Osteoarthritis In the Aging Athlete

By Daniel Redziniak, MD

Anne Arundel Medical Center

. http://www.aahs.org/

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Osteoarthritis In the Aging Athlete

Osteoarthritis (OA), or degenerative joint disease, is one of the most common medical problems for middle-aged people. The goal for treatment of OA is to control pain and minimize disability. It is important for patients to know about treatment options for OA and to work with their doctor to set realistic goals. This article reviews the most common forms of non-invasive treatment such as lifestyle modifications, physical therapy, bracing and support devices, medications, and injections.

Lifestyle Modifications

Losing weight decreases the risk of developing and aggravating OA, as obesity is a known risk factor. Moderate exercise can help reduce the decline in overall function that occurs as we age. This includes low impact activities such as swimming, rowing and bicycling. Choose an exercise that won’t put pressure on the joint between the kneecap and the femur, known as the patellofemoral joint. So avoid high-impact exercises like jumping, running, climbing stairs and squatting.

Physical Therapy

Cross training and flexibility are important components of a complete rehabilitation program. Improving muscle strength and the range of motion of an osteoarthritic joint has been shown to increase mobility and ease pain. Heat, ultrasound, hydrotherapy and cryotherapy (icing) are also effective in reducing the pain associated with OA.

Bracing and Support Devices

Simple joint sleeves and braces have been shown to relieve knee pain and provide a sense of stability. Patients with unicompartmental arthritis can be fitted with an “unloader” brace. These are effective in patients who have arthritis confined to the medial compartment. Using a cane in the opposite hand is an effective way to reduce symptoms by relieving force on the lower arthritic joints.

Medications

Nonsteroidal Anti-Inflammatory Medications, or NSAIDs, are the preferred oral medication for the treatment of swollen and painful arthritic knees due to their pain relieving and anti-inflammatory properties.

Acetaminophen is a great option for pain relief, as it is less likely to irritate the stomach lining than NSAIDs. However, it lacks the anti-inflammatory action of NSAIDs. Patients should inquire about routine lab work if they will be on acetaminophen for the long-term.

As with all medications, patients should talk to their doctors about the right course and dosage for their specific needs.

Injections

Corticosteroids

Corticosteroid injections are helpful in patients that have not gotten relief from anti-inflammatory therapy or oral medications. Injected directly into the joint, it is a potent anti-inflammatory agent with low risk of side effects. Injections provide variable relief, lasting from a few days to six months or more.

Viscosupplementation

Injectable hyaluronic acid, or “viscosupplementation,” is available as a series of injections for treatment of symptomatic OA. Hyaluronic acid is a naturally occurring substance found in joint fluid. These injections supplement its reduced concentration in OA patients. It acts as a lubricant to enable bones to move smoothly over each other and as a shock absorber for joint loads. These injections provide variable relief, lasting an average of six months to one year.

Dr. Redziniak is a member of The Orthopedic and Sports Medicine Center, which has offices in Annapolis, Bowie and Millersville. You are invited to meet him and other sports medicine and orthopedics experts at the March 29 docsTALK, “Stay in the Game.”