September 29, 2020
Osteoarthritis is a common form of arthritis and affects more than 32 million U.S. adults. It can damage any joint, but most commonly affects joints in the knees, hips, hands, feet and spine.
With osteoarthritis, the protective cartilage that cushions the ends of bones wears down over time and can cause pain, stiffness and swelling, and in some cases reduced function, said Dr. Brett Bentley, assistant professor of sports medicine at The University of Alabama College of Community Health Sciences.
Bentley provided the second lecture of this semester’s Mini Medical School program. Mini Medical School is a joint program of UA’s OLLI program and CCHS and provides an opportunity for OLLI and community members to learn about trends in medicine and health.
In addition to his academic role, Bentley also cares for patients at University Medical Center’s Dr. Bill deShazo Sports Medicine Clinic. UMC is operated by CCHS.
Bentley said most people diagnosed with osteoarthritis are age 50 and older. Hallmark indicators include a narrowing of or no joint space as well as subchondral sclerosis or a hardening of the bone just below the cartilage surface.
Among the symptoms of osteoarthritis are joint pain with no injury, stiffness, and joint pain in the morning that lasts for more than an hour, Bentley said. Risk factors include age, being overweight, family history, previous joint injury, a history of manual labor and participation in sports with repetitive impact, he said.
During an exam, doctors will look for signs of swelling, joint-line tenderness and a reduced range of motion. While X-rays are not required for diagnosis with typical symptoms and risk factors, imaging can show joint space narrowing and subchondral sclerosis, Bentley said.
“We do get imaging to cement a diagnosis,” he said.
Unfortunately, there’s not a lot that can be done to prevent osteoarthritis, but it can be managed Bentley said. Exercise is important, and low-impact and aquatic exercise can be easier “because it takes weight off the joints.” Being a healthy weight is also important, especially for lower extremity osteoarthritis, he said.
While there is not a cure for osteoarthritis, there are several treatments that can provide relief, Bentley said. Acetaminophen, such as over-the-counter extra strength Tylenol, can help, as well as corticosteroid injections and hyaluronic acid injections.
Bentley said hyaluronic acid injections are generally effective only in knees and work this way: “Osteoarthritis results in the loss of articular cartilage and creates potholes, so to speak. That’s how I describe it. When you inject hyaluronic acid in the knee, it smooths over the potholes and provides more relief.”
Bentley said doctors want to do everything they can to keep patients off the operating table. “Surgery is invasive and there’s a long recovery and lots of physical therapy afterward. And with any surgery, there can be complications. We can help kick the can down the road.”
Still, he acknowledged that “there might come a time when you have to squash the can. If you’re at the end of the road and have tried everything else, and it’s impacting your quality of life, then you might consider surgery.”
Mini Medical School lectures are presented by faculty physicians at CCHS, who also care for patients at UMC. The Osher Lifelong Learning Institute is a member-led educational program for those aged 50 and older.