Arthritis and activity
 By
Michael Gordon, MD, Milwaukee Orthopaedic Group, Ltd. Orthopedic
Surgery, Sports Medicine Fellowship
Arthritis does not discriminate by age. This equal opportunity
disease afflicts almost 40 million people a year in the U.S. Annually,
it leads to 315 million physician visits and 8 million hospital
admissions. Data published in 1992, estimated that the cost of treatment
for arthritis in the U.S. topped $149.4 billion. By 2020, it is
projected that 60 million Americans will feel its wrath.
With over 100 different types of arthritic conditions, osteoarthritis
has the highest rate of occurrence. This disease typically afflicts the
hands, feet, spine and large weight-bearing joints. The most common
location for osteoarthritis is the knee joint where it directly causes
the breakdown and loss of articular cartilage — the smooth gliding
surface on the end of the bones. Symptoms of osteoarthritis include
pain, stiffness, swelling and decreased range of motion that can
ultimately lead to limits in mobility and an increased risk for falling.
Arthritis doesn't have to put a stop to your activities. There are
multiple ways to treat arthritis in the active individual including
medications, bracing, physical therapy, injections and surgery.
Furthermore, the role of exercise cannot be understated as
weight-bearing activity helps to maintain bone density, joint mobility,
as well as muscle strength.
Medications include over-the-counter (OTC) options such as
acetaminophen, ibuprofen or naproxen, along with prescription drugs such
as Celebrex, Relafen and Mobic. While these medications will generally
address the symptoms of osteoarthritis, they will not affect the natural
history and progression of the disease. Nutritional supplements, such as
glucosamine sulfate and chondroitin sulfate, have shown promise in
international studies and are currently under extensive review here in
the U.S. In addition to being able to help to control the symptoms,
these supplements may be able to slow down the degradation of the
cartilage.
Bracing and shoe inserts are another non-invasive way to treat
osteoarthritis by helping to “unload” (i.e., support) the affected
portion of the knee. A simple knee sleeve can also help to keep the
joint warm and decrease the sense of stiffness.
Physical therapy can increase range of motion and improve the
strength of the surrounding muscles. Most importantly, therapists can
help to restore “joint sense” thereby improving stability and decreasing
the risk of falling.
Injection therapy includes corticosteroids (“cortisone”) and
viscosupplements. Cortisone is a potent anti-inflammatory that can
quickly quell an arthritic flare. Viscosupplements are like an oil
change for the knee; they work by decreasing the level of inflammation
within the knee.
The next and final option for patients is surgery. Depending on the
individual, surgery can be fantastically successful in helping return a
patient to their active lifestyle. Recently, there has been some
controversy over the appropriateness of arthroscopy in the arthritic
knee; however, it is generally accepted that a patient with a sense of
locking and catching or having “mechanical symptoms” will benefit from
an arthroscopic procedure. In the case of end-stage arthritis where pain
is persistent and activity has been dramatically limited, a total joint
replacement can dramatically improve an individual's quality of life.
The goal of physicians treating patients with osteoarthritis is to
help them maintain function and activity levels while reducing joint
pain and inflammation. I continually encourage my patients to remain
active and exercise regularly. The treatments listed above provide a
variety of options to meet this objective.
Dr. Michael Gordon, of the Milwaukee Orthopaedic Group, Ltd. is an
orthopedic surgeon with a fellowship in sports medicine. For questions,
you can reach Dr. Gordon at 414-276-6000.
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