Arthritis Isn’t Inevitable

Arthritis is not an inevitable consequence of getting older, nor should it be treated that way. Here's how doctors look at and treat osteoarthritis.

from Long Life Prescription

A guy walks into his doctor’s office. The doctor asks “What’s wrong?”

“It’s my left knee,” the patient says. “It hurts when I walk.”

“Well, you’re 70,” says the doctor. “That’s what happens as you get older.”

“But doc,” the patient says, “my right knee is the same age, and it feels fine!”

The message? Arthritis is not an inevitable consequence of getting older, nor should it be treated that way. These days, even teenagers, particularly super-athletes spending more time on the soccer field than in the classroom, are turning up with arthritis — and they’re certainly not old.

Yet one in four patients seen by primary care physicians are there because of musculoskeletal problems; and among those over 65, the most common complaint is osteoarthritis. The condition affects 50 percent of those 65 and older, and up to 85 percent of those 75 and older.

Osteoarthritis results from microscopic damage in the structure and makeup of cartilage — the soft slippery tissue that covers the ends of bones in a joint. When cartilage is healthy, your bones glide smoothly over one another, the cartilage acting as a kind of shock absorber for movement. But when you have osteoarthritis, that surface layer of cartilage has worn down, allowing the bones to rub together. The result? Pain, swelling, and loss of motion. Over time, bone spurs called osteophytes might grow on the edges of the joint, and bits of bone or cartilage can even break off and float inside the joint space, increasing the pain.

Over the past 20 years, researchers have discovered that the underlying causes of many diseases are different than what we had once thought, and that’s true, too, with osteoporosis. In this case, scientists now suspect that the damage lies with cells that help maintain normal cartilage, called chondrocytes. Genetics and wear and tear contribute to chondrocyte damage, impacting their ability to maintain healthy cartilage. In particular, injury and biomechanical stress (that is, how you walk and move) are tough on chondrocytes. With each injury, additional blood and oxygen rush into the area to help repair the damage. This creates oxidative damage, accelerating chondrocyte death and leading to osteoarthritis.

As little as 20 years ago, doctors primarily treated arthritis with medication and rest. Today, they’re more likely to prescribe a set of isometric exercises and a 20-minute walk than any type of pill. A comprehensive treatment plan also includes nutritional advice, relaxation, and nonmedical methods of pain relief.

Learn more about osteoarthritis treatment options:
Eat to Beat the Pain of Arthritis
Fight Back With Food: How Food May Help Osteoarthritis
Get Pain-Free Knees

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