It is the leading cause of disability among U.S. adults and affects one in five (53 million) adults in the United States. By far the most common form of arthritis is osteoarthritis, affecting half (27 million) of all arthritis sufferers, followed by fibromyalgia (5 million), gout (3 million), and rheumatoid arthritis (1.5 million).1,2
OA is also called degenerative joint disease because it results from gradual wear and tear of cartilage and other parts of your joints. Thus, it’s more common in older adults. In younger adults, it’s more likely to result from overuse or injury. Children rarely are affected by osteoarthritis.
OA is characterized by painful, stiff or creaky joints and reduced motion in the hands and main weight-bearing joints (knees, hips and spine). Depending on the disease progression, it can produce anywhere from mild, occasional pain affecting the ability to do simple tasks, to severe pain and total disability.
Risk factors for OA
Although everyone will experience some level of joint wear and tear in their lifetime, the risk3 of developing OA is higher for people who:
- Are female. In every age group, women (26% overall) have a higher incidence of OA than men (19% overall).
- Are overweight or obese. Extra pounds mean extra stress on your joints, especially the knees. One out of four people who are overweight, and one out of three people who are obese, report having doctor-diagnosed OA.
- Have past injuries or surgeries. OA in younger people is more likely to be the result of “secondary” factors such as prior joint injury, surgery, or metabolic disorders affecting the cartilage, ligaments or tendons.
How OA develops
Each of your joints has five main components: bones, tendons, ligaments, cartilage, and synovial fluid.
- Tendons are fibrous connective tissues that attach muscles to bones.
- Ligaments are fibrous connective tissues that attach bones to other bones.
- Cartilage is a firm yet flexible tissue that covers the ends of the bones within the joint.
- Synovial fluid is a clear, thick fluid that acts as a natural lubricant.
In a healthy joint, cartilage and synovial fluid enable your bones to glide smoothly over each other during movement. Over time, the surface layer of cartilage can break down and wear away. When this happens minor pain can occur as the breakdown of cartilage causes the tendons and ligaments to stretch. More severe pain will occur in places where cartilage has worn away completely or if bits of cartilage or bone become lodged within the joint cavity.
Self-care therapies for minor pain
(NOTE: Be sure to let your Graybill Provider know if you’re considering engaging in any self-care strategy for your OA, including the ones shown below.)
Heat and cold. Heat from warm towels, hot packs, light massage, or a warm bath or shower, can relieve pain and stiffness by increasing blood flow. Cold packs (bags of ice or frozen vegetables wrapped in a towel–NEVER apply ice directly to the skin) can alleviate inflammation by numbing the sore area.
Exercise and physical activity. Exercising may seem counterintuitive, especially if movement is causing you pain. However, people who regularly engage in physical activity are less likely to suffer from OA, and research shows that exercise is actually one of the best therapies for OA. According to one study of older adults with knee OA, engaging in moderate physical activity at least three times a week reduced the risk of arthritis-related disability by nearly half.4
- Low impact aerobic exercises like walking, swimming or bicycling will help provide relief from OA through increased flexibility in your tendons and ligaments, strengthening of the muscles around your joints, improved blood flow, weight loss, and improved overall health and mental outlook.
- Light weight training can strengthen muscles, thereby relieving pressure off your joints.
Yoga and tai chi. While yoga and tai chi have ancient origins, there’s ample modern day scientific evidence to suggest that these gentle forms of exercise may be helpful in addressing joint pain and stiffness.
- Yoga generally involves positioning the body in various poses along with coordinated breathing and meditation exercises. A randomized control trial of older women (mean age 72 years) with knee OA concluded that “a weekly [Hatha] yoga exercise program with home practice was feasible, acceptable, and safe for older women with knee OA, and showed therapeutic benefits.”5
- Tai chi is a low impact, slow motion exercise that has been shown to improve muscle strength, flexibility, balance and aerobic conditioning. A systemic review of controlled clinical trials found encouraging evidence that tai chi may be effective for pain control in patients with knee OA.6
Weight management. Carrying extra weight places undue stress on the knees and hips. In one study, the loss of as little as eleven pounds reduced the risk of developing knee arthritis in women by half. Work with your Graybill Provider to determine your optimal weight, then work towards that goal by adopting a healthy diet and regular, moderate exercise.
Anti-inflammatory drugs. Several prescription and over-the-counter drugs are available for treating mild to moderate arthritis pain. The most common of these are known as non-steroidal anti-inflammatory drugs, or NSAIDs. NSAIDs work by reducing the production of pain-causing chemicals called prostaglandins. However, prostaglandins also have beneficial roles (they protect the lining of your stomach and intestines, promote blood clotting, and support normal kidney function), and overuse of NSAIDs can cause in serious side effects. For this reason, long-term use of NSAIDs is not recommended. As well, be sure to consult with your Graybill Provider before taking NSAIDs if you have certain conditions such as an ulcer, heartburn, high blood pressure, or heart, kidney or liver disease.
Supplements. Evidence suggests that glucosamine, a natural compound that supports the formation of cartilage, and the herbal supplements turmeric, boswellia and ginger can provide effective pain relief without the side effects of NSAIDs. Be aware that effectiveness of these supplements has not been firmly established by large-scale research. Always tell your Graybill Provider about all supplements and medications you are taking, and be sure to obtain any supplements from a credible, quality manufacturer.
Acupuncture. Acupuncture is a practice in which fine needles are inserted into the skin at specific points, called meridians, by a licensed healthcare professional. It is believed acupuncture relieves pain by stimulating the release of natural, pain-relieving chemicals called beta-endorphins. A meta analysis of 29 random controlled trials with a total of 17,922 patients concluded that acupuncture is effective for four chronic pain conditions including back and neck pain, osteoarthritis, chronic headache, and shoulder pain and therefore a reasonable referral option.7
Surgery. If all other options have been explored and you still have no relief, your Graybill Provider may refer you to a specialist called an orthopedic surgeon, or orthopedist. He/she can determine whether you’re a candidate for surgery and which surgical option might work best for you, based on your disease progression, age, activity level, overall health, and ability to take time off for recovery, among other factors.
- Brault MW, Hootman J, Helmick CG, Theis KA, Armour BS. Prevalence and most common causes of disability among adults, United States, 2005. Morb Mortal Wkly Rep. 2009;58(16):421-426.
- Barbour KE, Helmick CG, Theis KA, Murphy LB, Hootman JM, Brady TJ, et al. Prevalence of Doctor-Diagnosed Arthritis and Arthritis-Attributable Activity Limitation – United States, 2010-2012. Morb Mortal Wkly Rep. 2013;62(44):869-873.
- Felson DT, Zhang Y. An update on the epidemiology of knee and hip osteoarthritis with a view to prevention. Arthritis Rheum. 1998;41(8):1343-1355.
- Penninx BW, Messier SP, Rejeski WJ, et al. Physical exercise and the prevention of disability in activities of daily living in older persons with osteoarthritis. Arch Intern Med. 2001;161(19):2309-2316.
- Cheung C, Wyman JF, Resnick B, Savik K. Yoga for managing knee osteoarthritis in older women: a pilot randomized controlled trial. BMC Complement Altern Med. 2014 May 19;14:160
- Lee MS, Pittler MH, Ernst E. Tai chi for osteoarthritis: a systematic review. Clin Rheumatol. 2008 Feb;27(2):211-218.
- Vickers AJ, Cronin, MS, Maschino AC, et al. Acupuncture for chronic pain. Individual patient data meta-analysis. Arch Intern Med. 2012;172(19):1444-1453.