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Is osteoarthritis inevitable?

Osteoarthritis affects millions of people. This most common form of arthritis occurs when the protective cartilage on the ends of your bones wears down over time. 

Lorraine Rapp and Linda Lowen, hosts of WRVO's health and wellness show, "Take Care," spoke to Dr. Robert Shmerling, a rheumatologist and Harvard professor, about whether everyone gets arthritis with age -- and what can be done about it.

Lorraine Rapp: You know, most of us don’t find it unusual to have a certain degree of stiffness or occasional aches and pains, as we’re aging especially. When does it cross over from being something that’s slightly annoying but nothing serious to actually being a diagnosis of osteoarthritis?

Dr. Shmerling: It’s kind of a universal experience of living that one might have aches and pains and a lot of those don’t come from osteoarthritis. They come from tendonitis or muscle strain. The diagnosis of osteoarthritis really comes along typically, as someone has symptoms, usually an older individual and it's usually something that affects their quality of life and their function. When activities of daily living, when sports or hobbies, when work is affected -- or if there is swelling in joint and motion is limited. Those are the sort of symptoms that would bring a patient to a doctor, where based on this history and based on the examination, x-rays would likely be performed and the diagnosis could be established.

Lorraine Rapp: So is it inevitable that we’re all going to get it to one degree or another as we age?

Dr. Shmerling: Yes and no. It’s probably inevitable in the sense that if you did x-rays of everyone who was 80 years old, if you did x-rays of their neck or of their hands, hips or knees, it’s very likely that you would see osteoarthritis. But it may not affect them to any significant extent. So there’s not a perfect correlation between x-rays and symptoms.

Linda Lowen: Can osteoarthritis be slowed down or prevented? What are the risk factors for it?

Dr. Shmerling: Well, the biggest risk factors that have been identified are obesity, especially for the weight-baring joints like hips and knees; genetics, which of course you can’t change, but inherited tendency to osteoarthritis is said to account for maybe half of osteoarthritis; injury and trauma; and age. so, probably the short answer to whether it can be prevented is mostly not, other than avoiding obesity, maintaining a healthy weight and avoiding injury.

Linda Lowen: When osteoarthritis can be medically treated. What is that treatment like?

Dr. Shmerling: Well, the medical treatments usually start with acetaminophen... anti-inflammatory medicine, like ibuprofen and naproxen... then there are stronger pain relievers, ranging from Tramadol to opiate or narcotic medications. By in large though, these are modestly beneficial. Frequently for patients with osteoarthritis, it sort of takes edge off, it’s somewhat helpful but it’s certainly no cure.

Lorraine Rapp: Is there anything new and exciting on the horizon that looks promising maybe that just hasn’t been approved yet?

Dr. Shmerling: There are some exciting research studies going on looking at agents that actually affect the biology of the joint that may affect cartilage health or bone health. These are medications that affect cytokines which are chemical messengers within the joint that may be playing a role in the deterioration of cartilage or of bone. We’re a ways away from seeing them in practice. And it’s been disappointing that for years we haven’t really had any kind of major breakthrough in the treatment of osteoarthritis. But I’m certainly still hopeful.