Timothy E. Kremchek, MD
Orthopaedic Surgeon - Beacon Orthopaedics and Sports Medicine
Cincinnati, Ohio
Background
Osteoarthritis acts differently in men and women
Managing symptoms
The painful joint disease commonly referred to as osteoarthritis is also called "oseteoarthrosis", "arthrosis", and "degenerative joint disease"
Osteoarthritis is a degenerative process that occurs with the aging process. Osteoarthritis differs from rheumatoid arthritis, a condition which is hereditary and affects the whole body. Traumatic arthritis is a third form of the disease and occurs after individual or repeated traumatic injury.
What changes occur when osteoarthritis strikes?
Cartilage in joints progressively roughens and becomes thin
Bone underneath the cartilage thickens
Bone at the edge of the joint grows outwards creating bony spurs
Synovium, the lining of the joint, swells slightly and may produce additional fluid causing joints to swell. Our body produces extra synovium as a response to arthritis. The extra fluid serves as a lubricant intended to ease movement.
Capsule and ligaments slowly thicken and contract in an attempt to stabilize the joint
Muscles that move with the joint may weaken and become thin and atrophied. As the joint becomes more arthritic and swollen, pain can increase causing decreased use of the joint and resulting diminished use of related muscles. Muscles can atrophy, movement decreases, pain increases and a viscous cycle begins.Patients under the age of 40 rarely suffer from osteoarthritis. It usually begins to develop in patients between the ages of 45 and 60.
For several reasons, osteoarthritis occurs three times more frequently in women than in men. This increased frequency may in part be due to the types of foot ware favored by many women. Current studies indicate that high heels can cause an increase in knee problems.
Why? Shoes with heels greater than 2 inches tall force the foot into a supinated position in which the foot is rotated forcing that the outer edge of the sole to bear the body's weight. This position prevents the natural movement used to absorb shock as the heel strikes the ground. The knee is forced to absorb more shock than it is designed to accommodate. Wearing flat shoes allows for natural movement and disperses the shock from walking into the knee, hip, and low back.
Osteoarthritis acts differently in men and women:
In women it is generally associated with being overweight causing increased stress on joints, foot ware selection and foot type.
Osteoarthritis in men is generally associated with occupation and activity.
Osteoarthritis in the knees of women generally occurs in both knees.
Osteoarthritis in the knees of men generally occurs in just one knee.With current technology, early detection is hindered by the lack of specific and sensitive diagnostic tools.
Newer diagnostic technology:
One innovative technique involves using CTX-II (collagen type II: is almost exclusive to cartilage and is a major structural component of the tissue) as a marker in urine for cartilage degradation for earlier detection. CTX-II levels in urine are higher in people with osteoarthritis and rheumatoid Arthritis
Other signs of the disease include increased cartilage degradation during & after menopause. As women age and experience menopause, there is an increase in the prevalence of osteoarthritis. Women taking hormone replacement therapy have a lower prevalence of OA, specifically in the lower hip, than women not taking hormone replacement therapy.
If you suffer from osteoarthritis, reduce stress on joints by:
Achieving and maintaining your ideal weight
Spread you activities throughout the day
Wear shoes with thick soft soles for comfort and shock absorption
Use a walking stick for hikes and long walks
Keep moving your joints the motion is the lotion!The motion is the lotion: Exercise is the key component to manage weight and keep joints moving. Treatment can include exercise activity modification. High-impact activities such as running and jumping may be replaced with low-impact exercise including cycling, biking and using elliptical training machines.
Medications options include over-the-counter pain relievers like aspirin, ibuprofen and naproxen can be considered for symptom relief. Glucosamine and chondroitin sulfate supplements may offer some increased ease in movement.
Cortisone injections can also offer pain relief that does not respond to oral pain relieving therapies. Finally, patient may consider joint replacement in consultation with their physician.
Remember, there is no cure for osteoarthritis. Recognizing that you have arthritis is half the battle. Talk to your doctor about the numerous treatment options available to relieve pain and keep moving.
