Unlike the common misconception, Osteoarthritis isn’t restricted to the elderly. Here’s what you need to know about joint health – its causes, treatments and preventive measures.
What is Osteoarthritis?
Osteoarthritis or OA, as it is more commonly called, is a condition where the cartilage that cushions the joint breaks down, causing pain, stiffness and loss of movement in the joints. It affects around one in four Indians and is more common than cancer and heart disease combined. No one knows for sure what causes it, but research shows that heredity, excess weight, and previous joint injuries are major factors. In India, OA of the knee is more prevalent than that of the hip, perhaps because we squat and sit cross-legged so much. While many people regard arthritis as a disease of the elderly, OA can strike at any age and younger patients are increasingly affected.
OA in Younger People:
A recent English study found an increased risk of OA for younger people who regularly walk long distances over rough ground, sit or stand for prolonged periods, or frequently lift heavy objects. One reason for the increase is that middle-aged Indians now have high expectations of how physically active they can be. Compared to previous generations they exercise a lot more and for a greater number of years, putting long-term stress on joints, and increasing the likelihood of major injuries or repetitive minor injuries to their joints. Others have a couch potato lifestyle that spawns weight problems and poor posture – both contributors to OA.
OA in Women:
Women may be especially prone to OA in the knees. Studies have shown that hormonal changes during a woman’s menstrual cycle affect the elasticity of the body’s ligaments. An American study revealed that women’s knee muscles do not contract under stress as men’s do, putting their knee joints at greater risk creating knee pain. Researchers have proved that women who play sports involving jumping and pivoting are up to eight times more likely to injure their knees than men playing the same sport.
Medication and Exercise for OA:
Although there is no cure for OA, supplements and medications can reduce joint pain and swelling. If taken when a person has early to moderate OA, prescription drugs may decrease pain and improve function. Over-the-counter medications such as aspirin, ibuprofen and paracetamol have been shown to be effective, but they should not be used over long periods, and must also be avoided by those having renal or gastrointestinal disorders.
Although there is no cure for OA, supplements and medications can reduce joint pain and swelling. If taken when a person has early to moderate OA, prescription drugs may decrease pain and improve function. Over-the-counter medications such as aspirin, ibuprofen and paracetamol have been shown to be effective, but they should not be used over long periods, and must also be avoided by those having renal or gastrointestinal disorders.
Exercise, even if it hurts, is usually good for the joints. Ask your doctor if you can do low-impact activities like stationary biking, swimming and walking. Not moving the joints often worsens the problem. But don’t go overboard. Exercise within the limits, your doctor lays down for you. Many people also find relief through acupuncture and massage. Sometimes the solution is as simple as having the right shoes.
Knee and Hip Replacements- Facts about the treatments and other alternatives:
For many OA sufferers, however, replacing the joint is the only option. The success rate of knee and hip replacements is high and the new knee or hip should last 15 to 20 years. But even if an implant does last that long, recipients under the age of 65 will probably require at least one surgery to correct for wear and tear. Implants are expensive. Knee replacement surgeries can cost anywhere between Rs. 1.5 lakhs and Rs. 1.7 lakhs (subject to change) if a foreign implant is used. Hip replacements may cost between Rs 90,000 and Rs 1.3 lakhs (subject to change). These costs can be reduced if Indian implants are used, but their quality is not as good as imported ones, so doctors don’t recommend them.
Meanwhile, alternatives to total knee and hip replacements are emerging. Hip resurfacing, for example, involves capping rather than replacing the dome of the thighbone. While traditional hip-replacement patients are advised to avoid high-impact activities, those with a resurfaced hip have fewer restrictions. Hip resurfacing is best suited for people under 65 with good bone density and without arthritic conditions in multiple joints.
For Osteoarthritis in the knee, some patients are trying a procedure called viscosupplementation, where a gel-like substance is injected into the joint, restoring the lubrication properties of damaged cartilage, eliminating knee pain. Treatment involves three to five injections and is usually effective for several months. But it doesn’t work for everyone, and there are questions about its cost-effectiveness: the treatment can set you back by Rs. 10,000 to Rs. 15,000 (for three injections and about Rs. 5,000 more in case of five injections). And, depending on the patient’s age, a Rs. 100 shot of cortisone would be as effective.
Treatments that may be available in the future include cartilage transplant and biodegradable plastics that can stimulate the re-growth of the healthy cartilage. Australian researchers are working on a bone substitute seeded with the patient’s own marrow stem cells. The idea is to create a substance that will provide immediate support yet be incorporated into the natural bone so rapidly that it will soon be replaced with new bone.
Preventive Measure One Should Consider:
If you are lucky enough to still have healthy joints, start taking care of them now. Maintain a healthy body weight, and make good posture a habit: Change sitting positions often and learn how to lift and carry heavy objects properly. Eat a diet rich in vitamin C, which can slow the pace of dissipating cartilage and calcium for skeletal strength. And minimize your chance of injury: Avoid high heels, and choose appropriate shoes for walking and sports.
A regular exercise program can also help. Consult your doctor, a physiotherapist or certified fitness instructor about the right exercises for your body and how to do them. One of the best things you can do is walk two to three kilometers a day. It’s good for both your joints and your overall health. Remember to alternate high-impact activities like jogging with laps at the swimming pool, or cycling. Rushing to the gym is probably not a good idea if you can’t do a proper warm-up and cool down.
These days people are always in a hurry. They want to do everything right away. But hurrying is a certain way of getting hurt.