Controlling the Progression of Osteoarthritis
Osteoarthritis is the most common form of arthritis, and one of the leading causes of pain and disability in America. About 27 million Americans struggle with OA, but some of those people may not even know they have the progressive joint disease. In fact, the stiffness, inflammation and pain of OA only tends to show up once you’re passed the early stages of the disease.
Although you may not be able to eradicate your OA, there’s plenty you can do to control – and perhaps slow down – the symptoms and progression of osteoarthritis. The right treatment will depend on the stage of your OA, and what joints it affects, so understanding how the illness progresses is important for a targeted plan of attack.
How Osteoarthritis Moves Through the Body
OA can start off mild, with intermittent stiffness and pain in the joints. However, it is a progressive disease, which means that once the joints have begun to degenerate, the process will likely continue slowly and steadily. The pain and stiffness stem from a few main processes:
- Cartilage disintegration. The main aspect of OA is the thinning of the cartilage that caps the ends of bones. As the cartilage wears down, there is less protection for the bones.
- Deficient cartilage repair. Although cartilage is not easily rebuilt, many medical experts believe a healthy body is able to heal and rejuvenate damaged cartilage.
- Synovial inflammation. Synovial fluid is a thick liquid in the joints that eases friction between the bones for easier movement. In OA, this liquid becomes inflamed, causing pain and swelling.
Physical degeneration begins in the joints often before symptoms show up, but the pain and discomfort tend to move in a predictable pattern.
Early stage: You probably won’t notice when the cartilage in your joints begins to thin out, since cartilage has no nerves. But as the layer of cartilage continues to wear down, the friction that comes with joint movement will start to bother the bones underneath. You might feel tender points when you press down on your affected joints.
Moderate stage: In this stage of OA, pain tends to worsen as the day goes on, and it may lead to sudden weakness – the feeling of a knee or ankle giving out on you. At this point, cartilage has worn down quite a bit and the ends of the bones begin to thicken, leading to protruding, tender bumps known as bone spurs. The less active you are, the more pronounced your muscle weakness will be, and the more likely you will need to start taking medication to control the pain and inflammation.
Late stage: At this point, most of your synovial fluid has been lost, and other inflammatory fluids could start to crowd and inflame the joint. As bone rubs on bone, more swelling, pain, and stiffness results, and you’ll need to take more measures to control the discomfort. Some patients can increase or adjust their pain medication, but others may need to have surgery to replace the joint.
Slowing Symptom Progression of Osteoarthritis
Unfortunately, many newly diagnosed OA patients see their illness as a force beyond their control, something that will eventually take away their independence and mobility. But while OA is a progressive disease, you are in charge of how that progression takes place: the more actions you take to counter the joint damage, the better you can control and limit the scope of your OA. Luckily, there are several proven methods to strengthen your natural defenses, and compensate for the physical restrictions of OA.
Physical Therapy and Exercise
Physically moving and stretching your joints is one of the best ways to keep your OA in check. The idea is to strengthen the muscles around your joint to better stabilize the joint, and improve your range of motion so you can move more easily. Couple your physical therapy with occupational therapy to find clever ways around problematic or painful tasks, and you can drastically reduce the amount of stress you put on your joints.
Exercise may seem like the last thing to do for sore joints, but it works in all sorts of ways. From helping you to achieve and maintain a healthy weight to improving stability and support (which will help prevent injury and muscle imbalance).
It should come as no surprise that a healthy diet can go far to quelling your OA pain and stiffness. Vegetables and fruits should make up the majority of your meals, but be sure to include whole grains and fatty fish for omega-3 fatty acids, too.
Two categories of nutrients, known as chondroproductive nutrients, may stimulate certain cells to naturally heal cartilage. One group is glycosaminoglycans (GAGs), which are available in supplement form, and the other is antioxidants – which are readily derived from a healthy diet. Look for dark fruits like blueberries, cherries and grapes, and include lots of dark green and bright orange veggies to get more antioxidants from the food you eat.
Medication is usually started at the moderate stage of the disease, when symptoms begin to worsen through the day rather than ease with rest. Non-steroidal anti-inflammatory drugs like ibuprofen or naproxen are the first line of attack, since they can effectively reduce the inflammation causing the pain in your joints.
As your pain worsens, you may need to switch to more powerful pain relievers, like opioids. However, opioids are systemic medications that can be very addictive; in some cases, it’s a better idea to go right to the source of the pain, with an injection into the affected joint. Steroid shots in the joint can be exceptionally effective, but since you are limited in the number of shots you can take, it’s best to work with your doctor to develop a pain-control regimen if the injections wear off.
In advanced cases of OA, joint replacement surgery may be the best way to regain mobility and get rid of the pain, once and for all. Most joint replacement surgeries have very high success rates, and as long as you take care of your body before and after, you could be enjoying an active lifestyle within a month or two.
As with any surgery, the best way to ensure a speedy recovery is by getting into shape before the event. This means getting to an ideal weight, quitting smoking, eating more vegetables every day, and getting as much exercise as your joints can handle. You’ll thank yourself for your good preparation.
Although most experts agree that OA cannot be cured, there have been some studies that show a more optimistic future for OA patients. There’s some evidence that spontaneous remission or symptom reversal is possible, and researchers are studying certain cellular regeneration methods that could help cartilage to repair itself. But while research continues to pinpoint the mechanics of OA reversal, you can certainly help your body by devoting time and attention to all aspects of your healthy lifestyle.