If Your Joints Ache, Read This

If you feel aching and tightness in your joints after a period of inactivity, such as sitting for a long time, you may have osteoarthritis. And if you have those same pains after vigorous activity, such as a bike ride, you also may have osteoarthritis.

Sometimes called wear-and-tear arthritis, osteoarthritis is the most common type of arthritis. Millions of people worldwide have it, but there is treatment that can ease the pain.

Read on for answers to common questions about osteoarthritis.

What causes osteoarthritis?

Articular cartilage is the smooth, white tissue that covers the ends of your bones where they come together to form joints.

“This cartilage is essentially the shock absorber of the joint,” says UNC Health sports medicine specialist Lauren Porras, MD.

Over time, that cartilage can wear down, resulting in osteoarthritis.  Although osteoarthritis can damage any joint, it most commonly affects the knees, hands and hips.

Who is at risk for osteoarthritis?

Obesity is the biggest risk factor for developing osteoarthritis, Dr. Porras says. “With more weight, there is more force through the joint.”

Lack of physical activity is also a significant contributor.

“You want to stay active, and you want to exercise, because if you’re less active, the joints tend to stiffen up and become more painful,” Dr. Porras says.

While anyone can get osteoarthritis, it’s more likely after age 40 and in women.

“At some time in their life, at least 45 percent of women have osteoarthritis of the knee,” Dr. Porras says. Osteoarthritis in the hands tends to occur at a younger age, while osteoarthritis in the hips occurs much later, usually around age 80.

Injuries to the joint also can cause osteoarthritis. Construction workers and roofers, or anyone who works with heavy equipment, tend to be more likely to develop it.

Genetics play a role, too.

“Some people will have a genetic predisposition in terms of whether or not their joints will wear down over time,” Dr. Porras says.

What are symptoms of osteoarthritis?

The most predominant symptom of osteoarthritis is pain; swelling is also common. You may experience stiffness in the joints, particularly first thing in the morning when you get out of bed.

“A lot of times people with osteoarthritis have a feeling of instability—like they can’t trust the joint—that it’s going to give out,” Dr. Porras says.

How do you treat osteoarthritis?

If you experience regular joint pain, over-the-counter pain medication such as Tylenol can help. For knee or hand pain, try an anti-inflammatory, over-the-counter topical gel called Voltaren, Dr. Porras says.

If your pain persists, a knee or hand brace might be helpful. Losing weight can bring relief; Dr. Porras suggests low-impact exercise such as water aerobics or swimming. Cycling and elliptical machines are good options, too.

Depending on the severity of your symptoms, you may need to see a doctor for an injection. Your first option is a cortisone (steroid) injection into the joint.

“It calms down the pain and inflammation associated with the arthritis, and that lasts about three to four months,” Dr. Porras says.

If that brings relief, you can repeat the injection when the pain returns. For the larger joints, particularly the knees, another option is a shot that contains hyaluronic acid, which helps lubricate the joint and prevents friction and rubbing in the area. Relief after this type of shot typically lasts about six months, Dr. Porras says.

If those injections do not work, orthobiologic treatments—made from substances in the body—may be an option. “These are treatments that involve using your own cells to help promote healing in the joint,” Dr. Porras says.

Orthobiologic treatments include PRP (platelet-rich plasma), amniotic membrane injections and stem cell-like injections from your own cells.

“All of these treatments are designed to decrease the inflammation and induce some regeneration in the joints, which is really exciting,” Dr. Porras says.

Orthobiologic treatments tend to last much longer than cortisone and hyaluronic acid injections. Unfortunately, they are not covered by insurance.

Finally, if you continue to have pain and injections don’t help or you no longer have any cartilage, you would be a candidate for joint replacement surgery, in which parts of your joint are removed and replaced with a metal, plastic or ceramic prosthesis.

Have pain in your joints? Talk to your doctor or find one near you.