Osteoarthritis - Does Your Car Need a Tune-Up?

Osteoarthritis (OA) affects at least 27 million Americans and 70 to 90 percent of Americans over 75. Men and women are equally affected and there are several risk factors for developing OA. Some of the risk factors are age, injury history and obesity to name a few.

I look at a joint with osteoarthritis and break the treatment down into three categories. I like to address the mechanical issues, the possible regenerative approaches and the pain or inflammation. After each of these areas is addressed properly, many times my patients can live a more comfortable and active lifestyle.

The analogy for the mechanical issues that I like to use with my patients is that of a car’s tires. With knees, for example, the joint tends to wear on one side or the other like a car that needs its tires balanced and rotated. The wear pattern can be altered by bracing and use of orthotics to change the wear pattern or to balance those old tires.

Now, it’s time for an oil change. The next challenge is that of restoring the joint to a more natural state. There are two injectables that I have had success with over the past decade. The first is visco-supplimentation injections which can come in a series or one injection. After this procedure, it is theorized that the joint fluid becomes healthier and helps reduce the pain associated with OA. We are also having great success in some patients with Platelet Rich Plasma (PRP), which is the use of one’s own platelets to help with the pain associated with OA. The third category is to reduce the inflammation thus helping to reduce the pain. There are many good natural alternatives (too many to list) that patients have used successfully through the years. Some are supplements, and many come through the patient’s diet. I frequently will prescribe non steroidal anti-inflammatory medicines (oral and topical), as well as, the natural alternatives. There are, of course, risks with these, and the risks vs. benefits have to be carefully weighted before choosing. In addition, Acetaminophen can also be used and tends to be safer than NSAID’s for most patients. Last but not least, good ole “cortisone” injections which are steroids injected into the joint are frequently used. These injections work well but do have side effects and their benefits tent to diminish over time.

Returning to my car analogy, if your tires are balanced, your parts are lubricated and the car is maintained, it’s bound to run smoother and longer. Whether you view yourself as a Pinto or a Porsche, get the mot our of your car model.

By. Michael Potter, MD