Bones and joints Archive

Osteoarthritis pain can be debilitating. Strategies can help get you moving again.

Pain from osteoarthritis is more than just a nuisance. Knee pain, in particular, can not only keep people from exercising, but also have a chilling effect on their ability to participate in social activities, especially those that involve walking or traveling, says Elena Losina, the Robert W. Lovett Professor of Orthopedic Surgery at Harvard Medical School and co-director of the Orthopaedic and Arthritis Center for Outcomes Research at Brigham and Women's Hospital.

"In fact, the quality of life of a person with persistent pain due to knee osteoarthritis is similar to quality of life in women with metastatic breast cancer controlled by therapy," she says.

Autoimmune diseases occur when the body generates an immune response against itself. Some people with rheumatic or autoimmune diseases, such as rheumatoid arthritis or lupus, develop an autoimmune lung disease. Marked by lung inflammation and possible scarring, it’s easier to treat if detected early.

News briefs

On Feb. 14, 2020, the FDA announced that two popular symptom-relief drugs can now be sold without a doctor's prescription. One is diclofenac sodium topical gel, 1% (Voltaren Arthritis Pain), which is used to temporarily relieve arthritis. The other is olopatadine (Pataday), which comes in eye drop form (in two strengths, for once-a-day or twice-a-day dosing) to relive itchy or red eyes from pollen, ragweed, grass, or animal hair or dander. Even though these medications are now available over the counter, they still have risks and benefits, so talk to your doctor before using any new treatment.

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Even the healthiest people can find it hard to stick with an exercise regimen — and if you suffer from the joint pain of arthritis, moving your body may be the last thing you want to think about. But regular exercise not only helps maintain joint function, it also relieves stiffness and reduces pain and fatigue.

If you have arthritis, you want to be sure your exercise routine has these goals in mind:

Addressing arthritis, hearing loss, and cataracts will help preserve your independence.

Older age brings lots of physical changes, like stiffer joints and difficulty seeing or hearing. Those developments may not cause disability, but they may have an effect — even a subtle one — on your driving. That's why it's smart to be proactive once you notice physical changes, to find out how each condition can jeopardize your driving skills, your safety, and the safety of others on the road.

Common ailments

There are many physical changes that can affect your driving skills. The following are among the most common.

On call

Q. I have osteoarthritis. My right knee is especially painful and stiff. How do I know when the time is right for knee replacement surgery?

A. Timing is key. If you get the procedure too soon, you might not see enough improvement to make the surgery worth it. In addition, the younger you are when you have knee replacement surgery, the greater the chances it will not last and another surgery may be needed. But if you wait too long, you may subject yourself to unnecessary pain and disability.

They can offer temporary pain relief, but are they right for you?

If you're battling with a flare-up of arthritis, bursitis, or tendinitis, you may find relief from an injection of cortisone (a type of steroid).

"People turn to injections when conservative treatments like over-the-counter and prescription pain medication or physical therapy no longer work, and their pain begins to interfere with quality of life," says Dr. Rob Shmerling, clinical chief of rheumatology at Harvard-affiliated Beth Israel Deaconess Medical Center.

Ask the doctors

Q. I recently started experiencing a lot of pain in my hand from osteoarthritis. Can I reverse this condition?

A. You can't reverse osteoarthritis, but there are things you can do to manage your pain and improve your symptoms. Osteoarthritis occurs when the protective cartilage that acts as cushioning between your bones starts to fray and wear down over time. Eventually this enables the bones to rub together, which causes the pain you are experiencing as well as swelling and stiffness that makes it difficult to move your hand freely. Typically, when you have arthritis, the pain and symptoms will be worse at some times than at others. You may experience a flare-up one day and feel better the next. To help reduce the discomfort of a flare-up, talk to your doctor about medication to relieve pain. She or he may recommend an over-the-counter pain reliever. Some people also get symptom relief using a topical pain reliever that is rubbed into the skin. Other strategies that can ease pain are splints or braces, heat or cold therapy, activity modification, and exercises or physical therapy to increase flexibility and strengthen your hand muscles.

Research we're watching

To manage the painful joint disease known as osteoarthritis, people often take ibuprofen (Advil, Motrin) and naproxen (Aleve, Anaprox). But these and related drugs — known as NSAIDs — may account for the higher rates of heart disease seen in people with osteoarthritis, a new study suggests.

Researchers matched 7,743 people with osteoarthritis with 23,229 healthy people who rarely or never took NSAIDs. People with osteoarthritis had a 42% higher risk of heart failure and a 17% higher risk of coronary artery disease compared with healthy people. After controlling for a range of factors that contribute to heart disease (including high body mass index, high blood pressure, and diabetes), they concluded that 41% of the increased risk of heart disease related to osteoarthritis was due to the use of NSAIDs.