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Our seals take a lot of abuse over the years.
That's one reason to half of Americans over 65 have osteoarthritis, when the protective cartilage on the ends of bones wears down. This causes pain and stiffness in areas such as the knees, hips and hands, which can make walking, climbing stairs, brushing your teeth and even fatping a doorknob or pen challenging.
Because there is no cure, easing pain is key. But Pei Chen, associate medical director at the UCSF Center for Geriatric Care. And potentially addictive drugs such as opioids are sometimes used. Fortunately, nondrug works for many people, with virtually no side effects.
Manage your weight
If you're overweight, shedding a few pounds (say, five to 10) can help with bread and function. More is better: In a 2018 study in Arthritis Care & Research, people who lost 10 percent of their body weight drop to 50 percent.
What you can do also makes a difference, says Dominic King, an orthopedic surgeon at the Cleveland Clinic. A diet rich in fatty fish, healthy fats, fruits, green leafy veggies and nuts may help relieve some of the inflammation associated with arthritis.
Stay active
Exercise may seem like it would cause more bread, but research suggests otherwise.
A 2015 review of 54 studies found that an exercise program was effective in easing pain and improving function as a nonsteroidal anti-inflammatory drug (NSAID).
The U.S. government advises 150 weekly minutes of moderate activity (walking, cycling, swimming), plus muscle-strengthening twice a week. Tai chi gentle gold yoga can help. Even chair yoga was found in a 2017 study in the Journal of the American Geriatrics Society.
How to start? "If someone's never really exercised before, I'll send them first to physical therapy to make sure they're using proper techniques," says Joseph Herrera, chair of rehabilitation medicine at Mount Sinai Health System in New York. "If they are already active, I'll print out a homework program for them to try first to see if it can help."
If you've been exercising for a few weeks without pain, you can benefit from physical therapy.
"If you can strengthen the muscles around an arthritic joint through physical exercise and physical therapy," says NYU orthopedic specialist Claudette Lajam, a spokesperson for the American Academy of Orthopedic Surgeons.
Use meds with care
For severe pain, your doctor may suggest an over-the-counter (OTC) pain reliever, at least to get you through physical therapy. The NSAID naproxen (Aleve and Generic) was ranked most effective for osteoarthritis in a 2018 study in the Journal of the American Academy of Orthopedic Surgeons (JAAOS).
Purpose NSAIDs can cause gastrointestinal problems, including bleeding.
"I've found that my patients can not tolerate being on an NSAID for their stomach," Chen says. So, Chen suggests acetaminophen (Tylenol and generic).
Some doctors may recommend topical prescription creams for bread. These goals are out-of-pocket, and a recent study in the Annals of Internal Medicine found that they have no more benefit than a placebo.
Many people use opioids in the following joint surgery. OTC painkillers for osteoarthritis.
Be cautious with injections
Although steroid injections can improve inflammation and bread, they can damage the joint and cartilage, Herrera says. Injections of hyaluronic acid in the knee joint are thought to act like a lubricant. Aimed at 2018 study in JAAOS found they were not helpful.
In injections of platelet-rich plasma, platelets are extracted from your blood and injected into an affected joint. A 2016 review of six studies in the journal Arthroscopy found that people reported significant pain relief up to 12 months after injection, compared with those given hyaluronic acid. But this experimental treatment can be costly and typically not covered by insurance.
See surgery as a last resort
Some orthopedic surgeons recommend arthroscopy – a tiny camera inserted into your knee allows a doctor to repair cartilage tears and remove cartilage fragments – goal research shows that it 's better than exercise therapy. As a result, an international panel of experts recommended against it in 2017.
When it comes to knee or hip replacement, "the best candidates are people who have already had several treatments, are already at a healthy weight, and feel their quality of life. "King says.
If you decide on it, look for a surgeon who does not have a knee or a hip replacement with a complication rate of 3 percent or lower, and a hospital that less than 1 percent.
Give water workouts a try
Too achy to exercise? "Herrera says," because it puts pressure on joints. And it works: A 2016 study published in the Journal of Rheumatology found that seduced people with osteoarthritis who swam for 45 weeks.
Vary your strokes to exercise all your joints and muscles. Although swimming is a good water workout, you can also opt for an aquatic fitness class. Many aquatic centers and YMCAs offer classes geared to people with arthritis.
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