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Osteoarthritis affects millions, but who's most at risk?


It may be common to have pain and stiffness in your joints -- especially as you age-- but what’s the difference between routine pain and a serious disease? This week on “Take Care,” we talk to Dr. Robert Shmerling about osteoarthritis, the most common form of arthritis, which affects millions of people. Shmerling an associate professor in medicine at Harvard Medical School, senior medical editor at Harvard Health Publications and associate physician and clinical chief of rheumatology at the Beth Israel Deaconess Medical Center.

Click 'Read More' to hear our interview with Dr. Shmerling.

So where is that line when it crosses over from a little pain to being osteoarthritis? Dr. Shmerling says that it can be subtle and hard to tell.

“It’s a universal experience of living that one might have aches and pains and lot of those don’t come from arthritis. They come from tendonitis or a muscle strain,” he said.

Osteoarthritis usually affects older people and has an effect on their quality of life, Dr. Shmerling said, adding that it can make sports and hobbies difficult and can limit a person’s motion. He said that is can also cause a swelling in joint areas.

Contrary to what many might think, overuse of a joint does not contribute to osteoarthritis, Dr. Shmerling said. In a study, elite and marathon runners were just as likely as everyone else to develop osteoarthritis in the hip and knee area. Dr. Shmerling did outline these risk factors that are often associated with osteoarthritis:

  • Obesity: this can cause some wear and tear on weight-bearing joints, like the hips and the knees
  • Genetics: Dr. Shmerling said that genetic predisposition accounts for about half of all osteoarthritis cases
  • Injury and trauma: if you break a bone that goes through a joint, or get surgery that requires the removal of loose pieces of cartilage, it can increase your risk of obtaining osteoarthritis
  • Age: Dr. Shmerling said age is one of the most important factors, as most cases of osteoarthritis are diagnosed to older people. In fact, he said, if you were to look at x-rays of all 80 year-olds, you’re bound to find some degree of osteoarthritis in everyone, but it won’t affect everyone to a severe extent and may not be systematic.

Dr. Shmerling said the only thing you can do to help avoid osteoarthritis is to maintain a healthy weight and avoid injury. He also said that there isn’t much of a cure. Pain relievers, from Tylenol to narcotics can help with symptoms, he added, but you should consult a rheumatologist when it comes to dealing with osteoarthritis. Dr. Shmerling said non-surgical options like acupuncture, massage and physical and occupation therapy can help as well. Glucosamine may also help, but if it doesn’t help after a month or two, Dr. Shmerling advises rethinking it.

While there isn’t a cure at the moment, Dr. Shmerling said he is hopeful. New research studies are being conducted that look at the agents that affect the biology of the joint and bone and cartilage health, which could help in the future.