Arthritis: It’s Not Just for Old People

Submitted by Dr. Jonathan M. Vigdorchik
Posted on 08 Nov, 2020

Many people think arthritis is an elderly person's disease or that it's an inevitable part of growing old. The risk of arthritis does increase with age: Almost half of adults age 65 or older have it, but younger people can get it too. In fact, two out of three people are under age 65, and 7.3 percent of those ages 18 to 44 report doctor-diagnosed arthritis.

Far from being unavoidable as you age, there's a lot you can do to prevent arthritis or keep it from getting worse if you already have it, potentially preventing a knee- or hip-replacement surgery.

Wear-and-Tear Arthritis
Arthritis occurs when cartilage in the joints starts to break down. Cartilage is the firm, flexible tissue that cushions the ends of bones and helps joints move smoothly.

There are many different kinds of arthritis. The most common form is osteoarthritis (OA), also known as degenerative arthritis, which affects nearly 27 million Americans. It results from wear and tear on the joints, usually from mechanical forces. OA most frequently affects the knees, hips, hands and spine. The resulting pain, stiffness and occasional swelling in the affected joints can eventually become debilitating, making it difficult to walk, go up and down stairs, or even put on socks and shoes.

Prevention Tips
Some people are predisposed to OA, such as those with misaligned bones or a malformed joint that puts stress on a small area of cartilage. A family history of arthritis also may increase your risk. Still, you can minimize key contributing factors by making the following lifestyle changes:

1. Maintain a healthy body weight through exercise and a balanced diet. Losing weight is one of the best things you can do to decrease stress on your joints, reduce pain and prevent onset or progression of arthritis.
2. Protect your joints by exercising properly. Use correct form and avoid extreme range-of-motion positions, such as some of those practiced in yoga and CrossFit training. It's important to practice these exercises under the supervision of trained experts.
3. Modify activities that cause pain. For instance, if running causes joint pain, switch to elliptical training, swimming or biking.

Stabilize your joints by performing exercises to strengthen muscles around your hips and knees.

Early Warning Signs
Early intervention can often delay the onset of degenerative arthritis or prevent it from getting worse, so it's important to know the warning signs:

• Deep-seated joint pain that doesn't feel like it's coming from your muscles. For example, groin pain could be a sign of arthritis in the hip.
• Stiffness in any joint.
• Pain in the knee during activity or aching pain at night.
• Difficulty going down stairs or sitting for long periods.
• Swelling, stiffness and enlargement of the joints in the fingers and thumbs.

If you notice any of these warning signs, see your doctor for an evaluation and diagnosis. Arthritis can be difficult to diagnose, so if your pain continues, seek out a specialist, such as a rheumatologist, orthopedic surgeon or sports medicine-trained doctor, or go to a comprehensive joint-disease center if one is available in your area.

Treatment Steps
Catching osteoarthritis as early as possible is critical to preventing further cartilage damage, maintaining your quality of life and staying out of the operating room.
In the earliest stages of OA, your doctor should work with you to protect and preserve your joints, with the goal of eliminating pain, preventing arthritis from progressing and avoiding future surgery. Initial treatment measures may consist of the prevention tips mentioned above as well as anti-inflammatory medication for joint pain and swelling and bracing when appropriate.

Cortisone injections into the joint can also calm inflammation and thus reduce pain. Some people try platelet-rich plasma or even stem-cell injections to preserve the cartilage. However, the current medical literature contains little support for these measures, and they can be expensive.

When OA pain continues in the large joints, the next treatment steps aim to stop further progression by surgically restoring joint mechanics. If caught early enough before cartilage damage, a variety of operations are available today to preserve cartilage. Surgeons can repair damage to the cartilage, reshape or reorient hip and knee bones and even do cartilage transplants.

Researchers like those at NYU Langone Medical Center's Joint Preservation and Arthritis Center also are studying new treatment approaches and techniques to delay the onset and progression of degenerative arthritis.

Unfortunately, if arthritis has progressed too far, treatment options are limited. For instance, in the large joints, a knee or hip replacement may be the only remedy left. That's why your best hope against arthritis in the future is to protect your joints and heed any early warning signs today.

Readers -- Do you or anyone you know suffer from osteoarthritis? What kinds of treatments help with the symptoms? Are there certain activities that you are unable to take part in because of OA? Leave a comment below and let us know.

Jonathan M. Vigdorchik, M.D., is assistant professor of orthopaedic surgery at the NYU School of Medicine and associate fellowship director at NYU Langone Medical Center's Joint Preservation and Arthritis Center, which offers personalized approaches to reduce joint-related pain and delay the onset of degenerative arthritis.