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Monday, Sept. 23, 2019

Managing Osteoarthritis

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The Importance of Movement and Balance

“Oh, my shoulder hurts!” “I keep dropping things and can’t seem to hold on anymore!” or “My knee just buckles on me!” If you have said these things or heard them from your family, there may be a reason for that problem: You may have arthritis!

There are more than 100 types of arthritis (joint diseases) that affect 53 million adults and 300,000 children in the U.S. By 2040, and it is expected to rise to 78 million adults. The most common type of arthritis, degenerative, occurs more in women (26%) than men (18%), and it is more frequently seen as people get older. Osteoarthritis (OA), or degenerative type, is the most common joint disorder in the United States and ranks as the leading cause of disability among adults.

There are many risk factors for degenerative arthritis that are not modifiable. Age is one of the strongest risk factors for OA, and it can involve multiple joints. Additionally, it is affected by various biologic changes that occur with aging, making the joint less able to cope with adversity. These changes include cartilage thinning, weak muscle strength, poor perception of where the joint is in space, and oxidative damage. Gender and hormone levels in women not only make them more likely to have OA than men, but they also have increased the severity of the disease. OA is also considered to have an inherited component, but much more information is needed for this to be clear. If one of your parents has OA, it would be wise to consider arthritis a possibility and consider exploring the modifiable risk factors. It is unclear if nutritional factors play a role in the incidence and progression of OA, with specific research being done on vitamins D and C. Overall, the risk factors for OA are multifactorial and include an interplay between systemic and local factors. Finally, the relative risk factors may vary for different joints, stages and progression of the disease.

A common risk factor seen locally is being obese or overweight, both of which are known to be potential risk factors for knee OA. Therefore, weight loss is associated with an improvement in pain and physical function. When an individual’s occupation is associated with the repetitive use of a particular joint, this can also serve as a risk factor for OA. For example, farmers have a high prevalence of hip OA. In mid-life, job activities such as carrying, kneeling or squatting are two times greater for knee OA in men. The male knee is also likely to suffer if a man is overweight or has a job that involves lifting. From an economic standpoint, almost two-thirds of adults in the U.S. with arthritis are of working age (18-64). Finally, arthritis is much more common among people who have other chronic conditions with heart disease (49%), diabetes (47%) and obesity (31%). Within the past 40-50 years, health-care providers waited to treat arthritis after it had done its damage. Now health-care providers prefer to treat early in the disease process since they have more options to minimize symptoms and to keep you functioning.

Common symptoms reported by those with OA include pain, stiffness, swelling and decreased range of motion. These symptoms may come and go, or they may be mild, moderate or severe. Over time they may get worse and cause some damage in the joint and affect your daily activities such as walking, stepping up a curb or standing to preparing your meals. Over time joints can lose strength and motion, making your daily function more challenging.

The good news is that many joint symptoms that are not severe can be managed with these suggestions:

• Balance your activity with rest

• Using heat or cold therapies

• Regular physical activity

• Maintaining a healthy weight

• Strengthening the muscles around the joint for added support

• Physical or occupational therapy for movement guidance and an exercise program

• Use an assistive device

• Avoid repetitive movements

• Check with your doctor about medications.

Remember, the more you understand your health issues, the better informed you are to make the best decisions! There are many options for activity in the community, including the Caddo Council on Aging, local gyms and churches, or just friends deciding to start working out together. The important message is to make good decisions and move!

The LSU Health Shreveport Physical Therapy Program in partnership with the Caddo Council on Aging sponsors spring and fall classes to the community on “balance” that is no cost to the participant to attend. Fall class dates are Sept. 17, Sept. 24, Oct. 1 and Oct. 8. For questions or to sign up, contact the Caddo Council on Aging at 318-676-7900.

RESOURCES: Arthritis Foundation (www.arthritis.org) and National Institute on Health

Paula Click Fenter, DHSc, PT, associate professor of physical therapy, LSU Health Shreveport, School of Allied Health Professions.

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