Ways to Treat and Prevent Progression of Osteoarthritis: Part 2 of 3
Special Feature “ Health & Exercise Forum” with Geisinger Commonwealth School of Medicine the 3rd Monday of every month!
Guest Columnist: Antonio Adiletta, MD3
Antonio Adiletta, MD3 is a third year medical student at Geisinger Commonwealth School of Medicine from Lancaster, PA. During his first two years, he served as President of his class and helped create a General Surgery Interest Group. He is currently interested in Orthopedic Surgery.
Last week in Health & Exercise Forum, we discussed the most common causes and areas of the body most affected by osteoarthritis. This week we will present the 3 of the 5 most effective methods of prevention and treatment and next week, part three will conclude with the last two methods.
Osteoarthritis, (OA) also known as degenerative joint disease and wear and tear arthritis, is the most common type of arthritis affecting approximately 27 million Americans. OA is caused by damage to the cartilage, the rubber-like padding that protects the ends of bones at the joints. While living with OA can be challenging, there are things you can do to prevent and manage the problem such as exercise, weight loss and joint protection.
It may seem confusing that exercise could be a recommended treatment for a disease known as the “wear and tear” arthritis, but research has shown that people with OA can and should exercise. The benefit of exercise is multifold for your joint pain. Exercise will help strengthen the muscles that stabilize your joint, increase range of motion, and decrease stiffness, all while benefiting your overall health and contributing to weight loss.
Flexibility: OA can cause your joints to become stiff and painful to move. Starting to lightly stretch your painful joints more and more each day will help to increase your range of motion. Work your way up every day to being able to stretch your joint through its full span of motion.
Cardio: Exercise that gets your heart beating will promote general physical fitness. This, in turn, can improve your mood, decrease your chance of developing diabetes, increase blood flow to damaged joints that will improve healing, and maintain a healthy weight.
It is recommended to exercise for either 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise per week. A standard way to access intensity is to follow the “220-age” rule for heart rate. Age-predicted maximum heart rate is 220 minus your age. If you are 50, for example, the average maximum heart rate is 220- 50 = 170. This can be used to access your intensity level while you are exercising by checking your pulse when you are done.
Strength: Exercise that strengthens the muscles that support your painful joint. By improving the strength of your muscles, you are also stabilizing, supporting, and protecting your joint. Ask your doctor, physical therapist, or research ways to strengthen the muscles of your affected joint.
It is prudent to begin slowly when trying new exercises or exercising for longer than usual. It is important to listen to your body and to not do things that aggravate your joint. Be sure to see your doctor or physical therapist for an individualized recommendation on how you can strengthen your joint and decrease pain interfering with your daily activities. Exercise will also help with our next tip, weight loss.
Being overweight is known to be a major contributing factor to the development of OA. The good news is that it’s something that can be worked on! Weight loss will decrease the stress on your joints, relieve pain, and help prolong the need for drastic measures such as surgery. The problem is that being overweight puts an increased amount of stress on your joints especially the knee. When a person walks it is estimated that a force three to six times the person's body weight is applied to the knee. That means that any increase in body weight will increase the stress on your knees by 3 to 6 times per pound; underscoring the importance of preventing weight gain and striving to lose weight.
Interestingly, it has been shown that people who are overweight are also at an increased risk of developing hand OA; therefore it’s suspected that there are circulating systemic factors contributing as well. So weight gain does more than increasing the stress on your joints and it may contribute in an insidious way.
An easy way to learn how much weight you need to lose is to look up your body mass index (BMI). This can be done easily by looking up a BMI calculator online or asking your doctor. Overweight is a BMI of 25-29.9 while obesity is a BMI of 30 or greater. It is important to know where you stand because women who are overweight have a 4 time increased risk of developing OA while men have 5 times increased risk. Weight loss is so effective in decreasing OA that it has been shown that if a woman of average height loses 11 pounds she decreases her risk of developing OA by greater than 50%! Losing weight is an effective and essential part of decreasing the progression of OA and relieving your joint pain.
While exercise is an essential part of weight loss, eating right is just as important. The importance of exercise was talked about in our first tip. It is important to cut back on dietary fat and total calorie intake. Talk to your doctor about ways to improve healthy eating or talk to a dietitian.
When a joint experiences major injury it can be left susceptible to OA. Fractures to the bone, or tears to ligaments that help stabilize the joint such as the anterior cruciate ligament (ACL) or meniscus in the knee and the labrum (the rim of cartilage in your hip socket) in the hip, can lead to premature OA. Injuries during physical activity or other accidents can cause damage to the cartilage in your joints. If these injuries are not taken care of they can lead to permanent alterations in the way your joint move and this can lead to more cartilage destruction. Therefore it is important to wear the correct protective gear and be cautious when playing sports or exercising.
Injuries can be avoided by taking care of your body and taking the right precautions. Warming up before strenuous activity, stretching, and knowing your limits are some ways that you can help prevent injury. Be sure you are using exercise equipment properly and are practicing safe ways to exercise or play sports. It is important to seek treatment if you think you have injured something in your joints. Injuries that are not treated properly can lead to improper healing and further damage. The earlier you seek treatment, the earlier you can begin on the proper road to recovery.
NEXT WEEK: Part 3 of 3: Ways to Prevent and Treat Osteoarthritis
Medical Contributor: John Doherty, MD, Geisinger Orthopedics, Scranton, PA
Read Dr. Mackarey’s Health & Exercise Forum – every Monday. 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: firstname.lastname@example.org
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 associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.