With Yvonne J. Braver, MD
The Cleveland Clinic Women's Health Center
Aching bones and joints due to osteoarthritis occur earlier and are more severe in women than in men. Typically there is pain in one or only a few joints, sometimes with inflammation and maybe a gritty or grinding sensation. Morning stiffness that lasts less than 30 minutes and improves with some activity or improves with a warm shower is often seen with osteoarthritis. Pain may be increased by mild to moderate physical activity. Besides being female, risk for osteoarthritis is increased by excess weight, age, injury and mechanical stress.
Maintaining a healthy body weight is the single most important thing a woman can do to prevent or control the symptoms of osteoarthritis. Excess weight throws off the normal body alignment and each pound is transferred as mechanical stress to the aching spine, hips, knees and ankles. Your doctor can usually diagnose osteoarthritis based on history, symptoms and physical findings, but may consider x-rays or blood work if another diagnosis is suspected. Vitamin D is very important for bone, joint and muscle health. Many persons living in northern climates are vitamin D deficient. The new vitamin D recommendations from the National Osteoporosis Foundation is 800-1,000 iu of vitamin D3 (cholecalciferol) daily.
The most important treatment goals for persons with osteoarthritis are maintaining normal function and quality of life. It may be necessary to modify activities that increase their pain and consider ways to reduce aggravation and inflammation of injured joints. Choose low impact exercises approved by the Arthritis Foundation
. Your doctor may recommend physical therapy to help control the symptoms and disability associated with osteoarthritis. Supplemental Vitamin D helps to prevent the bone loss that comes with age, and even stabilizes muscles and joints to help prevent falls.A bag of ice or a heating pad is a very safe and inexpensive alternative for reducing joint pain. Over the counter creams like aspirin cream or capsaicin cream (consider the roll-on or stick formula) can be applied directly to the aching joint to provide some relief without pills. Medications that control symptoms include the nonsteroidal anti-inflammatory drugs like aspirin, ibuprofen, and naproxen. Acetaminophen can also control pain. Discuss any new medications, even over the counter medications and supplements, with your doctor because of possible interactions with prescription medications or impact on the stomach, kidneys and blood pressure. Depending on how severely the joint is affected, your doctor may recommend a steroid or sodium hyaluronate injection. Some, but not all, clinical studies suggest that the supplement, Glucosamine may be beneficial for some people with arthritis pain. It is generlly considered safe, (in the absence of shell fish allergy) and may be worth trying for at least 2 months to see if mild to moderate arthritis pain improves. When conservative measures fail and your activities of daily life are severely impacted by pain, it’s time to discuss joint replacement with your doctor. Joint replacements, that have been designed just for female joints, are now available.
The good news is that many symptoms of osteoarthitis can be prevented and controlled with life style changes, weight control and low impact exercise and good nutrition Treatment of pain and stiffness, should start with the simplest and safest measures first like ice, heat and topical creams. Work closely with your doctor to determine the best treatment for you.
