Wisdom and wrinkles are not the only things we can acquire with age. For many of us, arthritis is a part of getting older, too. A lot of confusion and fear can surround this diagnosis—here are some ways to better understand and manage it.
What is arthritis?
Arthritis is the swelling or inflammation of one or more of your body’s joints (where two bones come together). There are more than 100 different types of arthritis; the most common kinds are osteoarthritis (OA) and rheumatoid arthritis (RA) (CDC, 2021).
Arthritis can affect a range of joints that help you move around and interact with your world—from big joints like your hips, shoulders, and knees, to smaller joints in your spine, hands, and feet.
What does a healthy joint look like?
Have you ever seen the smooth, shiny surface wrapping the end of a chicken bone? That’s a special type of tissue called cartilage found in the joints of many animals, including you! It cushions the ends of your bones and allows them to glide against each other with ease.
Bathing this cartilage is a slippery gel-like lubricant called synovial fluid. Made by the tissue that surrounds a joint (the joint capsule), synovial fluid acts like oil in a squeaky wheel, nourishing your cartilage and helping your bones move even more fluidly.
How does a joint become arthritic?
Some underlying reason—it could be an injury, an infection, too much weight from being obese, repeated overuse of a joint, or a list of other factors including your age, genetics, and family history—causes a switch to flip inside a healthy joint:
The shiny cartilage wrapping the ends of your bones breaks down and becomes thinner, the joint capsule lining gets irritated, the amount of lubricant changes, and joints swell—resulting in arthritis and the pain and stiffness that comes along with it.
RA and OA: What’s the difference?
Both OA and RA cause damage to your joints—but in different ways.
Rheumatoid Arthritis (RA)
Rheumatoid arthritis is caused by a misfire of your immune system. Normally, your immune system attacks and removes foreign invaders (like germs) from your body. With RA, your immune system mistakes the tissues in and around your joints as foreign. It launches an attack on these tissues, ultimately causing joint damage, pain, swelling, deformity, and other symptoms.
Anyone can get RA, but these factors increase your risk: older age, family history, female sex, current or prior cigarette smoking, and pregnancy.
Osteoarthritis, on the other hand, is not caused by an auto-immune disorder, but rather as either a part of the aging process or from some form of physical stress to your joints (be it a soccer injury, repeatedly bending your knees for work, or carrying around too much body weight, for example).
This is why older age, previous injuries, and obesity all raise the risk for OA; other risk factors include family history and female sex.
It’s important to note, though, that not everyone who gets older gets OA. And some people with signs of OA on x-rays do not experience any symptoms. There is a wide range of normal.
Additionally, although OA is not an autoimmune disorder, inflammation is still a component. As a joint breaks down, it triggers the body’s immune system to respond, resulting in the swelling that you sometimes see.
What are the symptoms of arthritis?
Joint pain—like the jolt felt on the first step out of bed or the hand throb of opening a jar—is the most common symptom of arthritis, followed by joint stiffness and swelling. People often feel these symptoms more in the morning or after long periods of rest.
OA and RA share many of these common symptoms, but there are some unique characteristics that help distinguish the two:
- The symptoms of OA typically come on slowly (over the course of many years,) while RA symptoms tend to develop more quickly (over the course of weeks or months).
- While the pain of OA is typically limited to joints, people with RA may also experience flu-like symptoms (low-grade fever, fatigue, muscle aches).
- People with RA often have symptoms in the same joint(s) on both sides of the body (for example, in the same fingers on both hands). With OA, one side of the body is usually more affected than the other (this is why many people will adapt and rely on their ‘good side’ for daily activities).
A medical provider will ultimately help determine which kind of arthritis is present.
How is arthritis diagnosed?
Doctors usually diagnose arthritis by listening to your story, examining your body, and reviewing x-rays and blood tests. When examining your body, a doctor will compare how your joints appear and move on one side of your body versus the other. Medical providers will also look for any bony abnormalities or signs of extra fluid in your joints.
Is arthritis curable?
Unfortunately, arthritis cannot be reversed. Once a joint loses its protective cushioning, it cannot make more. But this does not mean you can’t improve how you feel and help prevent your arthritis from getting worse. Arthritis treatment focuses on strategies to help you manage your pain and keep moving, while slowing down (or even stopping) the progression of this condition.
Can I just take a pill?
Even with all the advances in modern technology and medicine, there is no cure-all pill for arthritis.
Some medications, like NSAIDs and pain relievers, can help control your pain from time to time—especially if you are experiencing a flare-up. But the risks of taking these pills long-term often outweighs the benefits. Chronic NSAID use, for example, can increase risk of ulcers, kidney disease, stroke, high blood pressure, and heart failure (Marcum, 2010). And long-term opioid use is linked to serious problems of addiction, overdose, and death (CDC, 2021).
There are medications that help control arthritis by keeping your immune system in check (you may have seen them advertised on commercials), but these are only for auto-immune joint diseases, like RA. “I commonly get asked by patients if these medications will help ,” says Jim Fiechtl, MD, a sports medicine physician at Vori. “Unfortunately, those medications don’t help OA, which is also, unfortunately, the most common type of arthritis.”
So, what can I do to stop my arthritis from getting worse?
You may not be able to eliminate arthritis, but you can help slow its progression. Here are two key ways:
Maintain a healthy weight and eat well
A healthy weight goes a long way to lessen the burden of arthritis—for every one pound of weight you lose, there is a four pound reduction in load on your knee (CDC, 2021). That means losing 10 pounds will feel like a 40-pound weight lifted off of your joints!
Plus, the benefits of losing weight go beyond just lightening your load. Research shows that with obesity the body produces high levels of chemicals that can worsen inflammation and a range of problems from diabetes to arthritis. Losing weight not only lessens physical stress on your body, but can also help quiet inflammation and improve these conditions (Coonce, 2013).
Even if you don’t need to lose weight, simple diet changes may help lessen your pain. Certain foods, like saturated fats found in fried and highly-processed packaged goods, can worsen your pain while others, like one-half cup of blueberries, can improve it. Team up with a nutritionist or health coach to learn which anti-inflammatory foods to add to your grocery cart and which items to avoid entirely.
Although your initial instinct with pain may be to stay put, you should really stay active! Physical activity is proven to be a safe and effective way to relieve arthritic pain. As our physical therapy team often says: “Motion is lotion!”
Partner with a physical therapist to learn how to strengthen, stabilize, and protect your joints—with virtual physical therapy, you can do this all conveniently from the comfort of your own home. Low impact activities like walking, biking, and swimming are also smart options that get you going without stressing arthritic joints.
Will I need joint replacement surgery?
There is no definitive answer to this question nor a “right” time for a joint replacement—this decision is dependent upon a number of factors, including your overall quality of life.
As a general rule, surgery should be your last ditch attempt to treat a sore arthritic joint, after all other treatments have failed. If your symptoms prevent you from doing most of your normal activities despite trying non-surgical treatments like physical therapy, diet modifications, and weight management, surgery may be indicated. Your age and overall health factor heavily into this decision as well.
If surgery is indicated, several options are available, including partial and total joint replacements. If you do need surgery, it is important to start making smart choices now—like optimizing your diet, sleep, and weight. “The better you are going into surgery, the better you will be after,” says Dr. Fiechtl. Talk with your medical provider or learn more about surgery prep programs that can set yourself up for success.
We’re here to help
Talk to your medical provider or the collaborative care team at Vori about important lifestyle changes you can make to stop your arthritis from getting worse. With coping strategies, healthy weight loss programs, convenient virtual physical therapy, and more, learn how we can help you take control of this condition and get back to doing the things you love.