“Pain is inevitable; misery is optional.” Whether you attribute that quote to the Buddha or the Dali Lama, it is apt advice for the aging process and the pain of osteoarthritis.
Growing older with grace requires adapting to our body as it changes. Much of the aging process is beyond our control, but we can often delay the onset or at least ease the pain of osteoarthritis.
It just requires lifestyle changes, says Victor Hugo Hernandez, M.D., M.S., an orthopaedic surgeon and director of the adult reconstruction and joint replacement division at the University of Miami Health System.
“Osteoarthritis is a mechanical process caused when cartilage in the joints wears down over time,” says Dr. Hernandez.
In contrast, arthritis is an inflammatory condition. It usually results from an underlying autoimmune disease such as rheumatoid arthritis, infections, or a genetic or metabolic abnormality that progressively damages the structure of the joint.
When osteoarthritis causes joint pain, Dr. Hernandez guides his patients to solutions that help alleviate discomfort and increase flexibility.
“Exercise is the number one recommendation to relieve pain from the American Academy of Orthopaedic Surgeons,” says Dr. Hernandez. “It decreases pressure on the joints and strengthens the supporting muscles surrounding the joint.” Physical activity also increases circulation, reduces swelling, and lubricates the joint by pumping more synovial fluid over the cartilage. “This fluid acts like oil or a lubricating substance between the joints.”
Before you leap into action, choose your workout carefully. “Walking, bicycling, swimming, water therapy, and strength training with weights are good options. Avoid putting pressure on your joints by doing activities that involve repetitive jumping or high impact sports.” Tai chi, bouncing on a miniature trampoline, and swimming are beneficial to lessen pain, lubricate joints, and improve mobility.
Some exercises, like stair climbing and running on an incline, can cause more pain if you have arthritic knees. “It creates too much friction on the joints,” Dr. Hernandez says. Whichever activity you choose, start gradually, building strength as you go to prevent further damage.
A mini-trampoline is a worthy investment, says Dr. Hernandez. Low-impact bouncing on a mini-tramp restores some of the synovial fluid in your joints. Older individuals should use a trampoline with a grab bar for balance.
Take the pressure off your joints
That’s a polite way of saying being overweight aggravates osteoarthritis. “The loss of space between joints damages cartilage and creates bone-on-bone wear. The more weight there is on the joint, the more pain you experience. Besides exercise, weight loss is the most optimal way to relieve pain,” Dr. Hernandez says. If you’re not sure how much weight you need to lose, ask your doctor to evaluate your Body Mass Index (BMI) measurement or body fat percentage.
You are what you eat (and drink)
Any discussion of weight loss opens the door to a conversation about diet. As much as possible, eliminate foods that cause inflammation since it makes osteoarthritis worse and leads to other health problems. “Avoid sugar, alcohol, red meat, highly processed foods, and high-fat foods. Eat a diet rich in anti-inflammatory foods such as walnuts, soy, flaxseed, chia seed, vegetables, and certain fruits,” Dr. Hernandez says.
He also recommends ginger tea and turmeric for their anti-inflammatory qualities. “Turmeric contains curcumin, a natural, plant-based chemical that decreases inflammation.” If you don’t care for the taste of turmeric, take turmeric supplements.
Try a home remedy
Your achy joints will appreciate a gentle start to your day. “Apply warm compresses to the arthritic joint at the beginning of the day, followed by arnica gel. (Arnica is an over-the-counter homeopathic remedy sold in most drug stores.) Add some turmeric to your breakfast, or take capsules, and sip a glass of water with one to two tablespoons of raw, unfiltered apple cider vinegar,” says Dr. Hernandez. Lastly, warm up your joints with some stretches before you work out.
At night, Dr. Hernandez says you should sip on ginger tea, repeat your turmeric routine, and apply ice to stiff or painful joints. Night is also an excellent time to take an over-the-counter anti-inflammatory medication such as aspirin or ibuprofen.
We’ve all heard that sitting is the new smoking
Sitting certainly doesn’t help an arthritic hip. “Don’t remain too long in the same position; it decreases the amount of fluid in your joint. Stand up from your desk at least every two hours, walk around the office or house, stretch or do simple exercises,” Dr. Hernandez says. If you have hip problems, avoid sitting at a position below a 90-degree angle.
Persistent pain? See a doctor
If your ability to perform daily tasks is still limited after trying these suggestions, consult an orthopaedist. “Start by losing weight, exercising, and improving your diet. If you still feel pain, ask your doctor about physical therapy to strengthen your muscles and improve cartilage health.
Injections may be helpful if the pain persists, or if you have moderate or advanced osteoarthritis,” Dr. Hernandez says.
The most common ones are:
- Cortisone injections, used for acute pain, may be given up to a maximum of three times a year because of their side effects.
- Hyaluronic acid, or viscosupplementation injections, ease moderate knee arthritis and relieve pain for up to six months to a year. Results vary, depending on the amount of osteoarthritis you have in your knees.
- Platelet-rich plasma (PRP) or stem cell injections produce questionable results, and the relief they provide is still unknown. Because of the lack of available research, these injections are not normally covered by insurance.
When these methods stop working, your doctor may recommend a more invasive approach that includes radiofrequency ablation, especially if you’re not a candidate for joint replacement surgery. “This nerve block procedure burns the nerves that cause pain into the joint and can relieve part of the pain for up to a year,” Dr. Hernandez says.
Orthopaedists once told patients to wait as long as possible – usually around age 65 or 70 – before having joint replacement surgery.
Don't wait too long
“Research now shows that if you wait too long – until you need a cane, walker, or wheelchair – your muscles atrophy and do not recover as well as a patient that did not wait that long. Nowadays, better materials and shorter recovery periods allow us to perform these surgeries in younger patients with excellent results. With today’s technology, there are multiple joint replacement options, so people don’t have to allow osteoarthritis pain to interfere with their daily activities.”
If you’re concerned about osteoarthritis, schedule a consultation with joint replacement doctors by calling 305-243-3000.
Nancy Moreland is a regular contributor to UMiami Health News. She has written for several major health care systems and the CDC. Her writing also appears in the Chicago Tribune and U.S. News & World Report.
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