Dealing with pain can be the hardest part of having arthritis or a related condition, but you can learn to manage it and its impact on your life. The first step is knowing which type of arthritis or condition you have, because that will help determine your treatment. Before learning different management techniques, however, it's important to understand some concepts about pain.
The Most Common Form of Arthritis
According to Johns Hopkins
Osteoarthritis (OA) is the most common form of arthritis and the most frequent cause of disability in the United States. This condition results from the gradual deterio¬ration of cartilage, the smooth elastic layer of connective tissue that encases the ends of bones, helping to absorb the shock of joint motion and permit fluid, easy movement. Over time, as the cartilage continues to break down, the smooth surface of the cartilage roughens, pieces of car¬tilage can break off and float in the joint space, and bony growths, or spurs, can develop at the edges of the bone -- changes that contribute to the stiffness and soreness typical of OA.
By age 40, about 90 percent of all people have x-ray evidence of OA in the weight-bear¬ing joints, such as the hips and knees. But most people don’t experience symptoms until later in life. It is estimated that more than 20 million Americans currently have symptoms of OA.
The progression of OA varies from person to person. For many people, the deterioration results in only moderate discomfort. In some people, however, a complete wearing down of the cartilage allows the two adjacent bones to rub against each other, which produces a great deal of pain, even at rest. While OA has no impact on life expectancy, severe involve¬ment of the hips, knees, and spinal column may greatly limit activity and diminish overall quality of life.
Currently, there is no cure for OA; treatment is aimed at relieving pain and improving joint mobility. In severe cases, the damaged joint may be removed and replaced with an artificial joint to restore mobility.
Causes of Osteoarthritis:
Primary osteoarthritis, the gradual breakdown of cartilage that occurs with age, is the most common type of OA. It is caused by cartilage damage due mostly to stress on the joint -- for example, from obesity. In fact, obesity raises the risk of all types of arthritis (but especially OA) by about 30 percent in both men and women, according to the Centers for Disease Control and Prevention. Genetic factors are also important.
Primary OA most commonly involves the joints of the hips, knees, spine, fingers, base of the thumb, and big toe. It can be present in just one of these joints or in all of them. Secondary osteoarthritis can affect any joint following trauma, chronic joint injury due to another type of arthritis (such as rheumatoid arthritis), or overuse of the joint. Although most body tissues can make repairs following an injury, cartilage repair is hampered by a limited blood supply and the lack of an effec¬tive mechanism for cartilage regrowth. Because trauma or overuse hastens the degeneration of cartilage, secondary OA can cause symptoms at a much younger age than primary OA.
Treatment Options for Osteoarthritis:
The rate of development and ultimate severity of OA are unpredictable. No treatment can stop or reverse its progression. But discomfort and incapacitation are not inevitable. In fact, research shows that the prognosis is generally good, especially among patients whose initial symptoms were mild or moderate, which is the case for most people with OA.
Goals of Treatment
The goals of OA treatment are to relieve pain and maintain as much normal joint function as possible. To accomplish these goals, physicians apply a combination of treatment approaches. The most common are the careful use of med¬ication for pain management; physical and occupational therapy to maintain flexibility and strengthen the muscles around the joint; and weight loss to lessen stress on the weight-bearing joints. In some cases, surgery may be beneficial. If possible, treatment should start with nondrug/nonsurgical options, although OA may worsen over time,
The information on these pages is not intended to substitute for the advice of a physician.