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Cody Church Susan Ingram English 1103-036 1 November 2012

The Solutions for Osteoarthritis

Are you of age 65 or older? Do you play sports and have sustained an injury in the past? Do parts of your body become inflamed and swollen especially in the morning? If you answered yes to any of these questions then you might be one of the millions of Americans living with osteoarthritis. Overall OA affects 13.9% of adults aged 25 and older and 33.6% (12.4 million) of those 65+; an estimated 26.9 million US adults in 2005 up from 21 million in 1990 (CDC). Osteoarthritis is the most common form of arthritis. It is a disease that affects the joint in your body and causes them to decay, causing your cartilage to deteriorate which leaves no cushion to stop bone rubbing against bone. This can cause immense pain that only gets greater as the disease progresses and surprisingly can lead to death. About 500 people each year die from osteoarthritis, not necessarily the disease itself but by a factor associated by having the disease. Possible explanations for the excess mortality include reduced levels of physical activity among persons with osteoarthritis due to involvement of lower limb joints and presence of comorbid conditions, as well as adverse effects of medications used to treat symptomatic osteoarthritis, particularly non-steroidal anti-inflammatory drugs (PubMed). So to say the least, anyone can get it and it has greatly affected the lives of the people living with the disease.

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So how do you know if you have the disease? The questions you have already read above can give you some hints. As you get older your risk for developing the disease will increase and with people living longer than ever the number of people with the disease is expected to skyrocket in the next few years. By 2030, a projected 67 million people will have doctor-diagnosed arthritis (NIAMS). Common symptoms are pain, swelling, and stiffness. It can also cause other psychological symptoms such as depression, anxiety, and feelings of helplessness. As a person who has this disease myself it can be very frustrating because one day no one would ever know you have it and the next youre in such pain that you just want to stay in your bed. Your joint feels like it goes numb and the pain usually leads to the depressive state. In my opinion this is the worst because the people around you wont understand and when Im in this state I try to avoid human contact so I dont bring others down or get them angry at me because like I said they dont understand. The best way to check to see if you have the disease is to go to your doctor as they can tell you for certain as well as the amount of progression you have. If you do have it there are ways to fight it and slow the progression so that it never gets to the point where it restricts you from physical activity or forces you to have surgery. You have the option to seek medical care or fix it on your own through natural remedies, but which one is better to do? Most people would probably go for the medical care because they want a doctors opinion; after all they did go to medical school for it and have more knowledge than your average Joe. The only problem with this is it can be very expensive and you may not be getting the heath care you are looking for. Osteoarthritis raises total health care costs in the United States by $186 billion each year, according to new research stressing the importance of improved awareness and screening for this painful form of arthritis (Spine Health). With this substantial

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amount of money being paid you may expect to be getting top dollar medical care. It is true that we see doctors all the time for just about anything and they are smart and rarely make a mistake, but when they do it can be costly. Misdiagnosis is one of the most common medical errors, occurring about fifteen percent of the time, according to autopsy studies. And it can have dire consequences, leading to unnecessary or delayed treatments and physical and emotional suffering (Arthritis Today). One of the ways for your doctor to check if you have osteoarthritis is to look for antibodies that pop up in response to the disease, but the problem with this is it is a false test more of the time than it should be (Arthritis Today). Frances Muller, who has been living with the disease for decades, went for twenty years without being properly diagnosed (Arthritis Today). Mrs. Muller went to fourteen different doctors before being diagnosed with the disease. In Mullers case, for example, over the years, more than one doctor suspected RA and ordered blood tests to look for tell-tale rheumatoid factor and anti-CCP antibodies that sometimes signal the disease. But the tests all came back negative as they do in up to 30 percent of people with RA (Arthritis Today). The same tests that are used for rheumatoid arthritis are also used for osteoarthritis. Other ways may be to do X-rays to see bone or cartilage damage. They may even consider clinical history and physical examinations. If you can make it through the diagnosis with a defiant answer then you can move on to the next step into treatment which is the medications. One of the first medications your doctor may prescribe is acetaminophen which is just another form of Tylenol. It is only used for pain relief and doesnt help with the inflammation. It can also cause liver damage if taken more than prescribed. Another form of medication to think about if acetaminophen isnt working is NSAIDS which are non-steroidal antiinflammatory drugs such as ibuprofen. These drugs have steeper side effects than the one before

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with the risks of stomach bleeding and kidney damage if taken to long. About 30 to 40 percent of people who take NSAIDs regularly stop doing so because of the side effects (Everyday Health). The doctor may also prescribe prescription strength NSAIDS such as Cyclooxygenase2 inhibitors that take away the stomach problems but do have increased risk of heart attack and stroke (Everyday Health). If none of these things work then you will have to go to heaver medications usually only associated with the most advanced stages of osteoarthritis. The most known about drug they may prescribe is opioids which is made from the same thing as opium. These drugs have many side effects and can become addictive, but it is important to know that if taken as prescribed people rarely becomes addicted to them. Another route is corticosteroid injections which are injected into the site of pain and they really work to get rid of even the most painful aches, but the problem with this treatment is it only lasts for one or two weeks. It is only meant to temporarily get rid of the pain. It is important to remember that most of the deaths associated with osteoarthritis are from medications as stated before. The option when nothing else works is surgery. You will only have surgery if you meet the qualifications such as severe pain and are unable to have full use of a joint. To have surgery you also have to be in good standing which is another way of saying that your health is good enough to handle the stress of surgery. You have to be in good mental health and you cant be obese, so the bad thing here is even if you need surgery you may not be able to get it with a health ailment or your body weight and even if you can have surgery its expensive. In 1997 the estimated cost of knee and hip replacement was 7.9 billion (CDC). The downside to this option as you can see is that is in no way cheap. There are several different types of surgery. Arthroscopy is a surgery that cleans out bone fragments that in theory causes pain. There is not any conclusive evidence if this surgery even helps its patients and is still debated today.

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Research and debate continues on whether arthroscopy provides true benefits for those with osteoarthritis and, if so, which patients may benefit the most from it (NY Times). The next type is joint replacement which is highly successful with the patients usually doing better and the implants now last longer than ever which is about fifteen to twenty years. Younger patients usually dont go this route because they will need to do it multiple times because it wears out. It is important to know that the level of mobility you get with the new joint is determined by how active you are after surgery which can mean that an inactive person may have just wasted money because it wont help at all. Rehab usually takes six weeks. There are some limitations with this surgery like with hip replacements the patient is no longer able to run and in knee replacements only eighty percent of patients are able to walk better. Even though this surgery is impressive there are still chances of complications such as infections and blood clots which can be life threatening. The other form of treatment is self-imposed. If you are one of those people who doesnt like taking a pill or paying for surgery then you might be up to trying an alternative lifestyle. You can help your arthritis own your own with proper diet, exercise, and even some alternative medicines. The first thing to know when doing this is know what youre doing because there are treatments out there that dont work like bee stings. They say that if you let a bee sting you that it helps your osteoarthritis but there is no conclusive evidence that this works and in fact it can endanger your health if you have allergic reactions to the poison. So I say to you knowledge I the key to this form of treatment. It is true that doctors recommend that you do these things but sense its you who does them they really arent considered medical care which is why they are in separate categories.

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The first thing is staying active because the more you just sit around the more the disease will keep you sitting down. Strengthening exercises are good because you build up the muscles around your joints which provide greater support. I can attest to this because when I was at home just sitting in my room my arthritis would flare up several times a month, but since I moved to college I and walk to class every day I may have one flare up a month and some morning stiffness but that is as bad as it has got so far and Ive been here for over two months. Range of motion is important as well. It is what keeps your joints flexible and mobile so practice stretching as much as possible and after a while add weighs in with you stretching to promote even more strength building. Proper diet is important too because the more you weight the more pressure you are putting on your joints. A study published in 1963 indicated that patients with osteoarthritis average fifteen pounds above their recommended weight limit (Taking Control of Arthritis). In fact obesity is a cause of osteoarthritis as the extra pressure slowly helps wear down you joints. As for the diet you should consume Vitamin C, D, and calcium as these things can help build and keep strong bones and joints. The bad thing with this is that there is no one diet that is universal and some people could be eating the wrong types of food for them. Using a common sense approach to food is the best defense against the legions of special arthritis diets promoted in clever books and magazine articles (Understanding Arthritis). Yoga can be just as important with studies showing that over time yoga can get a patient greater range of motion and strengthen the joints. A study showed that people struggling with hand osteoarthritis gained significant strength and flexion back as long as they kept up the hard work (Alternative Treatments for Arthritis). There are currently 3.1 million adults in the United states undergoing acupuncture treatments and are likely doing so to treat their arthritis

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(Alternative Treatments for Arthritis). Acupuncture is a treatment that involves sticking needles or pins into the skin at certain pressure points to help your bodys natural energy travel easier. Doctors have performed a number of small studies to see if acupuncture really helps and they found that it does for very few and even then it is not significant enough to say that it will definitely help (Alternative Treatments for Arthritis). Another form of treatment could also be massage therapy which works by relieving tensions in the muscles which in turn releases stress from the joints. The final step for self-help is knowing how to properly help yourself by recognizing what works for you and being safe with you activities. There are a bunch of phony claims about random drugs that can cause serious side effects over time and make you condition worse so talk with your doctor before taking anything new. The so called metal bracelets that you wear have no effect unless its a placebo effect youre talking about so dont be fooled. Another device promoted in the 1950s and 1960s irrigated the colon with water and oxygen to flush out toxins; unfortunately, it also sometimes perforated the colon wall and caused serious infections (Understanding Arthritis). So to conclude with self-help remedies you have to know what you are talking about to be successful otherwise you could just make it worse. There is a serious lack of studies for alternative therapies for arthritis so doctors say that if you want to try them then go ahead but dont replace medical facts and remedies for holistic ones if there is no serious concrete proof (Alternative Treatments for Arthritis). Every doctor will tell you when you try something new such as a remedy ask your medical physician before doing so. Doing this will insure your safety because a trained professional can advise you of what the approach may or may not require as well as its benefits.

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To conclude I think that through this discussion that the two sides have been presented and you can make an informed decision, but if I had to choose I would say medical care is the way to go. They may not be the most cost effective people or always get the diagnosis right but in the end they do know what they are talking about more times than not. I have met some people dealing with this disease and they have said that if it wasnt for the medications and the care they receive from their doctor they would not be where they are today. We have modern medicine for a reason and thats because without it we would not live as long or as happy of live as we do today without it.

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Works Cited Center for Disease Control and Prevention Osteoarthritis (2011). Web. 7 Nov. 2012. Goodman, Brenda. Misdiagnosed? Arthritis Today, (2012). Web. 7 Nov. 2012. Kantrowitz, Fred. TAKING CONTROL OF ARTHRITIS. New York: HarperCollinsPublishers, 1990. Print. Kusher, Irving, ed. Understanding Arthritis. New York: CHARLES SCRIBERNERS SONS, 1984. Print. NA. Alternative Treatments for Arthritis. (2010). Web. 3 Dec. 2012. NA. Handout on Health: Osteoarthritis. NIAMS, (July 2010). Web. 7 Nov. 2012. NA. Mortality in Osteoarthritis, (2008): S 120-4. PubMed.Gov. Web. 7 Nov. 2012. Spine-health. Osteoarthritis Increases U.S. Annual Health Care Costs by $186 Billion. (2009). Web. 7 Nov. 2012.