None of us look forward to getting older and those who are used to an active lifestyle dread being told that their bodies are starting to wear down. After all the years of punishing ourselves at work, on the ski hill, in the mountains, or in a rink or gym to keep our bodies healthy we can encounter the aches and pains of arthritis.

Osteoarthritis or OA is a natural change in our bodies as we age; unfortunately in some this process comes before we are quite ready to admit it or deal with it. 

OA was originally believed to be due to the stresses and loads that were applied to our joints over our lifetime. Although this is still accurate we can also blame our aches on our parents due to a genetic trend in how our bodies age. Roughly 60 per cent of OA is of a genetic origin predisposing some of us with a higher risk to develop OA. So chances are if you have a family history of back pain, bad knees and hips then you may be more likely to encounter similar signs and symptoms as you age. 

As we age the water content in the joint and cartilage decreases resulting in a loss of proteoglycans (a protein in the cartilage that protects it from fraying). The cartilage is now less resilient and less protected resulting in degeneration. Inflammation of the joint can worsen the degenerative process and contributes to the pain felt by those suffering with OA. Although the inflammation is mild compared to Rheumatoid Arthritis, it is still sufficient to deter people from keeping active. 

So what do you do to battle OA, minimize your pain and stay functioning? Most people suffering from OA will use medications such as anti-inflammitories, pain killers and analgesics to decrease their aches and pains. Over the counter medications such as ibuprofen and acetaminophen will help with mild cases but as the OA becomes more severe patients will often look to more effective medications and higher dosages of the anti-inflammitories and pain killers. Please consult your doctor or pharmacist for questions about medications for OA. 

There have been numerous research studies to support physical therapy and specific exercise programs to increase quality of life, decrease pain, and increase function. Research has shown that physical therapy and exercise is more effective than surgery for OA of the knee. 

Surgical intervention is the last straw for most patients due to the risks involved with any surgery. A study from the New England Journal of Medicine in 2002 has shown that arthroscopic surgery for OA of the knee is no more beneficial than a placebo. Arthroplastic surgeries to replace hip and knee joints however have shown very positive results with long term pain and return to function in those with very serious cases. The replacement of the joint surfaces eliminates the cause of pain and most patients recover and return to function in a period of three to six months. 

Those seeking alternative forms of treatment may look to acupuncture and glucosamine for some relief. Glucosamine sulphate was shown to be of benefit to those with OA but apparently glucosamine hydrochloride is not. The systematic review of journals also suggested acupuncture to be a statistically significant benefit although the authors were unsure if this would be of clinical benefit to the patient. 

If you are just heading down the road of aches and pains and have some of the early signs of OA then you should be proactive and discuss your condition with your health care provider. Pharmacists and doctors are great sources for learning about glucosamine, proper medication and dosages needed to be effective. Your physical therapist will discuss lifestyle modifications, proper exercises and activities, and can provide treatment through flare-ups to get you back to your lifestyle quicker.  

Sean FitzGerald MScPT