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Arthritis: A Joint Discussion


Arthritis: A Joint DiscussionI don't need a calendar to know when late fall or early winter has arrived. I can tell by the increased complaints I hear from my patients whose arthritis symptoms are aggravated by the cooler, damp weather.

Arthritis is inflammation of the joints in one or more places within the body. The most common cause of arthritis - osteoarthritis - can affect most joints in the body but typically causes pain in the spine, hands, knees, feet and shoulders. Osteoarthritis occurs in almost everyone as they age and I rarely see patients in their eighties who are not affected to some degree. Inflammation is usually mild and joint stiffness is a prominent complaint. Typically, joint stiffness in the back, knees and hips is noticeable when rising in the morning and relieved by activity or a warm bath or shower.

For mild symptoms, stretching, light physical activity and heat will often suffice to relieve discomfort. Directed exercise and, in some cases, physical therapy may be helpful for specific conditions such as spine, knee and shoulder arthritis.

In many cases analgesics can be used to control pain and discomfort. For mild or moderate pain, acetaminophen or acetaminophen combined with an anti-inflammatory drug is likely to provide some relief.

While these medications are generally safe, older patients are much more likely to have adverse effects than younger ones. An effective acetaminophen dose is 500mg to 1000mg three times per day. Ibuprofen at 400mg three times daily can also relieve symptoms.

Even though these drugs are readily available over-the counter, they should be used with caution and your physician's knowledge and supervision. Anti-inflammatory drugs (ibuprofen, naproxen and others) can cause nausea, loss of appetite, gastrointestinal bleeding, swelling, high blood pressure and kidney impairment. Close medical supervision is necessary, particularly with continuous use.

If you have more severe pain or swelling in any of your joints, talk with your physician. He or she may suggest over-the-counter pain medication or prescribe something else.

James Davis, MDStaying active can help keep your joints from getting stiff and sore during the cooler winter months. Keep warm and do gentle stretching activities, as appropriate for your age and fitness level.

Dr. James Davis is a board-certified geriatrician with the highly ranked UCLA Geriatrics Program in Westwood and Santa Monica. Information: (310) 319-4371.

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