Know Your Bones

Is There a Cure for Osteoarthritis?

Currently, there is no cure for osteoarthritis (OA). Unfortunately, there is no magic wand that can rebuild the very complex cartilage tissue. However, there are dozens of arthritis medications available to relieve the pain, swelling, and stiffness of OA. But remember, the rate at which your cartilage wears away will not change for better or for worse whether or not you take your medicines.

A sudden increase in your OA symptoms does not mean that your joints are wearing out faster. Usually, a surge in your symptoms means a flare of inflammation. With this in mind, and because you can readily feel the symptoms, you can take your osteoarthritis drugs on an as-needed basis. If you have a lot of pain and stiffness every day, then take the medicine every day. On the other hand, if you're fairly comfortable today, you can skip it. If you don't have pain, you don't need the medicine.

OA drugs are categorized by drug class. Each class differs in the way your body deals with the drug, know as the mechanism of action. Different mechanisms of action target different symptoms of OA ( i.e. pain, stiffness and/or inflammation. However, it's important that you understand

• how each drug works,
• which drugs are related because they work in a similar way,
• what side effects can occur, and
• why a drug may or may not be right for you.

Combining smaller does of different medications to maximize relief while minimizing side effects may be the right answer. In future posts, I'll try to answer some of these questions and other frequently asked questions posed by my patients.

Remember, you can also ask your pharmacist about non-prescription treatments as well. Ask them to help you decipher the active ingredients label on the package of any over-the-counter medications you are considering buying. Your pharmacist can cross-reference theses ingredients with any of your other medications and advise you about possible drug interations.

Use only one pharmacy so all of your medication records are at one location. Most pharmacies use a computerized database to keep track of the prescriptions they fill for you. This database will cross-reference your medicines to check for potential problems...if it knows about everything you take.

[The above article was taken from excerpts  from Know Your Bones: Making Sense of Arthritis Medicine, a guidebook written for those who suffer from osteoarthritis.]

What Is Pain, Anyway?

Pain is defined as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage." That is, it's your brain's way of telling you that something is wrong. Actual tissue damage is associated with problems like osteoarthritis (OA), where your joint is worn and irritated, or a broken bone or torn ligament.

Pain is also your body's way of protecting you from potential tissue damage. For instance, you'll pull away from something that's too hot to avoid a burn.

Your nervous system does a lot more for you than just telling you where it hurts. It regulates your body's response to any stimulus, good or bad, from within or from outside your body. Your nervous system tells your muscles where to move (and what to do when you get there), tells your eyes were to look (and what they see), and tells your ears what they hear. Each specific sensation has its own "wire" in the network connecting your body and brain.

Pain is transmitted by a "cable" or wires that is structurally and functionally distinct from all of the nervous system's other functions.

Medicines that relieve pain are call analgesics (an-ul-JEEX-ix). Their purpose is to quiet the way you perceive pain. That is, to minimize your awareness of pain. Ideally, they target on the pain cable and leave the rest of the network alone.

[The above article was taken from excerpts  from Know Your Bones: Making Sense of Arthritis Medicine, a guidebook written for those who suffer from osteoarthritis.]

What Is Osteoarthritis And Why Does It Hurt?

There are about 100 forms of arthritis. Osteoarthritis (OA) is the most common. "Osteo" is from the Greek word for bone. "Arthr" means joint. And "itis" means inflammation.

Osteoarthritic cartilage can become brittle, thin, and frayed. Eventually it wears away, leaving craters of underlying bone. This process can take many years, or sometimes happens quickly - perhaps after an injury. Irritated joints try to protect themselves by producing extra fluid, and can become swollen (called "water on the knee").

Normally, the synovial membrane (see my last post) that lines the joint looks like a sheet of satin. However, when inflamed, it becomes more like wet terrycloth. This inflammation of the joint lining is usually what causes arthritis pain. The swollen lining gets pinched between the moving bones. Once the cartilage layer is thinned and worn, the joint loses its spacer and becomes less stable. If your muscles are weak and flabby, they can't provide the necessary support.

Think of the rough surfaces within the joint acting like a match head on a flint. Imagine a wobbly knee where every step causes the jagged surfaces to rub together, igniting a little "fire." That fire is the inflammation of arthritis pain.

So what exactly is inflammation anyway?

Inflammation is the tissues' response to injury or irritation. It causes pain, swelling, redness and heat, and results from an elaborate sequence of biochemical reactions in the body. Although these biochemicals are associated with the undesirable symptoms of OA and fever, they also do good work.

• They begin the first steps of healing after an injury.
• They help the body fight off infection.
• They regulate kidney function.
• They balance acid and mucus production inside the stomach.
• They help maintain blood pressure
• They control blood clotting.

So when using medications that block inflammation to treat OA symptoms, the challenge is to block the bad effects of inflammation while permitting its healthy housekeeping functions to continue.

[The above article was taken from excerpts  from Know Your Bones: Making Sense of Arthritis Medicine, a guidebook written for those who suffer from osteoarthritis.]

Understanding Osteoarthritis - What Is A Joint And How Does It Work?

To better understand what osteoarthritis is, let's first take a look at what a joint is and how it works.

Your musculoskeletal system contains muscles, bones and associated tissues that move your body and maintain its form. Wherever two or more bones come together, a joint is formed. For example, your knee joint contains three bones - the femur or thighbone, the tibia or shinbone, and the patella or kneecap. Your hip is a ball-and-socket joint between the head of the thighbone and the pelvis. And your wrist is actually a linkage of 10 separate bones.

Bones are held together with strong bands called ligaments. Muscles cross the joints to provide active support and movement. Tendons attach muscles to bones. When a muscle contracts, it moves the bones like levers at the joint. Strong muscles protect the joints they cross by acting as stabilizers and shock absorbers.

Your joints are also lined with a sensitive membrane called the synovium (sin-OH-vee-um). This membrane's job is to produce a few drops of fluid, called synovium fluid, that lubricates the joint. A normal healthy knee joint, for example, usually contains about one half teaspoon of synovial fluid.

Cartilage is the tissue that covers the ends of the bones and forms the joint's surface. It is a remarkable tissue. Hyaline cartilage is the strong, slippery contact where motion occurs at your joints. And it is this cartilage that can become affected by osteoarthritis.

There are no blood vessels in cartilage. Here the synovial fluid and underlying bone nourish the cells. There is also no nerve endings in cartilage. So the actual fraying and cracking of worn cartilage is not really the source of pain. Instead, osteoarthritis symptoms arise from inflammation or strain in the structures that surround the joint.

In my next post, I'll discuss what osteoarthritis is and why it hurts.

[The above article was taken from excerpts  from Know Your Bones: Making Sense of Arthritis Medicine, a guidebook written for those who suffer from osteoarthritis.]