Health & Exercise Forum

Patrick McKenna, Editor for The Times-Tribune recently sent me copy of a press release regarding a warning from the Centers for Disease Control and Prevention (CDC) that the prevalence of arthritis will increase significantly by 2030. Pat, a true baby boomer, is an exercise and sports enthusiast who is working hard to fight the aging process. He had some serious concerns about this news and asked if I might address this topic in one of my columns.

A recent report from data collected by the CDC indicated that increases in arthritis and other rheumatic conditions are evident. They project a nationwide increase in arthritic conditions from 46 million adults to 67 million adults by 2030. These numbers will have a significant social and economic impact on the United States. Socially, people affected will have greater limitations in activity level and independence. They will rely on others such as family and professional caregivers to a greater degree. Economically, these people will be using more health care dollars for adaptive equipment, medication, rehabilitation, health care staff and joint replacement surgery.

The cause the skyrocketing prevalence of arthritis is multifaceted, according to the Arthritis Foundation. Sedentary lifestyles, obesity, and aging baby boomers are the primary reasons for this trend. The Arthritis Foundation offers several steps to reduce the likelihood of pain and lifestyle limitations from arthritis including education, early diagnosis, diet and exercise for weight control and lifestyle changes.

• Education- Learn more about arthritis. Early diagnosis, see your physician often and learn the signs and symptoms of arthritis.
• Diagnosis - Your family physician will examine your knee to determine if you have arthritis. In more advanced cases you may be referred to an orthopedic surgeon or rheumatologist for further examination and treatment. X-rays will show if the joint space between the bones in the knee is getting narrow from wear and tear arthritis. If rheumatoid arthritis is suspected, blood tests and an MRI may be ordered. The diagnosis will determine if you problem if minor, moderate or severe.

Three Most Common Forms of Arthritis of the Knee

Osteoarthritis

Osteoarthritis is also known as degenerative arthritis. It is the most common form of arthritis in the knee. It is usually a gradual, slow and progressive process of “wear and tear” to the cartilage in the knee joint which eventually wears down to the bony joint surface. It is most often found in middle-aged and older people and in weight bearing joints such as the hip, knee and ankle.

Rheumatoid Arthritis

Rheumatoid Arthritis is a form of inflammatory arthritis in which many joints of the body can be affected. It is very destructive to the cartilage, joint and tissues surrounding the joint. It can occur at any age and usually effects both knees.

Post-Traumatic Arthritis

Post-Traumatic Arthritis is a form of arthritis that can occur following a trauma or injury to the knee. It is a form of osteoarthritis that is triggered years after a fracture, ligament or cartilage injury.

Symptoms of Arthritis

• Pain - usually occurs gradually. However, a sudden onset can occur, especially associated with a sudden twist or fall. Pain is often worse in the morning and improves with movement. Changes in the weather or barometric pressure can cause pain associated with arthritis.
• Swelling – can swell after increase activity at the end of the day.
• Stiffness – is more noticeable in the morning and improves with movement. However, overuse can create more pain and swelling and lead to stiffness also.
• Weakness – from disuse associated with pain and can lead to occasional buckling of the knee when walking or climbing steps.
• Loss of Function- is associated with pain, swelling, weakness and stiffness which limits walking, stair climbing etc.

Treating Arthritis

Conservative Treatment

In the early stages your treatment will be a conservative, nonsurgical approach, which may include; anti-inflammatory medication, orthopedic physical therapy, exercise, activity modifications, supplements, bracing, etc. You and your family physician, orthopedic surgeon or rheumatologist will decide which choices are best.

• Anti-inflammatory Medications: such as aspirin, acetaminophen or ibuprofen to reduce pain and swelling in the joint.
• Orthopedic Physical Therapy: such as heat, cold, ultrasound, electrical stimulation, joint mobilization, range of motion exercises, strengthening exercises, partial weight bearing aerobic exercises.
• Activity Modifications: such as eat well and lose weight, doubles tennis instead of singles, sitting or lying leg exercises instead of standing, walk instead of run, soft bed treadmill instead of hard surfaces, avoid squatting, kneeling, and bending.
• Supportive Devices: such as knee sleeves, light bracing, use good running shoes for exercise and walking, use good quality supportive shoes for work/dress.
• Diet and Exercise: eat well and exercise often. Maintaining your optimal weight is much less stressful on your joints. Losing 10 pounds will take 40 pounds of pressure off the joints in your legs. It may reduce pain and improve activity.

Visit your doctor regularly and listen to your body.

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of  Scranton, PT Dept.