As we explore in The Clinic in this issue, there are active steps you can take as a patient to aid in your recovery from knee and hip osteoarthritis, or from non-OA joint pain in general. First, it's important to receive a proper diagnosis. What are the symptoms you should look for if you suspect you have some form of OA?
Symptoms of OA
Osteoarthritis develops when cartilage deteriorates. This important, flexible tissue lining the joints keeps the space between bones from growing too narrow. When it does, the bone surfaces change shape. Over time this leads to joint damage and pain.
The symptoms of osteoarthritis usually develop over many years. The first sign is often joint pain after strenuous activity or overusing a joint. Joints may be stiff in the morning, but loosen up after a few minutes of movement. Or the joint may be mildly tender, and movement may cause a crackling or grating sensation. Some people have continual joint pain that interferes with sleep.
People with OA often have it in more than one joint. It is most common in the knee, hip, lower back, neck and certain finger joints.
Knees. When osteoarthritis affects the knee, the result is pain, swelling, and stiffness of that joint. What starts out as some discomfort after a period of disuse can progress to difficulty walking, climbing, bathing and getting in and out of bed.
Hips and spine. When osteoarthritis affects the hip, pain may be felt in the groin, down the inside thigh or even as far away as the knee. Osteoarthritis of the cervical spine (in the neck) can cause pain in the shoulders and arms. When it affects the lower spine, pain can spread to the buttocks or legs.
Hands. Osteoarthritis of the hand often starts with stiffness and soreness of the fingers and in the base of the thumb, particularly in the morning. You may find that it becomes harder to pinch, and your joints crackle when moved. People with osteoarthritis may have difficulty doing routine movements, like opening a jar, turning a key or typing.
Mobility relies on the body’s two largest joints, the hips and knees. These two joints must bear our full weight and coordinate movement over a lifetime of standing, walking, running, dancing and sports. Not surprisingly, hip and knee pain are common complaints, and nearly everyone who lives into old age can expect some trouble with these joints. But taking care of your hips and knees and managing any pain that arises will help you avoid losing mobility as you age.
Try these self-help measures when knee or hip pain strikes:
RICE for acute pain or injuries. RICE, which stands for rest, ice, compression and elevation, is excellent first aid for any type of joint injury.
Rest. Don’t completely limit your activity—that can make injuries worse. Instead, avoid the type of motion that directly led to the injury, and try activities that keep pressure off the joint (see the list below for some ideas).
Ice. A homemade or store-bought ice pack applied to the injured area can reduce pain and swelling. Use it for 20 minutes at a time, with 20-minute pauses in between. Make sure a layer of cloth or other material is between the ice and your skin to protect you from frostbite.
Compression. A neoprene support or elastic bandage can promote recovery and reduce swelling. Make sure the wrap isn’t so tight that the skin becomes cool or blue.
Elevation. Raising an injured leg on a pillow or stool can also reduce swelling by preventing blood from pooling at the injured site.
Heat therapy for long-term pain and stiffness. Ice is the best therapy in the first day or two after an injury to reduce swelling; after that, applying heat can also help ease pain by relieving stiffness and promoting flexibility. You can use a store-bought heating pad or heat a damp towel in the microwave at 20-second increments until it reaches the desired temperature. Make sure the heat you’re applying feels warm, not hot, to avoid burning the skin.
It’s important to keep joints moving, even when you’re dealing with pain from arthritis or an overuse injury. These joint-friendly options can help keep you active:
stationary bike (recumbent or upright)
swimming, water aerobics or water walking
short walks throughout the day, instead of a long walk