How to minimize arthritis risk and symptoms
March 4, 2020
Exercise regularly, eat right, don’t smoke, maintain a healthy weight. We all know the basics for living a healthy life. But what happens when despite those good habits, aches and pains develop and don’t go away?
For millions of active Americans with osteoarthritis (OA) — the most common type of arthritis, often blamed on wear and tear — joint pain, swelling and stiffness can become chronic conditions. These are most often felt in the knees, but also affect the hips, lower back, neck and larger joints in the feet and hands.
The good news? There are effective ways to both minimize your risk of OA and manage the pain and stiffness. Exercise and strength work are at the top of the list.
“The more active you are the better,” said University of Chicago Medicine orthopaedic surgeon Sara Shippee Wallace, MD, MPH, who specializes in joint care.
And while arthritis is more common as we get older, it’s not inevitable. “We think that there’s largely a genetic predisposition for osteoarthritis,” Wallace said. “There are components of wear and tear, but that’s not the driving force. It’s more the way your cartilage was designed.”
Arthritis is a group of symptoms that can include joint pain, swelling and stiffness. It’s caused by a loss of cartilage, which is the rubbery material covering the ends of bones. As that cushioning between the bones starts wearing away, joints begin to hurt. In the early stages, X-rays will show joint space narrowing, formation of cysts or both. Later, bone spur formations and changes in the bone around the joint are seen. In the final stage, there is no cartilage and the joint is bone on bone.
Can arthritis be prevented?
Not completely, but you can minimize your risk and control symptoms — to some degree — by maintaining a healthy weight and remaining active, Wallace said.
“Marathon runners have some of the thickest cartilage at the ends of their bones of anybody,” she said. “Weight-bearing force helps maintain joint health.” Strengthening muscles around the joints is also key to reducing pain and taking stress off joints.
What causes arthritis?
Besides genetics, other factors that can contribute to arthritis include major injuries at or around the joint. “Breaking a bone or a ligament injury will increase the risk of developing arthritis,” Wallace said.
Obesity also significantly increases the risk of developing arthritis. Less common causes include inflammatory conditions and osteonecrosis, which is the loss of blood supply to the bone.
How do you manage arthritis?
“Stay active, exercise, get physical therapy to strengthen the muscles around the joints and continue strengthening once therapy is completed,” Wallace said. Maintain a healthy weight. Even a 5- to 10-pound weight loss can have a tremendous impact on reducing joint pain.
Gentle stretching, yoga and tai chi may also improve flexibility and reduce stiffness and pain. Options for pain include acetaminophen or an anti-inflammatory pain reliever such as ibuprofren. If those don’t work, the next steps would be corticosteroid injections to reduce inflammation and pain. “Beyond that, you are looking at joint replacement,” Wallace said.
Brendon Ross, DO, MS, a UChicago Medicine specialist in non-operative orthopaedics and sports medicine, focuses on exercise, physical therapy and orthobiologics to increase joint mobility.
“The goal behind exercise is to strengthen the muscles around the joint — whether it’s the hip, knee or shoulder — to offload the burden of force that’s being transmitted to the joint,” he said. “Muscles are a very important component of stability and structure and can often slow the degenerative changes of arthritis.”
Ross also offers injection therapies in his clinic. In addition to corticosteroids, these therapies include viscosupplementation with hyaluronic acid — a naturally occurring substance in joint fluid — and platelet-rich plasma injections to increase joint mobility, reduce pain and promote faster healing.
It’s best to avoid high-impact exercise like running or repetitive jumping if it makes your joint pain worse, although those activities won’t necessarily worsen arthritis, Ross said.
“We recommend cycling, swimming or the elliptical trainer,” Wallace said. There isn’t enough evidence to support taking glucosamine supplements, and while turmeric and other natural anti-inflammatories have some promising data and are low risk, orthopedic experts don’t know for certain how helpful they are in treating arthritis, she said.
The bottom line is to keep moving.
“Exercise is medicine,” Wallace said. “And the more balanced and strong the muscles around the joint are, the better the joint health will be overall and the less pain you will experience.”
Sara Wallace, MD
Sara Wallace, MD, is an orthopaedic surgeon who specializes in joint care. Dr. Wallace treats a wide range of common and complex hip and knee conditions, performing surgical procedures to restore mobility and reduce joint pain.Learn more about Dr. Wallace
Brendon Ross, DO
Brendon Ross, DO, MS, specializes in non-operative orthopaedics, providing comprehensive primary care sports medicine for adult and adolescent patients. Dr. Ross is an expert in treating a wide range of orthopaedic conditions.Learn more about Dr. Ross
Aches and Pains with Dr. Aravind Athiviraham
In this episode, we speak with sports medicine doctor Aravind Athiviraham to chat about why knees click and pop, what happens when bumping your elbow radiates pain into the pinky finger, and more.