Okay so I know I missed May, being National Arthritis Awareness month. My old colleagues at the arthritis clinic are shaking their cyber heads in disappointment at me right now… BUT above you’ll find a short video where I go ahead and tackle the signs, symptoms, treatment, and management of one of the most common forms of arthritis: osteoarthritis (OA). We’ll separate this bout from rheumatoid arthritis, and other forms we can cover in another blog and video. Over 50 million people in the US alone are affected by arthritis of some sort, and 30+ million of those by osteoarthritis particularly.
When I work at the Arthritis clinic, it was in medical records, so I wasn’t TOO involved with the actual patient care, but nonetheless being in the environment where the specialty nomenclature is being tossed around all about, and you see enough charts, things start to become familiar. Furthermore, I worked as a post-anesthesia care unit (PACU) nurse at the hospital, where taking care of post-op patients was the name of the game and orthopedic patients loved to play it. P.s. Surgical services is the shizzl.
Osteo (bone) arth (joint) itis (inflammation) tells us pretty much what we need to know about the basics of the condition. There’s inflammation of the bone and joints! And, as inflammation is the root of all evil—over time, the pain and stiffness that results from the inflammation gets bad. Like, really bad. Like can’t hold a normal pen bad, or can’t make it up the stairs bad. That’s incredibly disruptive to life and our daily tasks. Not cool dude.
As usual, genetic makeup, comorbidities, medications, etc can all be contributing factors to developing and the progression of osteoarthritis, but that’s the case with most things. Specifically with OA, when the firm tissue that protects the bones when they rub against each other called cartilage, aka that stuff people like on the end of chicken wings that grosses me tf out, starts to wear out over time. Sidebar, I was always a boneless boy, and now that I don’t eat meat, I’m just a boy… a sad… sad little boy. 😉 Ok back to OA.
You can probably imagine: two bones rubbing together without any protection = no bueno. We need that protection, and it gets lost. That’s what will cause the stiffness and pain that results in a loss of mobility and range of motion. If you’ve heard of “bone spurs” before, they’re basically an outgrowth or bump of a bone that forms in different spots around the joint because of the inflammation.
So, your body is like “OK well if there isn’t any protection there now, let’s lube it up by sending a bunch of fluid to the area to try to soften things up and help with the pain and movement.” This s what we call an effusion. Now we got a bunch of fluid that’s in the joint space that often times needs draining. This all sounds like a blast, right? Remember—tens of million American’s are dealing with this. You probably know a handful.
Let’s talk about risk factors. First and foremost: age. Let’s face it: as we age, everything gets worse… besides how much we give a f about other people’s opinions, and the AARP discounts. Coming in second we have high frequency of usage and over usage regardless of frequency. The example I Iike to pull for this s from sports. Think about a marathon runner and all of the repetitive motions, impact, joint movement, etc. Same goes for say a baseball pitcher’s shoulder. That’s all they do. Over and over again. Usually with the same shoulder! Practice, games, breaking the windows of haunted houses. It’s a problem.
Then we got obesity. Believe me when I say to you that as hard as I try, I cannot blame or shame anyone for who they are. My mamma taught me at a young age that I’m not better than anyone, no one’s better than me. I am, however, always right when her and I argue… which oddly enough is the opposite of what she thinks. 😉 BUT whether or not someone’s going to accept a big body for what it is, or an assholes going to put their insecurities on someone shaped differently than them. Sidebar, I can’t tell you how many overweight nurses have complained about their “fat patients” not “getting up off their ass” and walking around the unit like they should be doing. *eye roll* It’s projection, insecurity, past trauma, the list goes on. But enough about that—it doesn’t change the fact that carrying around extra weight causes more pressure on the bones and joints. This is common sense.
The Arthritis Foundation says that 10 pounds of extra weight on the body will add 30 to 650 pounds of pressure on the knees alone. All I can say is during my years of yo-yo dieting… my knees must have been giving me that look *insert black guy meme looking confused*..
Lastly, ladies, I’m sorry. Women get osteoarthritis more than men. At least that’s what my research tells me, and when I think about the patient demographics in joint replacements at the hospital and outpatient visits at the clinic, there were fare more females than males. There’s a whole blog post I can write about this, but let’s just accept it for now and move on. We got plenty of time to come back to it.
So – as I mention in the video. If you’re a 78-year-old obese female construction worker that moonlights as a gymnast… you might want to evaluate the life you’re living, for the sake of dem joints.
What joints you ask? Thanks for asking. Typically, arthritis strikes the spine, knees, hips, and the hands mostly. The pharmaceutical reps used to bring in these gigantic pens that were legit ridiculous looking, about the size of a zucchini round, meant for those with arthritis in their hands that weren’t able to grip regular sized pens. It was brilliant, but heartbreaking at the same time. It may measure up to some of the big scary disease like cancers and the like, but anything that slowly takes away what throughout our lives we’ve taken for granted, is hard.
Big pens are one way to help out as an assistive device, but what about treatments for osteoarthritis? We’ve got a variety of treatments and we’ll start from least invasive to most. Sidebar: forgive me for leaving out any homeopathic or natural remedies, I’m a firm believer in remedies of these sorts, but I’m counting on my readers/viewers to chime in with the success stories using alternative methods.
First off, if we’re overweight, dropping a few pounds here and there can drastically improve the progression of osteoarthritis and the symptoms that come along with it. I’m not saying go hit the gym for an hour, 30 minutes, or even 15. But a brisk walk added to your routine, doing a few extra house chores, or whatever you can do to get the body moving will contribute in so many beneficial ways, including cardiovascular, that I promise you will have no regrets, get to appreciate the nature we so often miss out on, and even maybe a tidier home.
While you’re shedding some pounds, if you so choose to, we can explore nonsteroidal anti-inflammatory drugs (NSAIDS; said as N-SAIDS). These are common ones like ibuprofen and Naproxen, which go under trade names like Advil, Motrin, and Aleve to name a few. But, they’ve all got the same goal, to be anti-inflammatory. How they work is beyond this video’s scope, though if you’re interested please let me know and I’ll do my best to cover it. You can get these NSAIDS as an oral pill, or topical treatment. Consult with your primary care provider as always to see what may work for you.
So, say you’ve dropped 10 pounds and your knees are feeling 30 to 60 pounds less pressure every step you take… every move you make… every single day, every— great now I gotta listen to some sting and puffy to get that out of my head—you’ve got the NSAIDS on board per your discussion with your PCP… and you’re STILL having pain. In come the steroids. No, don’t meet me in the back of Gold’s Gym by the dumpster. Not those kinds of steroids, those are anabolic steroids used for getting jacked irresponsibility, or getting hormone levels within an appropriate range responsibly. What I’m referring to are called glucocorticoids.
You’ve probably heard of these steroid injections people get into their joints that typically provide some relief, but it’s rarely long lasting, and almost never a long-term fix. Inf act, limiting the number of injections is important, as too many can actually be damaging… and while it may give you some temporary “aahhhhhhhh” moments, it ain’t worth it in the long wrong. I’d question any responsible provider that doesn’t agree.
Before we go any further, let’s get back to the assistive devices to help ease the discomfort. There are splints and immobilizers to help keep the joints in alignment, and then walkers, canes, and the like that will help you get to where you need to go. Sidebar: thrift shops are an excellent place to find these kinds of devices. There are even some that are dedicated specifically to assistive devices. Check your local listings. Tell them Nurse Stefan sent ya. They won’t care, but they might think they’re supposed to. Come on, it’ll be fun.
Okay my friends. All else failed. It’s time we talk surgery. *cue the crescendo*
Please don’t fret though, and pay attention to what we have to offer.
One of the most common orthopedic post-op patients I would care for were joint replacements. You’ve probably heard of a prosthesis, which is an artificial joint made of a variety of materials, and we replace your bones and joints with these so you can officially be bionic, and start talking like the Terminator. Sidebar: he’s something like a seven-time body building world champion, one of the most successful movie stars, and a governor of California to name a few accomplishments. A goofy Austrian with a dream, and quite familiar with the other kind of joints. What a world we live in.
Anyway, the results I’ve seen from joint replacements are remarkable. Especially with appropriate physical therapy follow-up which is of UTMOST importance. There have been many times I saw the same patient for the same knee because they admittedly didn’t follow their instructions once they were discharged from the hospital. Tsk tsk tsk. Don’t be that patient.
If the particular joint that’s problematic is not a candidate for replacement, we can fuse together the bones so they’re not rubbing against each other anymore, and are, well, fused together. This improves stabilization and the ability to bear weight, which helps alleviate the symptoms of osteoarthritis big time.
So, while it’s fun to write about, it’s not fun to experience. Osteoarthritis changes people’s lives in ways we don’t want our lives changed. It’s debilitating. It hurts. It’s depressing. So, we’d be naïve to overlook the psychological impact this has on a person. Lots of people with OA suffer from depression, not being able to do the things they used to alone, with family, or friends. Major limitations on simple daily activities. Needing help for things they never felt helpless for.
My point is that as innocuous as it sounds to someone without it, it’s totally not, and from human to human we should understand, consider, and figure out ways we can help each other. Even if it’s as simple as empathizing with someone with OA. Showing you care goes a long way.
I truly hope you got something from this and/or the video, but I’ve gotta run at the moment to shower, as my dad is coming over to fix the leak in my tub’s faucet. Sidebar: if you want to see real helplessness, watch me try to be a handyman… ay caramba. 😉
All my best,
Stefan
