Osteoarthritis and Women
Osteoarthritis(OA) is a condition that affects cartilage, the rubbery cushion covering bones in the joints, keeping them flexible. Over time, cartilage begins to stiffen and damages more easily -- and gradually it loses its "shock absorber" qualities. Bones start rubbing against each other, and the pain begins.
Women tend to be plagued by osteoarthritis more than men. Heredity increases the risk: A genetic defect triggering defective cartilage or a joint abnormality can lead to osteoarthritis. "If your mom had knobby fingers, you're more likely to develop arthritis there,".
Other risk factors are involved: Obesity puts extra stress on knees and hips, which leads to cartilage breakdown. A sports injury, severe back injury, or broken bone takes a toll on the joints -- and pretty soon, it's all about osteoarthritis.
"Pain is the symptom that gets everyone's attention,"
13 Tips: Rein in Your Osteoarthritis Pain
Your life doesn't have to be all about osteoarthritis. There's much you can do to enjoy a better quality of life. By learning about your disease -- and making some changes -- you can live well.
1. Lose Weight. If you are overweight or obese, you're putting extra stress on weight-bearing joints. Losing weight lessens the risk of further joint injury. It also increases your mobility.
2. Work on Your Diet. If losing weight is a goal, talk to a dietitian to get on track with healthy eating habits. Also, antioxidant and calcium supplements can boost your bone strength: Vitamin D (400 IU daily) and calcium (1,000-1,200 mg daily). Antioxidant vitamins C and E may also provide bone protection.
3. Stay Active. Exercise is hands-down the best treatment for osteoarthritis. Exercise helps you lose weight, increases flexibility, eases pain, boosts your mood, strengthens your heart, and improves blood flow. Mall walking, swimming, and water aerobics are popular because they are easy on joints. If exercise is painful at first, stay with it... it will get easier, reducing overall pain in the long run. But be sure to talk to your doctor before starting a new fitness or diet plan.
4. Get Strong. Muscles become weak when you have osteoarthritis, and that leads to more pain. By doing exercises to strengthen muscles, you ease the pain and develop greater stability in your joints -- so there's less risk of falls. Also, special exercises can increase the range of motion in your joints. Talk to your physician or physical therapist to be sure you're doing these exercises correctly.
5. Have Fun. Don't let your life be all about osteoarthritis. Get out, have a good time! When you're distracted from the pain, you'll feel happier. Sports, hobbies, volunteer projects, and other activities can take your mind off the pain. If you're having trouble participating in favorite activities, talk to an occupational therapist about your options.
6. Make Adjustments. Sensible changes can lessen the strain on joints and muscles and prevent painful spasms. If you have osteoarthritis in your back, make sure it gets good support when you sit. That means sitting in a chair to read, not reading in bed. If you have arthritis in your hip, it helps to adjust the toilet seat or furniture to a comfortable level.
7. Use Heat and Cold. Heating pads, hot packs, a warm bath or shower, warm wax (paraffin) applications -- these increase blood flow, easing pain and stiffness. Cold packs can reduce inflammation in a sore area. Many people keep bags of ice or frozen vegetables (like peas) on hand. Wrapped in a towel, these cold packs easily mold to fit a sore joint, like a knee.
8. Take a Break. While exercise is great for helping osteoarthritis, overexertion can cause even more pain. It's important to slow down or stop when you need to. Tune in to your body, and learn when you're doing too much.
9. Catch Lots of ZZZs. Life is better when you get a good night's sleep. You feel less pain and cope better overall. If you're having trouble sleeping, talk to your doctor or physical therapist. You may need a better mattress or different sleep position. Taking your medications on a different schedule can also provide more nighttime pain relief. Take a warm bath before bedtime to relax sore muscles.
10. Get a Soothing Massage. For treatment of pain, Americans rate massage as highly as medications. One in five adults got a therapeutic massage last year -- and three-quarters of them would recommend it to others, one survey showed. Massage helps relieve pain by increasing blood flow and warmth in painful areas.
11. Take Drugs Correctly. Non-prescription painkillers like Tylenol or nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil or Aleve can be effective at relieving osteoarthritis pain. But it's important to take them according to label directions. "A lot of patients take one pill a day and say it's not working," says Kaur. "Before you give up on it, you must take it around the clock as directed."
Creams, rubs, and sprays applied to the skin can also help relieve pain. These can be used in addition to oral painkillers -- but use them as directed, too, to make sure you get maximum benefit. Zostrix, Icy Hot, and Bengay are among the nonprescription topical pain relievers.
12. Alternative Therapy. When conventional pain treatments don't work, many people turn to complementary or alternative therapies. Research shows that acupuncture can help relieve joint pain by stimulating natural, pain-relieving chemicals produced by the nervous system.
Glucosamine and chondroitin are well-known and researched supplements for arthritis. Both are natural substances found in joint fluid. Each is thought to stimulate the increase of cartilage production and reduce inflammation. Studies have had mixed results; one large study found that the supplement had no effect on mild osteoarthritis, but did help with moderate-to-severe arthritis. Another study found that glucosamine slowed progression of osteoarthritis in the knee.
It doesn't hurt to try glucosamine or chondroitin, says Kaur. "If it doesn't work, it's one thing you can cross off your list."
13. Use Assistive Devices. If you feel unstable on your feet -- like you might fall -- it's time for a cane, walker, or knee brace. "Assistive devices help take weight off the joint and decrease pain, in addition to making you feel more stable on your feet," says Kaur.
She cautions: Make sure you select a cane that fits you. Then learn how to use it correctly. "A lot of people don't know how to select a cane -- the correct length of cane," she tells WebMD. "They don't how to hold it, how to use it. You don't use a cane on the same side as the pain. You want to take the load off that side."
Life isn't all about osteoarthritis. That's why the more you know about how to manage pain, the easier you'll manage your arthritis -- and life.
FACTORS:
I. Background
- Also known as degenerative joint disease.
- Most common form of arthritis.
- Classified as: Idiopathic (localized or generalized) or Secondary (traumatic, congenital, metabolic/endocrine/neuropathic and other medical causes).
- Characterized by focal and progressive loss of the hyaline cartilage of joints, underlying bony changes.
- Usually defined by symptoms, pathology or combination 1
- Pathology = radiographic changes (joint space narrowing, osteophytes, and bony sclerosis.)
- Symptoms = pain, swelling, and stiffness.
II. Prevalence
- Knee
- Age ≥60 years= 37.4 (42.1 female; 31.2 male).4
- Age ≥60 years= 47.8.5
- Age ≥45 years= 19.2 (19.3 female; 18.6 male.6
- Age ≥45 years= 37.4 (42.1 female; 31.2 male.7
- Age ≥26 years=4.9 (4.9 female; 4.6 male.6
- Hip
- Age ≥45 years = 28.0 (29.5 female; 25.4 male).8
- Knee
- Symptomatic radiographic OA—prevalence per 100
- Hand
- Age ≥26 years = 6.8 (9.2 female; 3.8male).9
- Age ≥60 years= 8.0 overall.10
- Knee
- Age ≥60 years= 12.1 (10.0 female; 13.6 male).4
- Age ≥45 years= 6.7 (7.2 female; 5.9 male).6
- Age ≥45 years= 16.7 (18.7 female; 13.5 male).7
- Age ≥26 years= 4.9 (4.9 female; 4.6 male).6
- Hip
- Age ≥45 years = 8.7 (9.3 female; 9.2 male).6
III. Incidence
- Age and sex-standardized incidence rates of symptomatic radiographic OA in the in adults aged ≥20 years and older:
- Hand OA = 100 per 100,000 person years.11
- Hip OA = 88 per 100,000 person years.11
- Knee OA = 240 per 100,000 person years.11
- Among women in the adult population:
- Incident radiographic knee OA 2-2.5% per year.5, 12, 13
- Incident symptomatic radiographic knee OA 1% per year.12
- Progressive radiographic knee OA 3-4% per year.5,12,13
- Incidence rates of OA increased with age, and level off around age 80.14
- Women had higher rates than men, especially after age 50.14
- Men have 45% lower risk of incident knee OA and 36% reduced risk of hip OA than women.15
IV. Mortality
- OA is associated with excess mortality.16
- Deaths from all causes, cardiovascular deaths, and dementia deaths among adults with OA were 1.6,1.7, and 2.0 times higher compared with the general population.16
- Annual average of 0.2 to 0.3 deaths per 100,000 population due to OA (1979–1988).17
- OA accounts for ~6% of all arthritis-related deaths.17
- ~ 500 deaths per year attributed to OA; numbers increased during the past 10 years.17
- OA deaths are likely highly underestimated. For example, gastrointestinal bleeding due to treatment with NSAIDs is not counted. 17
V. Hospitalizations
- OA accounts for 69.9% of all arthritis-related hospitalizations; 814,900 hospitalizations for OA as principal diagnosis in 2006.18
- Knee and hip joint replacement procedures (usually for OA) accounted for 35% of total arthritis-related procedures during hospitalization.19
- Nationally, from 1991 to 2007 the rate (per 100,000) of total knee replacement increased 187% from 192.2 to 551.3. In addition, the rate (per 100,000) of total hip replacement increased 86.2% from 135.7 to 252.7.18
- Non-Hispanic Blacks and persons with low income have lower rates of total knee replacement but higher complications and mortality than Non-Hispanic whites.20,21
VI. Ambulatory Care
- OA accounted for an annual prevalence of 20.9 million (26.8%) of all arthritis-related ambulatory medical care visits from 2001-2005.3
- About 39% of people with OA report inability to access needed health care rehabilitative services.22
VII. Costs
- Estimated costs due to hospital expenditures of total knee and hip joint replacements, respectively, $28.5 billion and $13.7 billion in 2009.23
- Average direct costs of OA per patient ~$2,600 per year.19
- Total (direct and indirect) annual costs of OA per patient = $5700 (US dollars FY2000).24
- Job-related OA costs $3.4 to $13.2 billion per year.14
VIII. Impact on health-related quality of life (HRQOL) [AAOS Fact Sheet; NHANES III data]
- OA of the knee is 1 of 5 leading causes of disability among non-institutionalized adults. 25
- About 80% of patients with OA have some degree of movement limitation.
- 25% cannot perform major activities of daily living (ADL's), 11% of adults with knee OA need help with personal care and 14% require help with routine needs.
- About 40% of adults with knee OA reported their health "poor" or "fair."
- In 1999, adults with knee OA reported more than 13 days of lost work due to health problems.
- Hip/knee OA ranked high in disability adjusted life years (DALYs)27 and years lived with disability (YLDs).26
IX. Unique characteristics
- Disease in weight bearing joints has greater clinical impact.
- About 20%–35% of knee OA and ~50% of hip and hand OA may be genetically determined.27,28
- Established modifiable and non-modifiable risk factors7,27,28,29,30,31:
- Modifiable
- Excess body mass (especially knee OA).
- Joint injury (sports, work, trauma).
- Knee pain.
- Hand OA is a risk factor for knee OA.
- Occupation (due to excessive mechanical stress: hard labor, heavy lifting, knee bending, repetitive motion).
- Men—often due to work that includes construction/mechanics, agriculture, blue collar laborers, and engineers.
- Women—often due to work that includes cleaning, construction, agriculture, and small business and retail.
- Structural malalignment, muscle weakness.
- Non-modifiable.
- Gender (women higher risk).
- Age (increases with age and levels around age 75).
- Race (some Asian populations have lower risk).
- Genetic predisposition.
- Modifiable
- Other possible factors:
- Estrogen deficiency (estrogen replacement therapy (ERT) may reduce risk of knee/hip OA).
- High bone density may increase risk of knee).
- Vitamins C, E, and D—equivocal reports.
- C-reactive protein (increased risk with higher levels).
Exercising For Osteoarthritis
Physical activity is the best non-drug treatment for improving pain and function.
While you may worry that exercising with osteoarthritis could harm your joints and cause more pain, research shows that people can and should exercise when they have osteoarthritis. Exercise is considered the most effective non-drug treatment for reducing pain and improving movement in osteoarthritis.
Three kinds of exercise are important for people with osteoarthritis: exercises involving range of motion, also called flexibility exercises; endurance or aerobic exercises; and strengthening exercises. Each one plays a role in maintaining and improving your ability to move and function.
Speak with your doctor or physical therapist about exercising with osteoarthritis and the specific exercises that are best for you.
Range of motion/flexibility: Range of motion refers to the ability to move your joints through the full motion they were designed to achieve. When you have osteoarthritis, pain and stiffness make it very difficult to move certain joints more than just a little bit, which can make even the simplest tasks challenging.
Range-of-motion exercises include gentle stretching and movements that take joints through their full span. Doing these exercises regularly – ideally every day – can help maintain and even improve the flexibility in your joints.
Aerobic/endurance: These exercises strengthen your heart and make your lungs more efficient. This conditioning has the added benefit of reducing fatigue, so you have more stamina throughout the day. Aerobic exercise also helps control your weight by increasing the amount of calories your body uses. Furthermore, this type of exercise can help you sleep better and improve your mood.
Three kinds of exercise are important for people with osteoarthritis: exercises involving range of motion, also called flexibility exercises; endurance or aerobic exercises; and strengthening exercises. Each one plays a role in maintaining and improving your ability to move and function.
Speak with your doctor or physical therapist about exercising with osteoarthritis and the specific exercises that are best for you.
Range of motion/flexibility: Range of motion refers to the ability to move your joints through the full motion they were designed to achieve. When you have osteoarthritis, pain and stiffness make it very difficult to move certain joints more than just a little bit, which can make even the simplest tasks challenging.
Range-of-motion exercises include gentle stretching and movements that take joints through their full span. Doing these exercises regularly – ideally every day – can help maintain and even improve the flexibility in your joints.
Aerobic/endurance: These exercises strengthen your heart and make your lungs more efficient. This conditioning has the added benefit of reducing fatigue, so you have more stamina throughout the day. Aerobic exercise also helps control your weight by increasing the amount of calories your body uses. Furthermore, this type of exercise can help you sleep better and improve your mood.
How much should you exercise? Current recommendations for
150 minutes of moderate-intensity aerobic exercise per week
OR
75 minutes of vigorous-intensity aerobic exercise per week
OR
an equivalent combination of moderate and vigorous exercise
Strengthening: Strengthening exercises help maintain and improve your muscle strength. Strong muscles can support and protect joints that are affected by arthritis.
Does stress affect OA?
Yes, having a chronic disease like osteoarthritis can be stressful. Stress, in turn, can make dealing with a disease like osteoarthritis more difficult – and painful.
That’s because when you feel stressed, your body becomes tense. This muscle tension can increase pain, making you feel helpless and frustrated because the added pain may limit your abilities. This, in turn, can depress you. Stress, depression and limited and lost abilities can all contribute to pain, which then perpetuates the cycle. If you understand how your body reacts physically and emotionally to stress and learn how to manage stress, you can break the destructive cycle.
That’s because when you feel stressed, your body becomes tense. This muscle tension can increase pain, making you feel helpless and frustrated because the added pain may limit your abilities. This, in turn, can depress you. Stress, depression and limited and lost abilities can all contribute to pain, which then perpetuates the cycle. If you understand how your body reacts physically and emotionally to stress and learn how to manage stress, you can break the destructive cycle.
How will losing weight help?
Excess body weight is a risk factor for the both the development and progression of osteoarthritis. For every pound of body weight you gain, your knees gain three pounds of added stress; for hips, each pound translates into six times the pressure on the joints. After many years of carrying extra pounds, the cartilage that cushions the joints tends to break down more quickly than usual.
Conversely, losing weight can reduce additional stress on joints that can cause cartilage to wear away. Easing the pressure on joints by shedding extra pounds can also reduce pain in osteoarthritis-affected joints, which will help you feel and move much better.
Conversely, losing weight can reduce additional stress on joints that can cause cartilage to wear away. Easing the pressure on joints by shedding extra pounds can also reduce pain in osteoarthritis-affected joints, which will help you feel and move much better.
Can OA be prevented?
Although you can’t do anything about the genes you inherit from your parents, you can and should take extra care in minimizing your other risk factors – primarily excess weight and joint injuries.
By maintaining a healthy body weight you avoid putting additional stress on your joints. This stress can wear away at cartilage more quickly than usual and lead to osteoarthritis in weight-bearing joints such as the knees.
Injuries from routine falls or severe bangs and bumps during athletic activities can cause major damage to the cartilage. These injuries can cause cartilage tears, or they can permanently alter the way your joints move so that they wear down cartilage more than usual. You can avoid injuries that may lead to osteoarthritis by taking care of your body. Warming up and stretching before athletic activity and exercise can help you prevent serious injury. If you do injure yourself, see your doctor to receive proper treatment. Injuries left untreated may heal improperly, which could lead to further damage later on.
By maintaining a healthy body weight you avoid putting additional stress on your joints. This stress can wear away at cartilage more quickly than usual and lead to osteoarthritis in weight-bearing joints such as the knees.
Injuries from routine falls or severe bangs and bumps during athletic activities can cause major damage to the cartilage. These injuries can cause cartilage tears, or they can permanently alter the way your joints move so that they wear down cartilage more than usual. You can avoid injuries that may lead to osteoarthritis by taking care of your body. Warming up and stretching before athletic activity and exercise can help you prevent serious injury. If you do injure yourself, see your doctor to receive proper treatment. Injuries left untreated may heal improperly, which could lead to further damage later on.
Treatments for Osteoarthritis
Lifestyle Treatments for Osteoarthritis
Exercise
Diet
Rest
Cold/Heat
Part 3 of 6: OTC Medication
Over-the-Counter Medications for Osteoarthritis
Acetaminophen
Nonsteroidal Anti-inflammatory Drugs
Topical Medications
Part 4 of 6: Prescription Medication
Prescription Medications for Osteoarthritis
Cortisone Shots
Prescription NSAIDS
Tramadol
Narcotics
Part 5 of 6: Other Treatments
Other Medical Treatments for Osteoarthritis
Knee Injections
Physical therapy
Part 6 of 6: Surgery
No comments:
Post a Comment
Thank You.