Points on Joints: Arthritis

Arthritis is the general medical term for any type of inflammation in a joint. Most individuals who suffer from arthritis pain have osteoarthritis (degenerative arthritis or degenerative joint disease, DJD). This type of arthritis presumably develops over time due to wear and tear on the joint. Joints most commonly affected are those that receive the most use, i.e., the hands, knees, spine and hips.  

In every joint, bones come together to form an area for movement. Since the bones are touching and moving on each other, cartilage over the end of each bone helps to protect it. In addition, within the joint space, fluid is produced to act as a lubricant. In DJD, there may be break down of the cartilage and underlying bone, as well as diminished fluid production. Most arthritis will cause the joint space lining to produce inflammatory cells in an attempt to heal the area. Inflammation leads to pain, swelling, and sometimes redness and heat.

There are many different causes for chronic joint pain and inflammation.  Most are less common than osteoarthritis, the wear and tear type.  Other causes include infections, gout, and inherited arthritis conditions such as rheumatoid arthritis. Many times a past injury to a joint (broken bone) can lead to progressive degeneration of the joint and eventual arthritis. Old sports injuries can wreak havoc in a joint, sometimes decades later.

The severity of degenerative arthritis can range from mild occasional discomfort to debilitating pain that completely interferes with daily function. Unfortunately, there is no cure for degenerative arthritis short of surgically replacing the joint. However, many remedies are available for relief of some of the symptoms, such as pain and inflammation.

Daily exercise is recommended for osteoarthritis and many other types of arthritis. Exercise helps to preserve the normal range of motion of the joint, keeping it from becoming permanently inflexible. Additionally, keeping strong muscles around the joint will aid in joint function and stability. Exercise also stimulates circulation.
Some individuals with severe arthritis may find that common exercises, like walking, produce too much pain due to the weight bearing. In these circumstances, exercises that minimize weight bearing, such as water aerobics or stationary bicycling, may be more appropriate.

Heat tends to loosen stiff joints, stimulate circulation and diminish pain in arthritic joints.  Heating pads, warm soaks, or topical heat rubs may all be beneficial in some individuals.

There are many medications used to treat the pain and inflammation associated with arthritis. Over-the-counter medicines such as acetaminophen (Tylenol), aspirin, naproxen, and ibuprofen are all effective in certain individuals for mild to moderate arthritis. Prescription strengths of these and many other anti-inflammatory drugs are available for more severe pain. Supplements such as glucosamine and chondroitin have been shown to be effective in some folks as well. More severe cases of osteoarthritis may temporarily benefit from medicines injected directly into the joint, such as cortisone.

Always check with your doctor before using any medicines to treat your arthritis, as some may interfere with other diseases or medications. It’s also a good idea to get specific recommendations on exercise from your regular physician.

Dr. Reynolds practices Family Medicine on Krause Road in Chesterfield; 425-7771.

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