Introduction
Osteoarthritis is the most common form of arthritis in the United States. Affecting roughly 12 percent of Americans between the ages of 25-74, osteoarthritis is an often painful and debilitating condition. The good news for patients is that there are osteoarthritis treatment options available that can reduce their symptoms and improve quality-of-life. This podcast – featuring Dr. Elinor Mody, Director of the Women’s Orthopedic and Joint Disease Center at Brigham and Women’s Hospital – will answer commonly asked questions about osteoarthritis.
What is osteoarthritis?
Osteoarthritis is the most common form of arthritis. The joints in the body are composed of bone, which are covered with a smooth layer of cartilage. Over time, the cartilage can get worn away. In some cases, this wearing away is so severe that the joints lose range-of-motion and cause pain. This condition is known as osteoarthritis. Weight-bearing joints – such as the hips and knees – are most vulnerable.
What exactly is the difference between osteoporosis and osteoarthritis?
Osteoporosis means bone thinning. This thinning can result in brittle bones that are more prone to breaks. We all reach our peak bone mass around age 35 and from that time our bones start getting thinner. Osteoarthritis, more common in women, is the wearing down of the cartilage in the joint. The body responds by developing new bone, not necessarily in the correct position. This new bone may make some joints appear larger and misshapen. The bony growth and the loss of cartilage can make the space between the bones smaller leading to the bones rubbing against one another and interfering with the joint's normal function.
Could you tell us about the risk factors for osteoarthritis?
Age, sex, and genetics are all factors that are thought to play a role in the development of osteoarthritis. Other risk factors for osteoarthritis include prior injury to the joint, deformity in the joint, obesity, muscle weakness and modifiable factors such as nutrition and possibly hormones.
What is the impact of osteoarthritis?
The symptoms of osteoarthritis are generally limited to the joint involved. Patients usually experience pain when they use the joint and the symptoms go away with rest. Patients may have some stiffness, when they first use a joint. If the arthritis is severe, patients may lose functional capacity in the joint that has osteoarthritis. For example, in severe osteoarthritis of the knee, a patient may experience such intense pain that they avoid walking or going up and down stairs. The pain can impact mobility and quality-of-life.
Dr. Mody, who treats osteoarthritis?
Osteoarthritis care begins with the primary care physician who can evaluate joint health. Rheumatologists, physiatrists, orthopedic surgeons and physical therapists provide treatment based on the symptoms and how far the osteoarthritis has progressed.
Tell us about what the health care provider looks for during a physical exam?
The joint can have bony enlargement and bumpiness. Patients with osteoarthritis of the hands can get knobs on their joints. There is usually minimal swelling of the involved joint. The joints can have decreased range-of-motion. Often the health care provider will order X-rays of the joint that can show a decrease in the cartilage space, new bone formation and incorrect alignment.
How is osteoarthritis treated?
There are many types of osteoarthritis treatments, often divided into two major groups – non-surgical and surgical.
What are non-surgical treatment options?
Non-surgical therapies include medications such as acetaminophen, non-steroidal anti-inflammatory drugs, and other pain medications. Additional non-surgical options are nutritional supplementation, physical therapy, occupational therapy, exercise, and weight loss.
And surgical treatment options?
There are several different types of surgical interventions. With arthroscopy, the surgeon makes a small incision in the skin and places a small tube through which he or she can examine a joint and perform procedures such as scraping cartilage or bone and repairing ligaments. In an osteotomy the surgeon removes part of the bone in a joint to realign the joint as a temporary treatment for osteoarthritis. In arthroplasty, a more permanent solution, the surgeon removes part of the bone and replaces the joint with a man-made joint.
What can I do to prevent osteoarthritis?
Maintaining a healthy lifestyle is the most important factor for preventing osteoarthritis. Maintaining a healthy weight from early adulthood on is important. Exercising regularly to maintain muscle tone helps protect the joints.
Are there complementary or alternative therapies for osteoarthritis?
Although there is little evidence to support the benefit of chiropractic manipulation, acupuncture and herbal remedies for osteoarthritis, they may provide pain relief for an affected joint. It is important to communicate your use of complementary therapies to your health care provider to insure that these treatments do not interfere with your other medical conditions or therapies.
What services are available at Brigham and Women’s Hospital?
The Women’s Orthopedic and Joint Disease Center, a program of the Orthopedic and Arthritis Center at Brigham and Women’s Hospital, focuses on specialized care for women – especially older women – diagnosed with joint pain and osteoarthritis. The center provides a comprehensive approach to linking patients with the resources they need.
For more information on the Women’s Orthopedic and Joint Disease Center, to make an appointment, or to learn more about the services and locations of the Brigham and Women's Hospital Orthopedics and Arthritis Center, call 1-800-bwh-9999 or visit us at www.brighamandwomens.org.
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