OUT OF JOINT

Arthritis is striking earlier these days. Most of those affected people are getting younger...

Written by L A Times,Washington Post | Published: March 14, 2009 12:18 am

Arthritis is striking earlier these days. Most of those affected people are getting younger,according to Dr Barry Waldman of OrthoMaryland and director of the Center for Joint Preservation and Replacement at the Rubin Institute for Advanced Orthopedics at Sinai Hospital in Baltimore.

“We don’t really know why,but we’re seeing an epidemic of patients with wearing out of joints in their 40s and even late 30s.” But the good news,Waldman says,is that diet and exercise are the best ways to treat the disease.

The disease and its prevention:

•What is arthritis?

The word means inflammation of the joint. This inflammation causes the cartilage in the joint to wear out. As it wears out,it causes four problems: pain,redness,swelling and deformity.

•Are all those symptoms usually present simultaneously?

No. They don’t have to be. And there are all kinds of arthritis. The one we’re most familiar with is osteoarthritis,the premature wearing out of the joints. There are other kinds caused by a number of diseases called inflammatory arthritis.

•Who are the people most susceptible to osteoarthritis?

Past trauma and family history can play a role. But the vast majority of people just get it,and we don’t know why.

•How is it diagnosed?

Generally by X-ray.

•What are the most common symptoms people experience?

Pain and swelling. The pain tends to be worse when they are sedentary. When they’re active,the joint hurts less.

•Why?

We don’t know,but cartilage tends to be healthier when it’s moving.

•When should someone seek treatment?

When the symptoms are interfering with things they want to do,whether it is walking or exercising.

•Are there other conditions people could have that would give the same symptoms?

It could be an injury,but generally there are not a lot of disorders you can confuse with arthritis.

•Does delaying treatment make the condition worse?

We encourage people to see a doctor as there are some kinds of arthritis that can be slowed down with medication.

•Some say weather makes their arthritis worse. Does research support that?

There have been a lot of studies done on arthritis and weather,and it seems that weather doesn’t make a difference in arthritis pain.

•What are the treatment options for those with osteoarthritis?

We always try things that aren’t surgery first. The best early treatment is exercise. Getting the muscles stronger around the joint will help. The next thing we try is acetaminophen,otherwise known as Tylenol. Then we move on to anti-inflammatory medicines like Motrin or Alleve. If that doesn’t work,there are medicines we can inject into the knee or shoulders. We can try anti-inflammatories like cortisone. We have one injectable medicine made of cartilage that can act as a cushioning agent.

•Do over-the-counter remedies such as glucosamine help?

There was recently a large study that the US National Institutes of Health did that found that glucosamine and chondroitin didn’t help improve arthritis; it was very ineffective. The American Academy of Orthopaedic Surgeons now recommends against taking it.

•What about arthroscopic surgery?

One of the complications of arthritis is that a big piece of cartilage can come loose inside the joint. Arthroscopic surgery can be very helpful in that case,but for most people,just washing out the joint with surgery won’t help.

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