A seventy year old patient of mine insisted that Tylenol and Advil no longer relieved his knee pains. The formerly active man was starting to experience the symptoms of osteoarthritis—the degeneration of joint cartilage and the bone—and wanted something more so he could continue walking his dog and performing other parts of his lively routine.
There is no arguing whether a pain medicine works or not. However, there are different classes of pain medication. No one class works for everyone. It may even take a couple of months to identify find a combination of medications that works best for you.
If you have osteoarthritis, known as the "wear-and-tear arthritis," you have a condition that's not going away. This type of arthritis can affect any joint in the body, but most commonly affects knees, hips, low back, neck and hands. Regardless, your goal should be to keep doing those things you like to do. It is also important to recognize the necessity to make certain lifestyle changes in order to maintain function and control pain of osteoarthritis.
You can't change your genetics and it's hard to change your line of work, so it's important to work smart and get regular exercise in addition to the use of medications. Exercising three to four times per week increases endorphins, improves circulation and builds muscle tone around the joint. More muscle tone means less pain and a lower likelihood of falling. Find activities with low impact and irritation on the involved joint. You don't want to overdo it. Pushing through the pain can cause more damage to the joint.
An increased intake of vitamin D and calcium (about a glass of milk per day) can also help postpone progression of osteoarthritis. These tend to be good for bone health. Get adequate rest; more is often required when experiencing increased pain or fatigue. Losing some pounds if you're overweight can also ease the stress on your joints.
When you make an appointment with your health care provider, come equipped to get the most from your meeting.
- Pain is unique to the person. Therefore, be specific about your pains. Is the pain aching or stabbing? Where is it exactly? What medications have you taken so far?
- List all the ways the condition is limiting your daily life. Paint a picture of how the pain is interfering with your activities.
- Search the Internet! The web is a mixed bag of good and bad information, but an informed patient who asks a lot of questions will probably get more from the appointment.
Ask your health care provider about alternative treatments, which some people find beneficial. These may include counter irritants, non-steroidal creams, joint injections, opiod analgesics and acupuncture.
If pain gets so unbearable that joint replacement surgery seems unavoidable, a good target age is around 65. Osteoarthritis usually hasn't developed significantly enough to warrant surgery in people under 65 and people at this age are healthy enough to undergo surgery without complications.
The bottom line is to focus on relieving the pain and sticking within the realm of activities that don't agitate your osteoarthritis.
Dr. McNabb is a Family Physician at the Martinez Health Center.
Healthy Outlook is written by the professional staff of Contra Costa Health Services, the county health department. Send questions to series coordinator Dr. David Pepper at firstname.lastname@example.org. For more health information, go to www.cchealth.org.