Great arthritis article

Slow the 'train to more pain' of arthritis By Nanci Hellmich, @nancihellmich, USA TODAY

When it comes to arthritis, patients often are quick to describe their pain -- everything from a constant dull ache to sharp pain in their knees, hips, fingers or back. Some people are in such pain they can't sleep at night and have trouble getting out of bed in the morning, says C. Thomas Vangsness, a professor of orthopedic surgery and chief of sports medicine at the University of Southern California's Keck School of Medicine. Others suffer less. Still, many people with arthritis are "on a slow train to more pain," but there are ways to reduce it, says Vangsness, author of The New Science of Overcoming Arthritis, written with Greg Ptacek. Almost 54 million adults in the USA report having doctor-diagnosed arthritis now, and by 2030, an estimated 67 million Americans will have it, the Centers for Disease Control and Prevention says. Arthritis includes more than 100 different rheumatic diseases and conditions, but the most common is osteoarthritis. Other forms of arthritis that occur often are rheumatoid arthritis, lupus, fibromyalgia and gout, the CDC says. Arthritis is the most common cause of disability among adults, the government says. "Osteoarthritis is a huge public health problem that's going to grow considerably in the next 20 years because of obesity, lack of physical activity, the aging population and injuries," says rheumatologist Patience White, a spokeswoman for the Arthritis Foundation. It is a chronic condition characterized by a breakdown of the joint's cartilage, she says. Cartilage is the part of the joint that cushions the ends of the bones and allows easy movement. The breakdown of cartilage causes the bones to rub against one another, causing stiffness, pain and loss of movement in the joint, the foundation says. The causes of osteoarthritis are not completely understood, but many factors play a role including age, obesity, injury or overuse, genetics and heredity and muscle weakness, the group says. For instance, increased body weight, which adds stress to lower-body joints, is a well-established factor in the development of osteoarthritis. Your knees, which carry the brunt of your weight, are particularly at risk. For every pound you gain, you add 4 pounds of pressure on your knees and six times the pressure on your hips. "There's a lot data that show that weight loss and physical activity improve pain and slow the progression of osteoarthritis," White says. Vangsness adds: "For many of my patients, if they lose 10 to 20 pounds, the pain from arthritis decreases. Exercise makes your muscles stronger, so they can absorb some of the force on joints in your hips and knees. The muscles act like shock absorbers. He recommends swimming or riding a stationary bike or a recumbent stationary bike, because those exercises put less force on the joints. He also suggests that patients join a health club where they'll have access to weight-training equipment and professional advice on how to get stronger and healthier. Walking is a great exercise for many patients, White says. A range of over-the-counter and prescription drugs is available to relieve the pain and inflammation associated with cartilage degeneration, Vangsness says. Acetaminophen (Tylenol) is a good one. It offers the advantage of pain relief while being gentle on the stomach, but it doesn't do anything for inflammation, he says. Medications such as ibuprofen (Advil, Motrin), naproxen (Aleve), aspirin (Bayer, Bufferin) and COX-2 inhibitors (Celebrex) offer the advantage of relieving both pain and inflammation. They are great medications, but they can cause side effects such as stomach pain, Vangsness says. When it comes to surgery, getting the right diagnosis for your condition is imperative, because it will determine not only which procedure is best but whether surgery is even necessary, he says