Dealing with painful joints

As we age, our body starts aching. One of the most common complaints amongst the elderly is joint pain affecting the knees, hips, lower back, neck and ankles. This pain is just a nuisance that does not affect day- to- day activities. However, in some people it can be disabling.

What exactly is osteoarthritis?

There are many forms of arthritis but the most common type in people above the age of 50 years is osteoarthritis.

This form of arthritis is due to wear and tear of the joint. The joints are usually made of bone lined by cartilage (a type of tissue that cushions the joint and prevents the bones from grating against each other).

Most joints also have some fluid to lubricate their movement. In osteoarthritis, the cartilage lining the bones wears out causing the bones to rub against each other. This results in the characteristic joint pain and stiffness.

This pain is usually worse later in the day. There can be swelling, warmth, and creaking of the affected joints. The pain and joint stiffness can also occur after long periods of sitting.

In osteoarthritis of the backbone, there is pain (or stiffness) in the neck or lower back. The changes in the backbone can irritate nerves, causing severe pain, numbness, muscle weakness and tingling in the arms or legs.

Is osteoarthritis only found in the elderly?

No, you can develop this form of arthritis if you are either obese or have had previous injury to the joint.

Can osteoarthritis affect other organs?

Unlike other forms of arthritis (like rheumatoid and lupus), osteoarthritis is confined to the joints only. These other two forms of arthritis have been associated with kidney, eye, skin and even digestive problems.

How is osteoarthritis diagnosed?

Usually the clinical symptoms are the best guide to diagnosing osteoarthritis. Your doctor will likely also perform radiographs (x-rays) to visualise the affected joints. If your doctor is concerned that you may be having a different type of arthritis, for example rheumatoid arthritis, he/she may request for blood tests.

How do I live with arthritis?

The goal of treatment of osteoarthritis is management of symptoms. This is done through:

• Regular gentle exercise: Good options are swimming and cycling. If this is not available to you, slow paced walking is an alternative. Jogging and weight training can be hard on the joints and should only be done after consultation with your doctor. Ensure you start each exercise session by stretching your joints and warming up.
• Weight loss: This is paramount. Medication will not be effective if your joints are still bearing excess weight. Even surgery has poor outcome in obese individuals.

• Wear suitable footwear: Avoid wearing shoes that do not allow for proper distribution of your weight – for example high heels. In addition, look for shoes that have good cushioning.

• Proper posture: If you work at a desk, make sure your chair is at the correct height and your feet should be flat on the floor. Avoid slouching and walk upright (use a cane to walk if necessary to help improve your posture and reduce pain). Do not sit for prolonged periods— take regular breaks to move around.

• Knee support: Wearing a brace around your knee can help reduce swelling, pressure and increase joint stability.

•Heat and cold therapy: Applying a hot or cold compress on a painful joint can offer relief.

•Massage therapy: This is a useful pain management strategy.

•Pain medication: This can either be taken in the form of tablets, syrups or can be applied to the joint in the form of gels, ointments and patches. In some cases, your doctor may inject pain relievers directly into the joint

•Physiotherapy: Severe osteoarthritis usually needs the help of a physiotherapist to help exercise the joints and reduce pain.

•Surgery: If the symptoms of arthritis are severe and fail to improve with the above measures, then your doctor may resort to surgery. Usually, it involves replacing the damaged joint with a metal prosthesis. It is commonly performed in damaged knee and hip joints.

Can the joint ‘heal itself’ with proper diet?

Unfortunately, no. Once the joint is damaged, it is permanent. Cartilage does not have blood supply, which prevents it from sufficiently replenishing itself once it is worn out. Contrary to popular belief, there is no special diet which causes the joints to fully regenerate.

However, foods rich in vitamins, omega oils and antioxidants have been found to help reduce the inflammation associated with arthritis.

These foods include vegetables, fruits, fish oils and nuts. In addition, eating a healthy diet will help keep your weight under control which will ultimately reduce your joint pain.

Risk of falls

Elderly people with osteoarthritis are at a high risk of falling while walking. This is because they have joint instability.

For example in severe osteoarthritis of the knees, they often experience locking of their joint (sudden lack of movement in the joint).

In addition, they also experience buckling (when the knee suddenly gives out). This causes frequent unexpected falls.