Jun2013_GET TO KNOW YOUR HEALTH

Osteoarthritis:

We all know that familiar ‘creeeek’, the one when we get up in the morning, the one when we stretch the old injured shoulder or the couple in the fingers when we hold on to something tight.  Chances are that creaking sound is the sound of Arthritis.

Arthritis literally translates from Greek as joint (arthro) inflammation (itis).  As you can probably tell (since it was named in ancient Greece) arthritis is not a new disease, in fact it is one of the oldest diseases to affect man as it has been found in remains of people who lived over 5000 year ago.  It has even popped up in dinosaur skeletons, which makes for an amusing mental image (Cue picture of T-Rex with a walking stick).  What most people don’t know is that arthritis includes more than 120 different disease states including Osteoarthritis, Rheumatoid Arthritis, Gout, Ankylosing Spondylitis and lupus and can affect anyone from children to the elderly.  For this article we will be focusing on the most common form of arthritis, Osteoarthritis. 

Osteoarthritis will affect approximately 50% of the population by the time they reach the age of 65, and the ladies are affected slightly more with approximately 60% of sufferers being women.  The total burden of death and disability osteoarthritis puts on the health care system in Australia (15.3%) is second only to cancer (16.2%) and above heart disease (13.8%), this is because the disease can be debilitating and ongoing.

Osteoarthritis occurs when the cartilage (which is a rubbery jelly version of WD-40) between our bones diminishes due to wear and tear or injury, which leaves the bones to rub closer to one another (squeaky door hinge).  Ultimately this causes pain, joint swelling and inflammation.  While it is a disease that generally affects older people, it is a mistake to group osteoarthritis and old age in the same basket; this is because in most cases the groundwork for the disease is laid when we are relatively young.  This is similar to skin cancer or osteoporosis, the time to maximise prevention is in our youth.  According to Professor David Hunter, a rheumatologist at the University of Sydney and the Royal North Shore Hospital and one of only a handful to specialise in Osteoarthritis, “It begins in relatively young people and if it were detected and dealt with then, we could reduce pain, disability and the need for surgery later in life.”

There are two big preventable risk factor for osteoarthritis, injury and obesity.  A joint that sustains an injury earlier in life is much more likely to develop osteoarthritis in later life.  The same goes for being overweight, if the joint has more pressure on it over its lifetime then it will wear out faster. However, as much as my mum used to like telling me it when I was younger, cracking your knuckles will not give you arthritis.  These groundwork issues are the reason that everyone needs to take notice and action earlier in life to help prevent a disease that has no cure.  There are some obvious and some not so obvious things that can be done to help with prevention and treatment.  The obvious ones relate to the above, lose a little weight and seek professional treatment.  Losing weight will help both to prevent the disease from occurring and also to improve the symptoms once it is diagnosed.  Professional advice and treatment for an injury seems like common sense but many people do not do it.  Physiotherapy and other necessary allied health services will improve long term outcomes for the injury and can negate any increases in risk of osteoarthritis.  The other most important treatment is exercise, when a joint hurts our first response is usually to cut back on exercise and rest.  While rest is necessary if there is acute inflammation, continued exercise to strengthen the muscles around the affected joint will actually decrease the pain by reducing pressure on the joint and reducing body weight.  This should only be done after consultation with a health care professional (we don’t want ma and pa spontaneously joining the pole vault team…)

Pills, pills and more pills.  As there is no cure for osteoarthritis, most therapy is aimed at controlling that annoying little thing called pain.  We will only cover some natural treatments as the pharmaceutical treatment are a little complex and we will run out of space in this article.  Glucosamine+chondroitin and Fish/Krill oil are the main players in this market.  Recently a wide analysis of evidence was conducted for glucosamine+chondroitin and it was found to have only a minimal effect on the disease, however if the patient has found a benefit from the medication they should continue therapy.  Fish/Krill oil contain Omega-3 fatty acid which when taken in high doses have an anti-inflammatory effect.  This natural treatment is really the only one which is supported with significant evidence however most people do not take enough.  The dose needs to be approximately 9 fish oil capsules or 3 krill oil capsules a day, and the effect is delayed for approximately 2 months.  Treatment can be complex however information and help is only as far away as the nearest health care professional.

That’s it for another month in the get to know your health column, as always if you have any questions or want more advice don’t hesitate to drop into the pharmacy or see another local health care professional. 

Written by Andrew Harvey (Your local pharmacist), 

Dayboro Pharmacy  Phone 3425 1435   

Mon – Fri 8.30am – 5.30pm    Sat 8.30am – 12.30pm