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Arthritis Without Pain
Dr. Zashin's arthritis book is a comprehensive guide for patients considering or undergoing treatment with the TNF blockers Enbrel®, Remicade®, or Humira®.

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Osteoarthritis
A
CONDITION OF WEAR AND TEAR
Osteoarthritis (OA) is the
most common form of
arthritis. More than 23
million Americans have OA.
Over one-third are women.
The vast majority are 45
years or older. Most people
believe that OA is a natural
consequence of aging, but
heredity and injury are
equally strong risk factors.
Osteoarthritis occurs when
the protective cartilage
that covers the joint wears
away. The joint space
narrows, bone spurs form,
the joint becomes inflamed,
and the nerve endings become
irritated.
People with osteoarthritis
usually complain of joint
pain after any activity
involving that joint.
Morning pain and stiffness
are also common, but usually
resolve after 15 to 30
minutes. Over time, as the
cartilage continues to wear,
pain often increases.
The hands, feet, knees, hips
and spine (cervical
spine/neck and lumbar
spine/low back) are the most
common areas affected by OA.
Osteoarthritis of the hands
often strikes the base of
the thumb, at the end and
middle joints. It is also
common in the base of the
big toe, and foot pain is
worsened by tight shoes and
heels. People with OA of the
hips feel pain in their
groin and thighs, which
sometimes travels or
“refers” to the knee. People
with OA of the knee complain
of pain and stiffness around
the joint.
Osteoarthritis can severely
restrict mobility and
movement. Osteoarthritis of
the hip and knee can cause
pain with even simple
weight-bearing activities,
such as walking.
Osteoarthritis of the hands
impairs activities that
require dexterity and hand
strength. Pain due to OA of
the spine often increases
when rising from a sitting
or lying position, and
worsens with prolonged
standing or walking.
A diagnosis of
osteoarthritis is based on
patient history, a physical
exam, and x-rays. X-rays
show narrowed joint spaces
(due to loss of cartilage)
and spur formation.
Laboratory studies may also
be performed, and results
will be normal if it truly
is OA. (An abnormal lab
result may suggest that
there is another cause of
the pain, or may indicate
that two types of arthritis
are present.)
There is no cure for
osteoarthritis. Treatment
focuses on relieving pain,
reducing inflammation and
improving joint motion.
Common medications used to
treat OA include both
prescription drugs and
over-the-counter
medications, including
acetaminophen, non-steroidal
anti-inflammatory drugs
(NSAIDs) such as ibuprofen,
and COX-2 inhibitors2 like
Celebrex®. Glucosamine is
another treatment that some
patients find helpful with
the pain of OA, and is
available over the counter.
A large clinical trial at
the National Institutes of
Health (NIH) is underway to
determine the safety and
effectiveness of glucosamine
in OA. In addition to drug
therapy, people with
osteoarthritis are usually
encouraged to exercise,
which increases flexibility
and builds muscle strength.
Controlling body weight is
another good strategy
because it helps to lessen
stress on weight-bearing
joints. Surgery is also
sometimes recommended to
relieve pain in damaged
joints, or to replace joints
that are severely damaged.)
Scott Zashin, MD, PA is a
respected Texas
osteoarthritis
Doctor/Specialist in
Dallas, TX. The above information about
osteoarthritis is
from Dr. Zashin's
arthritis book:
Arthritis Without
Pain, a
comprehensive guide for
patients considering or
undergoing treatment with
the TNF blockers Enbrel®,
Remicade®, or Humira®. All
rights reserved.





Rheumatology Practice of
Scott Zashin, MD