Osteoarthritis Quiz: Test Your Medical IQ

There are many types of arthritis, or conditions that involve inflammation of the joints. Osteoarthritis (OA) commonly affects the joints of the hands, fingers, knees, hips, and spine.

Osteoarthritis is the most common type of arthritis and it frequently occurs comes with age. In osteoarthritis, the cartilage between bones that cushions the joints begins to break down and as it does, the bones rub against each other causing pain, stiffness, and swelling.

Risk factors that increase the risk of developing osteoarthritis include:

• Age over 55
• Gender – women are 2-3 times more likely to develop OA
• Obesity
• Occupations that require frequent squatting and kneeling, such as dock work, shipyard work, carpentry, construction, farm work, and cotton processing
• Prolonged standing or walking several miles each day
• Sports such as wrestling, boxing, pitching in baseball, cycling, parachuting, gymnastics, soccer, and football

Osteoarthritis symptoms typically occur in hands, fingers, knees, hips, and spine. OA only rarely affects the joints of the elbow, wrist, and ankle.

Symptoms of osteoarthritis vary person to person and can include:

• Joint pain that worsens with activity and is relieved by rest. In severe cases, the pain may also occur at rest. Pain usually occurs near the affected joint.
• Morning joint stiffness that usually resolves within 30 minutes of waking.
• Joint swelling (effusion) which is a result of accumulation of excess fluid in the joint.
• Crackling or grating sensation in the joints (crepitus).
• Bony outgrowths called osteophytes or bone spurs that can be felt under the skin near joints and usually enlarge over time.

Lifestyle changes and non-drug therapies are usually recommended for everyone who has osteoarthritis to help improve symptoms.

• Weight loss lowers the risk of worsening OA and can decrease pain.
• Physical therapy and exercise programs can help improve flexibility and strengthen the muscles surrounding the joints, which will help decrease pain and improve joint function.
• Orthoses are medical devices that are used help to keep joints aligned to help reduce symptoms and maintain function.
• Splints immobilize the joints to reduce can reduce pain and inflammation.
• Assistive devices such as canes, walkers, electric-powered seat lifts, raised toilet seats, and tub and shower bars can reduce the stress on joints and can make it easier to perform daily tasks.
• Arthritis education and support can help patients participate in their self-care so they can learn how to manage their condition.
• Psychosocial support such as an informal support network or a formal OA support group can benefit patients.
• Glucosamine and chondroitin are dietary supplements that that may reduce pain but many studies show no benefit. With few side effects many doctors feel they are safe to try. Talk to your doctor before using any nutritional supplements.

Different over-the-counter (OTC) and prescription drugs may be used to help relieve osteoarthritis pain and stiffness, such as:

• Topical nonsteroidal anti-inflammatory drugs (NSAIDs) applied to the skin over the joint and are usually tried before oral NSAIDs (pills or tablets).
• Topical capsaicin (the active substance in capsaicin is hot chili pepper) can help with hand and knee OA.
• Oral nonsteroidal anti-inflammatory drugs help relieve pain and reduce inflammation. NSAIDs include ibuprofen (Advil, Motrin) and naproxen (Aleve) which are available over-the-counter (OTC), and prescription celecoxib (Celebrex).
• Steroid injections are occasionally recommended for some people who still have significant pain that has not responded to weight loss, exercise, and other medications.

• Acetaminophen (Tylenol) the minimal benefits are usually not significantly effective to relieve OA pain.
• Hyaluronate injections are generally not recommended because there is not a lot of evidence to show they help, and they are expensive.
• Opioids (narcotic pain relievers) are not recommended for long-term use as they are not any more effective than other pain medications, they have a high risk of side effects, and there is potential for abuse and addiction.

In severe cases of osteoarthritis that did not respond to other treatments and that significantly limit a person's activities, surgery may be recommended. Types of osteoarthritis surgeries include:

• Realignment of bones and other joint structures that have become misaligned because of chronic OA. This type of surgery may be used on younger and more active patients instead of replacing the joint entirely.
• Fusion surgery permanently fuses two or more bones together at a joint and us used for badly damaged joints when joint replacement surgery is not appropriate.
• Joint replacement surgery replaces a damaged joint with an artificial (prosthetic) joint. Joint replacement surgery performed when pain prevents a person from doing their usual activities and having an active lifestyle.

Regular exercise can decrease osteoarthritis pain and can improve quality of life. There is no one specific exercise that is best for everyone, and it is important to talk to your doctor about the exercise that is right for your condition so you do not aggravate already injured joints. Exercises may include:

• Strength exercises such as use of free weights, weight machines, or body weight
• Low-impact endurance exercises such as swimming and cycling
• Yoga or tai chi

There are certain foods that can help reduce inflammation and may help ease some osteoarthritis symptoms, including:

• Calcium and vitamin D-rich foods like leafy green vegetables
• Broccoli - contains a compound called sulforaphane, which could help slow the progression of OA
• Green tea - contains polyphenols, which are antioxidants that may reduce inflammation and slow cartilage destruction
• Citrus fruits – full of vitamin C
• Bell peppers – contain antioxidants that may prevent the deterioration of joints
• Pineapples and pomegranates – they have anti-inflammatory effects
• Garlic – contains the compound diallyl disulphine that may limit cartilage-damaging enzymes
• Oils with omega 3 fatty acids - extra virgin olive oil, avocado, safflower, and walnut oils

Certain foods can promote inflammation in the body. If you have osteoarthritis, foods to avoid may include:

• Wheat products such as pasta and refined grain products. Whole grains are preferred.
• Fried foods can raise cholesterol and contribute to inflammation and pain.
• Foods with omega-6 fatty acids such as red meat and egg yolks.
• Salt causes the body to retain water, which can lead to inflammation.
• Sugary snacks may worsen inflammation.