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I have always been pretty active – so when I injured my knee doing a Shine dance class and then again playing pickleball it was frustrating. I went to the doctor, and the diagnosis was arthritis. I have spent months doing physical therapy and working to rehab it – but I continue to be dogged with knee pain. It is significantly better – I have been able to go back to Shine – but running and squatting continue to be a challenge. Here are some things I have learned on this journey.

There are many types of arthritis but the two most common are Osteoarthritis and Rheumatoid Arthritis. We are talking about Osteoarthritis (OA) here. Rheumatoid Arthritis is an autoimmune disorder that can impact people of any age. Osteoarthritis is the “wear and tear” arthritis that we associate with aging (although it can affect younger people too) and it affects over 32.5 million adults in the United States. The Arthritis Foundation has lots of great info about OA including the following about symptoms and risk factors.

The symptoms of OA tend to show up gradually and can include:

• Pain or aching in a joint during activity, after long activity or at the end of the day.
• Joint stiffness usually occurs first thing in the morning or after resting.
• Limited range of motion that may go away after movement.
• Clicking or popping sound when a joint bends.
• Swelling around a joint.
• Muscle weakness around the joint.
• Joint instability or buckling (as when a knee gives out).

OA may affect different parts of the body in different ways.

• Hips. Pain in the groin area or buttocks and sometimes on the inside of the knee or thigh.
• Knees. A “grating” or “scraping” feeling when moving the knee. 
• Fingers. Bony growths (spurs) at the edge of joints can cause fingers to become swollen, tender and red, sometimes with pain at the base of the thumb.
• Feet. Pain and tenderness in the big toe, with possible swelling in the ankles or toes.

Risk factors for OA include:

• Age. The risk of developing OA increases with age and symptoms generally, but not always, appear in people over 50. 
• Joint injury. A bone fracture or cartilage or ligament tear can lead to OA, sometimes more quickly than in cases where there is not an obvious injury.
• Overuse. Using the same joints over and over in a job or sport can result in OA.
• Obesity. Excess weight adds stress and pressure on a joint, plus fat cells promote inflammation.
• Musculoskeletal abnormalities. Malalignment of bone or joint structures can contribute to faster development of OA.
• Weak muscles. If muscles don’t provide adequate joint support, poor alignment can result, which can lead to OA.
• Genetics. People with family members who have OA are more likely to develop it.
• Gender. Women are more likely to develop OA than men.

Understanding the risk factors can help us do things to mitigate the development of OA – but you can’t fix age, gender, injuries or genetics – so DO get help. 

For me, working with a physical therapist to increase muscle strength through my hips and legs has helped me get back to doing things I love. Exercise is an important tool in the OA treatment plan. Arthritis.org recommends at least 150 minutes of exercise per week. It should include strength training, flexibility, cardio and balance exercises. Sometimes it is tempting to prioritize more urgent things over exercise – but I won’t be able to take care of those urgent things eventually if I let the OA continue to progress. So, an important part of taking care of myself has become building exercise into my day most days of the week.

I have always struggled with maintaining a healthy weight. The conventional wisdom is that excess weight puts more pressure and strain on joints. However, I was surprised to learn that the incidence of OA in the hands is twice as high among obese individuals as it is in leaner people. There are several ways that obesity contributes to OA risk. In addition to the extra weight causing extra stress on joints, high glucose can make cartilage stiffer and more likely to break down. Fat is chemically active and releases inflammation causing proteins. Losing weight has been shown to reduce pain and inflammation. This is another motivation to get my weight under control – stay tuned! 

Although these non-drug therapies can be helpful, many people find more immediate relief from medications. Over the counter options that have been helpful to me include acetaminophen, ibuprofen, naproxen sodium and aspercreme gel. Many people also find relief from prescription medications and corticosteroid shots in the joints. 

Although OA presents challenges, it doesn’t have to define your life. You can take proactive steps to manage arthritis effectively. It may take some experimentation and patience to find what will help you, but staying informed, active and resilient will help you maintain that fulfilling lifestyle we all want. We’ve got this!!