Do you miss dancing or walking on the beach?
If you have stiff or sore joints after inactivity or overuse, or mild swelling in your joints, there’s a good chance you have arthritis. You’re not alone. The Arthritis Foundation estimates that arthritis affects 50 million adults and about 300,000 children.
Osteoarthritis, alone, affects 27 million Americans.
“There’s probably about 125 different types of arthritis, but the three most common ones are osteoarthritis, rheumatoid arthritis and post-traumatic arthritis,” explained orthopedic surgeon Donald O’Malley, MD at Cape Cod Sports Medicine in Falmouth. “If you think you have arthritis, it’s important to come in to see an orthopedic surgeon. The first thing that we’re going to do is take a history and figure out what type of arthritis we are dealing with, because every arthritis is dealt with a little differently.”
Osteoarthritis, otherwise known as degenerative joint disease or the “wear and tear” arthritis, is the most common form, according to Dr. O’Malley. It is caused when the cartilage that acts as a cushion between the bones in a joint wears down over time. Eventually, you will have bone rubbing on bone, which is what causes the pain and inflammation.
Rheumatoid arthritis is an autoimmune disorder that Dr. O’Malley cited as the second most common form of arthritis. Post-traumatic arthritis is arthritis that sets in years after an injury, such as a broken wrist.
“With post-traumatic arthritis, the cartilage starts wearing out because at the point of impact when you broke that wrist, you really sustained a lot of damage to that cartilage that doesn’t show up on usual X-rays,” he said. “It only shows itself years later.”
The usual first lines of treatment for osteoarthritis and post-traumatic arthritis are:
- A recommendation to not overload or overuse the joint
- No pounding type activities like running and jumping
- Injecting steroids into the joint
- Injecting a lubricating fluid into the joint to help it glide better
- Aquatic therapy
“I’m a big fan of aquatic therapy and we offer it at both hospitals on the Cape,” Dr. O’Malley said. “An aquatic pool is very nice because you lose the effect of gravity, you have the cooling effect of the water, and joints move much more easily in a fluid environment. You get better motion when you are in the water than you do on land.”
Joint replacement surgery is the ultimate fix for arthritis that is painful enough to affect daily activities.
“People aren’t aware of all the joint replacements we can do,” Dr. O’Malley said. “There is a total joint replacement for just about any joint in the body.”
While some doctors recommend saving joint replacement as a last resort of treatment, as a sports medicine doctor, Dr. O’Malley prefers to do it sooner rather than later because he wants his patients to be able to enjoy the sports they love pain-free. In his experience, if a patient has given up a sport like golf, skiing or tennis for five or six years, the chances they will return to that activity after a later joint replacement surgery is quite low.
“I generally tell patients the sooner you do it, the more you maintain your lifestyle,” he said. “I like to catch patients right when they start noticing that they are not doing all the things they used to do.”
The good news is that joint replacement technology just keeps getting better. Over the past five years, orthopedic surgeons have been replacing only a portion of joints like knees, hips and shoulders, rather than the whole joint. They take out the component of the joint that is damaged, but leave the healthy alone, he said. That means a shorter surgery with a much smaller incision. Most people go home the same day.
“I’ve seen people out dancing after a knee replacement and I’ve seen people return to skiing after a knee replacement,” Dr. O’Malley said. “It’s a very rewarding surgery to do.”