askthedoctor T


Seek Expert Help Each year, there are over 500,000 total knee re- placements and 250,000 hip replacements, most to treat arthritis. Pros- theses and surgical tech- niques are being refined over time. Studies have shown patients who develop muscle strength before surgery have a faster recovery.


46 MILITARY OFFICER NOVEMBER 2016 Osteoarthritis


Over 50 million people in the U.S., including about 300,000 children, have arthritis, which has been called America’s No. 1 cause of disability. By Rear Adm. Joyce Johnson, D.O.


There are over 100 different types of arthritis, with many different causes. For example, rheumatoid arthritis is due to infl ammation and autoimmune pro- cesses. Infectious agents — bacteria, vi- ruses, and fungi — can enter joint spaces and cause arthritis. Metabolic disease is another cause; arthritis also can be a con- sequence of Lyme disease. Someone with gout may have uric acid crystals form in the joints, especially the big toe, causing painful arthritis. Arthritis often is associ- ated with sickle cell disease; bleeding in the joint space leads to arthritis. Rates of arthritis increase with age, and about half of those over age 65 have at least one joint aff ected. The most common type of arthritis is


ated with sickle cell disease; bleeding in


osteoarthritis, also called degenerative joint disease, which is caused when the cartilage at the joints degenerates and the bones rub against each other. Bone spurs also can develop. About 27 million people have osteoarthritis. The characteristic symptoms are pain, swelling, and stiff ness. The joints most often aff ected are fi ngers (near the nail beds), thumbs, neck, lower back, knees, and hips. Risk factors for osteoarthritis are joint


injuries, repeated stress on joints (often from sports or occupations), genetic pre- disposition, increased weight, gender (with women at higher risk), and age. Osteoarthritis usually can be diag-


nosed with a medical history and physical exam, coupled with X-rays of the painful


joints. Sometimes blood work and other tests are done to rule out other types of arthritis and other diseases. There is no cure for osteoarthritis, but it can be managed. Heat or cold com- presses can reduce pain. Physical activity is important, as long as you choose activi- ties that don’t traumatize the joints. For example, swimming provides good range of motion and aerobic exercise without further damaging the joints. Exercise is also important to strengthen the muscles around a joint to reduce stress on it. Maintaining a healthy weight can be es- pecially important for those with arthri- tis in the knees. Medication management of arthritis usually begins with acetaminophen. Non- steroidal anti-infl ammatories (such as ibuprofen) are used later in treatment. However, take into account potential side eff ects, including liver disease and gastro- intestinal bleeding, when chronic use of medication is considered. Some patients have found acupuncture to provide short- term pain relief. Most studies have found dietary supplements such as glucosamine, chondroitin, dimethyl sulfoxide, methyl- sulfonylmethane, S-adenosyl-L-methio- nine, and herbal preparations have little long-term eff ect on osteoarthritis. MO


— Rear Adm. Joyce Johnson, USPHS (Ret), D.O., M.A., is a health care consultant in Chevy Chase, Md. Find more health and wellness resources at www.moaa.org/wellness. For sub- mission information, see page 4.


PHOTO: STEVE BARRETT


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76  |  Page 77  |  Page 78  |  Page 79  |  Page 80  |  Page 81  |  Page 82  |  Page 83  |  Page 84  |  Page 85  |  Page 86  |  Page 87  |  Page 88