Osteoarthritis of the Hands

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Article featured on Arthritis Foundation

About half of all women and one-quarter of all men will experience the stiffness and pain of osteoarthritis (OA) of the hands by the time they are 85 years old. A degenerative disease that affects all the tissues of a joint, OA leads to the breakdown over time of the smooth, protective cartilage on the ends of bones, so bones rub together, causing pain. The 29 bones of your hands and wrists come together to form many small joints that can be affected by OA.

Where OA Affects the Hand

OA most commonly affects three parts of the hand:

  • The base of the thumb, where the thumb and wrist join (the trapeziometacarpal [TMC] or carpometacarpal [CMC] joint)
  • The joint closest to the fingertip (the distal interphalangeal [DIP] joint)
  • The middle joint of a finger (the proximal interphalangeal [PIP] joint)

Causes of Hand OA

Osteoarthritis usually occurs later in life, with no specific cause. But several factors can play a role, including:

  • Age: the older you are, the more likely you are to have hand OA.
  • Sex: women are more likely to be affected than men.
  • Race: whites are more often affected than African Americans.
  • Weight: obese people are more likely to have hand OA than thinner people.
  • Genes: some people inherit the tendency to develop osteoarthritis, usually at a younger age.
  • Injuries: Even when properly treated, an injured joint is more likely to develop OA over time. Fractures and dislocations are among the most common injuries that lead to arthritis.
  • Joint issues: Joint infections, overuse, loose ligaments, and poorly aligned joints can also lead to hand or wrist arthritis.

Symptoms of Hand OA

Along with cartilage loss, OA also causes bone spurs to form. Bone spurs in and around the joints increase your stiffness and pain. With worsening OA, daily activities can become difficult and your finger joints may lose their normal shape.
Symptoms of hand OA can include:

  • Pain: At first, pain will come and go. It worsens with use and eases with rest. Morning pain and stiffness are typical. As the osteoarthritis advances, the pain becomes more constant and may change from a dull ache to a sharp pain. It may start waking you up at night.
  • Stiffness and loss of motion: As arthritis progresses, you may lose the ability to open and close your fingers completely.
  • Crepitus: When damaged joint surfaces rub together, you may feel grinding, clicking or cracking sensations.
  • Swelling: Your body may respond to constant irritation and damage to the tissues surrounding the joint by swelling and becoming red and tender to the touch.
  • Nodules: Bony lumps may form on the middle joint of the finger (Bouchard’s nodes) or at the joint near the fingertip (Heberden’s nodes).
  • Joint deformity: Bone changes, loss of cartilage, unstable or loose ligaments and swelling can make your finger joints large and misshapen.
  • Weakness: The combination of joint pain, loss of motion and joint deformity can leave your hands weak. Activities that once were easy, such as opening a jar or starting the car, become difficult.

Diagnosing Hand OA

Your doctor will examine how your hands look and work and may check other joints for signs of arthritis. X-rays may show loss of space in your joints – indicating cartilage loss – and formation of bone spurs. She’ll make a diagnosis by combining this information with your medical and family history.

Treatments for Hand OA

Osteoarthritis is a chronic disease. There is no cure, but healthy lifestyle habits and treatments can help manage your symptoms and keep you active.

  • Non-Drug Treatments: Reducing strain on joints with a splint or brace, adapting hand movements, doing hand exercises or using hot or cold therapy can help to ease pain.
  • Drug Treatments: Medicines to ease OA symptoms are available as pills, syrups, creams or lotions, or they are injected into a joint. They include pain relievers like acetaminophen, counterirritants like capsaicin or menthol and non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids.
  • Surgical Treatments: If medications or self-care activities fails to give relief, surgery may be an option. An orthopaedic surgeon can remove the damaged cartilage and fuse bones together or replace the damaged joint with a plastic, ceramic or metal implant.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Know the Warning Signs of Knee Osteoarthritis

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Article featured on MedicalNewsToday

Osteoarthritis of the knee happens when the cartilage that cushions the bones in the knee starts to erode. The bones begin to rub against each other, resulting in damage, swelling, and pain.

Cartilage is a smooth but tough tissue that stops the bones from rubbing together and prevents damage. It allows the bones to move pass smoothly over each other. As people get older, the weight they carry can cause the cartilage to wear away.

As the cartilage breaks down and the bones rub together, osteoarthritis (OA) can result.

OA is the most common type of arthritis. The symptoms include swelling, pain, and stiffness. When it affects the knee, it can be difficult for a person to exercise, to climb stairs, or even to walk.

Early signs and symptoms

OA usually affects people who are over 50 years of age, but it can happen earlier, too.

Symptoms that can appear at the early stages of knee OA are:

  • pain, especially on bending and straightening the knee and with weight bearing
  • swelling, caused by a buildup of fluid in the joint, or by bony growths called osteophytes that form as the cartilage breaks down
  • warmth in the skin over the knee, especially at the end of the day
  • tenderness when pressing down on the knee
  • stiffness when moving the joint, especially first thing in the morning or after a period of inactivity or walking
  • creaking or cracking on bending, known as crepitus

Activity can make symptoms worse, leading to pain at the end of the day, especially after a long time of standing or walking.

If the knee is red, the person has a fever, or both symptoms occur, the problem is probably not OA.

Treatment

Treatment of OA depends on how severe the symptoms are.

Home treatment

Some remedies and over-the-counter treatments for OA of the knee can be used at home and are readily available from the pharmacy.

These include:

  • Applying heat or cold: Heat relieves stiffness, and cold can ease pain and swelling. The heating pad or ice pack should be covered with a towel so as not to burn the skin.
  • Using an assistive device: A cane or walker can help take some of the weight off of the knees. Holding the cane in the opposite hand to the painful knee is most effective.
  • Pain relief medications: These are available over the counter, but people should use them with caution as they can cause side effects.

Medical treatment

If home or over-the-counter remedies do not help, the person should see a doctor.

They may prescribe one of the following:

  • steroid injections in the knee joint to reduce inflammation
  • physical therapy, with exercises to improve flexibility and range of motion in the joint

If these solutions do not work and damage is severe, the physician may recommend surgery to replace the joint.

When to see a doctor

For some people, pain and other symptoms are severe enough to interfere with daily life, and over-the-counter medications do not help.

The next step is to consult a general physician, who may refer the person to a rheumatologist or orthopedic surgeon.

To find out whether a patient has OA, the doctor may ask:

  • When and how did the pain start?
  • Where does it hurt?
  • Is there any stiffness, creaking, warmth, or swelling?
  • What makes it better? What makes it worse?
  • How have you treated it? Did home treatments work?
  • How have the symptoms affected daily activities?

The doctor will examine the knees, moving them forward and back to note the range of motion and to find out which movements cause pain.

They will look for areas of tenderness, check the warmth and see if any swelling is present. The physician will also check the ligaments for stability.

Diagnosis

A number of tests can help to diagnose OA:

  • Joint aspiration: The doctor uses a needle to draw a sample of fluid from the joint. They send the fluid to a laboratory for tests to check for signs of other joint problems, such as gout or infection.
  • Magnetic resonance imaging (MRI): This can provide detailed images of the knees, which may show fluid buildup in the thigh or knee bones.
  • X-rays: These can reveal damage to the knee joints in the later stages but may not detect changes in the early stages.

Lifestyle changes

Some lifestyle changes can relieve the pain and stiffness that occurs with knee arthritis:

Losing weight can relieve pain and prevent further joint damage.

For people with OA of the knee and either overweight or obesity, current guidelinesTrusted Source strongly recommend weight loss. A doctor can advise on how much weight to lose.

Exercise, and especially low-impact activities such as walking, riding a recumbent bicycle, or swimming, can relieve arthritis pain.

Swimming is ideal because the buoyancy of the water takes pressure off the joints, while the warmth soothes them.

Exercise increases motion and flexibility and strengthens the muscles that support the joints. It also helps people to maintain a healthy weight.

Takeaway

OA is a common but painful condition that affects many people as they age. Pain, stiffness, swelling, warmth, or cracking in the joints may be early signs that it is time to seek medical help.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Brief Overview of Osteoarthritis of the Hip

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Article featured on UCSF Health

Osteoarthritis of the hip causes the hip joint to get stiff and inflamed and can progress until resting no longer relieves your pain. Bone spurs might build up at the edges of the joint. When the cartilage wears away completely, bones rub directly against each other, making it very painful to move. You may lose the ability to rotate, flex or extend your hip. If you become less active to avoid the pain, the muscles controlling your joint get weak and you may start to limp.

Osteoarthritis, resulting from the wear and tear of your body as you age, affects more than 20 million people in the United States. The pressure of gravity on your joints and surrounding tissues causes physical damage, leading to pain, tenderness, swelling and decreased function. The smooth and glistening covering on the ends of your bones, called articular cartilage, which help your joints glide, may wear thin. Initially, osteoarthritis is not painful and its onset is subtle and gradual, usually involving one or only a few joints. The joints most often affected are the knee, hip and hand. In some instances, joint replacement (arthroplasty) of the hip or knee may be recommended to treat osteoarthritis.

Our Approach to Osteoarthritis of the Hip

When treating hip osteoarthritis, our goals are to relieve pain and restore normal movement. Treating the condition early, with nonsurgical options such as medication and physical therapy, can slow cartilage degeneration, minimize pain and preserve function. If the arthritis is already severe, joint replacement surgery can help, eliminating pain and improving the ability to walk.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Osteoarthritis and Runner’s Knee Can Both “Bring You to Your Knees”

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Article featured on Noyes Knee Institute

Pain in the knee area is a common issue among athletes. However, anyone can experience knee pain. It is vital to get proper treatment to get rid of the pain. More importantly, you should seek to understand the issue before considering treatment or scheduling a knee surgeon.

Will I Need a Knee Surgeon for Runner’s Knee?

A proper diagnosis from an orthopedic doctor is essential if your knee aches whenever you get from a chair or while walking, jogging, and running. You may also or experience a  constant dull ache around the knee area. Osteoarthritis (OA) and runner’s knee and are common causes of knee aches.

Injury, disease, and extra strain on the knees may also result in more sharp pain. You won’t necessarily need surgery to relieve knee pain or correct the underlying issue. The doctor will perform various tests and scans to determine what’s causing the pain.

How’s Runner’s Knee Different from Osteoarthritis?

Runner’s knee is medically referred to as patellofemoral syndrome and is basically pain experienced around your kneecap area. It occurs when you overuse your knees. Running, training, jogging, squatting, and climbing may exert excess stress on your kneecap.

If the kneecap isn’t moving properly in its groove, it may wear out the protective cartilage that prevents bones from rubbing on each other. Runner’s knee symptoms include a dull pain/ache in the kneecap area, especially after sitting for extended periods or when walking, running, and jumping.

Osteoarthritis is another form of knee pain among adults 50 years and older. It simply refers to knee joint arthritis. OA pain results from bones rubbing against each other when the cartilage begins to wear out, which is similar to what happens with runner’s knee.

Common symptoms of osteoarthritis include pain that gets worse over time, stiffness, warmth, swelling, redness, and difficulty maneuvering (bending/straightening) the knee. Arthritis pain may feel worse when you wake up or during bad weather. OA and the runner’s knee have many overlapping symptoms.

How Can I Relieve Runner’s Knee and Osteoarthritis?

It is essential to seek medical advice if you experience any pain around your knee area. Runner’s knee is common among track athletes, while osteoarthritis is widespread among older people of all levels of physical activity. However, both conditions can certainly happen to people of all ages.

Your orthopedic doctor will assess the pain and determine the right treatment option. Each case is unique, so pain stemming from injuries, such as falls, will require different treatment from cases of knee overuse. Below are the vital steps in relieving all types of knee pain:

  • Get Diagnosis – You should consult an orthopedic doctor for a comprehensive diagnosis of the issue to determine the underlying cause and scale of damage.
  • Discuss Treatment – The doctor will discuss different remedies available for your case. Common options include therapy, medication, injections. Surgery may be required in severe cases.
  • Ongoing Recovery – Your doctor will recommend various practices, including physical therapy, pain relievers, lifestyle changes, etc.

Advanced Knee Treatment

Both runner’s knee and osteoarthritis can cause severe pain and require prompt addressing. Without proper treatment, the condition may get worse, calling for advanced procedures and longer recoveries. As such, you should seek professional advice as soon as you notice the pain.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

What is Osteoarthritis and Everything You Need to Know

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Article featured on Medical News Today

Osteoarthritis (OA) causes inflammation in the joints and the breakdown and gradual loss of joint cartilage. As the cartilage wears down, a person experiences pain and difficulty with movement.

OA is a common joint disorder. It develops in the hand, for example, in 1 in 12 people over the age of 60, according to the Arthritis Foundation.

OA is a progressive disease, which means that symptoms worsen over time.

There is no cure, but treatment can help manage pain and swelling and keep a person mobile and active.

Symptoms

OA leads to pain and stiffness in the joints.

In the early stages, a person may have no symptoms. Symptoms may occur in one or more joints, and they tend to appear gradually.

When symptoms develop, they can include:

  • pain and stiffness that worsen after not moving the joint for a while
  • swelling
  • difficulty moving the affected joint
  • warmth and tenderness in the joints
  • a loss of muscle bulk
  • a grating or crackling sound in the joint, known as crepitus

The progression of OA involves:

  • synovitis — mild inflammation of the tissues around the joints
  • damage and loss of cartilage
  • bony growths that form around the edges of joints

Effects

Cartilage is a protective substance that cushions the ends of the bones in the joints and allows the joints to move smoothly and easily. In people with OA, the smooth surface of the cartilage becomes rough and starts to wear away. As a result, the unprotected bones start to rub together, causing damage and pain. Eventually, bony lumps form on the joint. The medical names for these are bone spurs or osteophytes, and they can lend a knobbly appearance to the joint. As the bones change shape, the joints become stiffer, less mobile, and painful. Fluid may also accumulate in the joint, resulting in swelling.

While OA can develop in any joint, it commonly affects the knees, hips, hands, lower back, and neck.

The knees

OA usually occurs in both knees, unless it results from an injury or another condition.

A person with the condition may notice that:

  • There is pain when walking, especially uphill or upstairs.
  • The knees lock into position, making it harder to straighten the leg.
  • There is a soft, grating sound when they bend or flex the knee.

The hips

A person with OA in the hips may find that any movement of the hip joint, such as standing up or sitting down, can cause difficulty or discomfort.

Pain in the hips is a common feature of the condition. OA in the hips can also cause pain in the knee or in the thighs and buttocks.

A person may experience this pain while resting as well as while walking, for example.

The hands

In the hands, OA can develop in:

  • the base of the thumb
  • the top joint of the other fingers, closest to the nail
  • the middle joint of the other fingers

A person with the condition may notice:

  • pain, stiffness, and swelling in the fingers
  • bumps that develop on the finger joints
  • a slight bend sideways at the affected joints
  • fluid-filled lumps or cysts on the backs of the fingers, which may be painful
  • a bump that develops where the thumb joins the wrist, which can make it difficult to write or turn a key

For some people, the finger pain decreases and eventually goes away, though the swelling and bumps remain.

Anyone who experiences joint stiffness and swelling for more than 2 weeks should see a doctor.

Causes

Doctors do not know the exact cause of OA, but it seems to develop when the body is unable to repair joint tissue in the usual way.

It often affects older people, but it can occur at any age.

Genetic factors

Some genetic features increase the risk of developing OA. When these features are present, the condition can occur in people as young as 20 years old.

Trauma and overuse

A traumatic injury, surgery, or overuse of a joint can undermine the body’s ability to carry out routine repairs and may trigger OA, eventually leading to symptoms.

It can take several years for OA symptoms to appear after an injury.

Reasons for overuse or repeated injury include jobs and sports that involve repetitive movement.

Risk factors

A number of risk factors increase the chances of developing OA.

  • Sex: OA is more common among females than males, especially after the age of 50.
  • Age: Symptoms are more likely to appear after the age of 40, though OA can develop in younger people after an injury — especially to the knee — or as a result of another joint condition.
  • Obesity: Excess weight can put strain on weight-bearing joints, increasing the risk of damage.
  • Occupation: Jobs that involve repetitive movements in a particular joint increase the risk.
  • Genetic and hereditary factors: These can increase the risk in some people.

Other conditions

Some diseases and conditions make it more likely that a person will develop OA.

  • inflammatory arthritis, such as gout or rheumatoid arthritis
  • Paget’s disease of the bone
  • septic arthritis
  • poor alignment of the knee, hip, and ankle
  • having legs of different lengths
  • some joint and cartilage abnormalities that are present from birth

Diagnosis

A doctor will ask about symptoms and perform a physical examination.

No definitive test can diagnose OA, but tests can show whether damage has occurred and help rule out other causes.

Tests may include:

X-rays and MRI: These can reveal bone spurs around a joint or a narrowing within a joint, suggesting that cartilage is breaking down.

Joint fluid analysis: A doctor will use a sterile needle to withdraw fluid from an inflamed joint for analysis. This can rule out gout or an infection.

Blood tests: These can help rule out other conditions, such as rheumatoid arthritis.

Treatment

While no treatment can reverse the damage of OA, some can help relieve symptoms and maintain mobility in the affected joints.

Interventions include exercise, manual therapy, lifestyle modification, and medication.

Medication

Medication can help reduce pain.

  • Acetaminophen: This can relieve pain in people with mild to moderate symptoms. Follow the doctor’s instructions, as overuse can lead to side effects and cause interactions with other medications.
  • Nonsteroidal anti-inflammatory drugs: If acetaminophen does not help, the doctor may recommend a stronger pain reliever.
  • Capsaicin cream: This is a topical medication that contains the active compound in chilies. It creates a sensation of heat that can reduce levels of substance P, a chemical that acts as a pain messenger. Pain relief can take 2 weeks to a month to fully take effect. Do not use the cream on broken or inflamed skin, and avoid touching the eyes, face, and genitals after using it.
  • Intra-articular cortisone injections: Corticosteroid injections in the joint can help manage severe pain, swelling, and inflammation. These are effective, but frequent use can lead to adverse effects, including joint damage and a higher risk of osteoporosis. Duloxetine (Cymbalta) is an oral drug that can help treat chronic musculoskeletal pain.

Physical therapy

Various types of physical therapy may help, including:

  • Transcutaneous electrical nerve stimulation (TENS): A TENS unit attaches to the skin with electrodes. Electrical currents then pass from the unit through the skin and overwhelm the nervous system, reducing its ability to transmit pain signals.
  • Thermotherapy: Heat and cold may help reduce pain and stiffness in the joints. A person could try wrapping a hot water bottle or an ice pack in a towel and placing it on the affected joint.
  • Manual therapy: This involves a physical therapist using hands-on techniques to help keep the joints flexible and supple.

Assistive devices

Various tools can provide physical support for a person with OA.

  • Special footwear or insoles can help, if OA affects the knees, hips, or feet, by distributing body weight more evenly. Some shock-absorbing insoles can also reduce the pressure on the joints.
  • A stick or cane can help take the weight off of the affected joints and may reduce the risk of a fall. A person should use it on side of the body opposite to the areas with OA.
  • Splints, leg braces, and supportive dressings can help with resting a painful joint. A splint is a piece of rigid material that provides joint or bone support.

Do not use a splint all the time, however, as the muscles can weaken without use.

Surgery

Some people may need surgery if OA severely affects the hips, knees, joints, or the base of the thumbs.

A doctor will usually only recommend surgery if other therapies have not helped or if there is severe damage in a joint.

Some helpful procedures include:

Arthroplasty

This involves a surgeon removing the damaged areas and inserting an artificial joint, made of metal and plastic. Some refer to this procedure as a total joint replacement.

The joints that most often require replacing are the hip and knee joints, but implants can also replace the joints in the shoulder, finger, ankle, and elbow.

Most people can use their new joint actively and painlessly. However, there is a small risk of infection and bleeding. An artificial joint may also come loose or wear down and eventually need replacing.

Arthrodesis

This involves a surgeon realigning, stabilizing, or surgically fixing the joint to encourage the bones to fuse. Increased stability can reduce pain.

A person with a fused ankle joint will be able to put their weight on it painlessly, but they will not be able to flex it.

Osteotomy

This involves a surgeon removing a small section of bone, either above or below the knee joint. It can realign the leg so that the person’s weight no longer bears down as heavily on the damaged part of the joint.

This can help relieve symptoms, but the person may need knee replacement surgery later on.

Complications

Septic arthritis is joint inflammation caused by bacteria. Joint replacement surgery slightly increases the risk of this infection.

This is a medical emergency, and hospitalization is necessary. Treatment involves antibiotic medication and drainage of the infected fluid from the joint.

To discover more evidence-based information and resources for arthritis, visit our dedicated hub.

Lifestyle tips

A range of strategies can help ease the symptoms of OA. Ask the doctor for advice about suitable lifestyle adjustments. They may recommend:

Exercise and weight control:

Exercise is crucial for:

  • maintaining mobility and range of movement
  • improving strength and muscle tone
  • preventing weight gain
  • building up muscles
  • reducing stress
  • lowering the risk of other conditions, such as cardiovascular disease

Current guidelines recommend that everyone should do at least 150 minutes of moderate-intensity exercise each week.

A doctor or physical therapist can help develop an exercise program, and it is important to follow their instructions carefully to prevent further damage.

Choose activities that will not put additional strain on the joints. Swimming and other types of water-based exercise are a good way to keep fit without putting additional pressure on the joints.

Learn more here about suitable exercises for arthritis of the knee.

Assistive devices and adjustments

A loss of mobility due to OA can lead to further problems, such as:

  • an increased risk of falls
  • difficulty carrying out daily tasks
  • stress
  • isolation and depression
  • difficulty working

A physical or occupational therapist can help with these issues. They may recommend:

  • Assistive devices: Using a walker or cane can help prevent falls.
  • Adjustments to furniture and home fittings: Higher chairs and devices such as levers that make it easier to turn faucet knobs, for example, can help.
  • Talking to an employer: It may be possible to make adjustments to the workplace or arrange for more flexible hours.

Supplements

Some research has suggested that people with low vitamin D levels have a higher risk of OA. Also, in people with a low vitamin C intake, the disease may progress more rapidly.

Low levels of vitamin K and selenium may also contribute, but confirming these findings will require further research.

Some people use supplements for OA, including:

  • omega-3 fatty acids
  • calcium
  • vitamin D

The American College of Rheumatology note that there is not enough evidence to support the safety and effectiveness of these supplements for OA. They recommend asking a doctor before using them.

Outlook

OA is a common disease that causes joints to deteriorate, leading to pain and stiffness. It tends to appear during middle age or later.

There is currently no cure, but researchers are looking for ways to slow or reverse the damage. Lifestyle remedies and pain relief medications can help manage it.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

What to Know About Front Shoulder Pain

What to Know About Front Shoulder Pain

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From Medical News Today; Medically reviewed by William Morrison, M.D. — Written by Sunali Wadehraon January 22, 2019

Damage to the shoulder may result from repetitive movements, manual labor, sports, or aging. A person may also injure this part of the body due to a bad fall or accident. Many people visit the doctor with front, or anterior, shoulder pain.


The shoulder is a mobile structure that allows the arm to move freely in all directions. Shoulder problems may limit arm movement, causing pain or discomfort.

The shoulder has three major bones:

  • the humerus, which is the long arm bone
  • the scapula, or shoulder blade
  • the clavicle, or collarbone

These bones interact at four joints. A joint called the glenohumeral or shoulder joint connects the upper arm bone and shoulder blade. Although surrounding structures provide support, this joint is susceptible to injury.

In this article, we discuss some common causes of front shoulder pain and explain how doctors diagnose and treat them.

What are the causes?

Shoulder pain can develop from problems in any part of the shoulder.

Damage to the joint may result from repetitive movements, manual labor, sports, or aging.

It may also occur when a person has a bad fall or accident.

Some injuries may cause a sudden onset of shoulder pain. Examples include dislocations, separations, and fractures.

Common causes of chronic front shoulder pain include the following:

Rotator cuff injury

The rotator cuff comprises muscles and tendons that act to stabilize the shoulder.

Bursae, which are fluid-filled sacs, reduce friction between the shoulder structures. The rotator cuff tendons, which connect the muscles to the bone, are vulnerable to compression from surrounding bony structures.

Rotator cuff tendinopathy, or injury to the rotator cuff tendons, may develop from repetitive activity, generally at or above shoulder height. People with rotator cuff tendinopathy may have pain around their shoulder, particularly when reaching overhead.

Impingement occurs when the acromion, a part of the shoulder blade, puts pressure on the rotator cuff tendons and bursae. It presents in an almost identical way to rotator cuff tendinopathy.

Rotator cuff tendon tears may result from sudden injury or slow, degenerative change. Symptoms include shoulder weakness and pain, as well as popping sensations during arm movement. Severe tears may impair the use of the shoulder, limiting day-to-day activities.

Biceps tendinopathy

Biceps tendinopathy is an injury to the tendon of the biceps muscle, which may result from repetitive lifting and reaching overhead. Symptoms include pain in the front of the shoulder that becomes worse when lifting, reaching overhead, and carrying objects. Continued performance of these activities may result in the sudden rupture of the tendon.

Adhesive capsulitis

Adhesive capsulitis, which people sometimes refer to as frozen shoulder, may develop from not using the shoulder. People with this condition may experience pain, a decrease in their range of motion, and stiff joints. Common causes of shoulder disuse include rotator cuff tendinopathy, diabetes mellitus, biceps tendinopathy, and trauma to the shoulder.

Osteoarthritis

Osteoarthritis, also known as “wear and tear” arthritis, commonly occurs in either the glenohumeral joint or the acromioclavicular joint. In this form of arthritis, the bones rub together as the cartilage between them wears away. Symptoms include pain, swelling, and stiffness in the shoulder joint.

Osteoarthritis generally worsens over time.

Fracture

Fractures, or breaks, occur most often in the collarbone or upper arm bone. Both types of fracture may result from a fall onto an outstretched hand or a blow to the shoulder. In most cases, they will cause severe pain, swelling, and bruising. The shoulder will be tender to touch around the injury, and the bones may appear out of position.

Dislocation

Shoulder dislocations occur when the ball of the upper arm bone pops out of its socket. The arm bone may dislocate forward, backward, or downward, either partially or completely.

Dislocations may recur if the surrounding structures of the shoulder become worn down. Symptoms include pain, swelling, numbness, and weakness. The arm may look out of place.

Separation

A shoulder separation occurs when the ligaments tear. The ligaments are tissues connecting the bones and cartilage. Separations in the acromioclavicular region between the collarbone and shoulder blade may occur from falls or direct blows. Symptoms include pain, swelling, and tenderness in the front shoulder, as well as a bump at the point of separation.

Treatment

People can manage many types of shoulder problem at home.

Treatment typically involves a period of rest and avoidance of activities that aggravate the pain.

A doctor may also recommend applying heat or ice to the injury for pain relief, as well as placing pressure on the area to reduce swelling. Physical therapy improves shoulder strength and flexibility.

Slings can be helpful in managing shoulder dislocations, separations, and fractures, as they keep the structures of the joint in position. Before applying a sling, a doctor will put the bones back into place.

Sometimes, doctors recommend medication to reduce pain and inflammation. Over-the-counter drugs, such as ibuprofen and aspirin, are available. Doctors can also prescribe medications and inject steroids or numbing medicine directly into the shoulder to relieve pain.

Some injuries require surgery for treatment. For example, rotator cuff tears and adhesive capsulitis do not always improve with rest and medicine. Severe rotator cuff tears or recurrent dislocations may warrant early surgical consultation rather than a trial of at-home management.

Diagnosis

Several conditions lead to shoulder pain.

A thorough clinical evaluation helps pinpoint the cause. A doctor will take a medical history and carry out a physical examination, during which they may ask the individual to perform several specific movements to assess the injury. They may also order lab and imaging tests if they need additional information.

If the pain is mild, it may not be necessary to visit a doctor right away. Some people prefer to rest and see if the pain will go away. If the pain does not improve, it is best to go to the doctor for further evaluation.

People should see a doctor right away if they experience any of the following signs or symptoms:

  • intense pain
  • sudden swelling
  • weakness or numbness in the arm or hand
  • inability to use the shoulder
  • deformity

Takeaway

Shoulder pain is a common complaint. The unique anatomy and range of motion of this joint make it susceptible to injury. Common triggers for injury include accidents, repetitive movements, manual labor, sports, and aging.

An injury that causes severe pain requires immediate care. A person should also see a doctor right away if they have any joint deformity, sudden swelling, an inability to use the joint, weakness or numbness in the arm or hands, or intolerable pain.

 

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Tips for Exercising When You Have Osteoarthritis

Tips for Exercising When You Have Osteoarthritis

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By K. Aleisha Fetters | Featured on US News

IF YOU HAVE osteoarthritis, your relationship with exercise is bound to be a tricky one. After all, increasing physical activity is one of the fundamental must-dos for managing the degenerative wear-and-tear joint disease and slowing its progression. But if you have osteoarthritis, certain exercises can be incredibly painful and contribute to further joint damage.

That’s why it’s critical to take a smart, measured approach to exercise if you’re one of the more than 30 million Americans that has osteoarthritis, according to the Centers for Disease Control and Prevention.

Here are seven pro pointers for reaping all of the joint-protecting benefits of exercising with osteoporosis and reducing the risk of exercise aches and pains:

  • Consult with a specialist.
  • Warm up.
  • Focus on low-impact workouts.
  • Use your full range of motion, as long as it’s pain-free.
  • Learn isometric exercises.
  • Keep things short and frequent.
  • Tune into your body and adjust as necessary.

Consult With a Specialist

Discussing your individual joint health, symptoms and exercise history with an expert is the perfect starting point when increasing physical activity with osteoarthritis, says Katrina Pilkington, a Nevada-based National Academy of Sports Medicine certified personal trainer and corrective exercise specialist. She recommends reaching out to your rheumatologist and getting set up with a personal trainer or physical therapist.

Working with a trainer or physical therapist is especially important if you have never worked with one in the past. Both can teach you the fundamentals of exercise form to ensure you perform all activity in the safest, healthiest manner for you.

Warm Up

When you’re short on time, it can be tempting to dive straight into your workout, but don’t give in. It’s critical to take a few minutes at the beginning of any exercise routine to increase blood flow to the muscles and joints you’re about to work, according to the Arthritis Foundation. Some gentle warmup drills include arm circles, side-to-side marches, partial bodyweight squats and light cardio, such as walking and cycling.

Focus on Low-Impact Workouts

High-impact exercises involving running and jumping can help strengthen your bones, joints and their supporting musculature, but this isn’t the best starting place for anyone with joint disease. “I would recommend starting with lower-impact exercises and gradually progress based on how you feel,” says physical therapist William Behrns, a board-certified Orthopedic Clinical Specialist at the Hospital for Special Surgery in New York City.

Great low- and no-impact forms of exercise include cycling, swimming and strength training, in which both feet stay planted on the floor at all times. For example, instead of stepping back and forth during lunges, performing them with a stationary split stance eliminates any potential jolting of your ankles, knees and hips. Similarly, swap out jump squats for goblet squats (where you hold a single weight in front of your chest) to work your muscles just as hard while reducing potentially irksome stress to your joints.

Use Your Full Range of Motion as Long as It’s Pain-Free

Your joints’ ability to freely move is contingent on regular movement, Pilkington says. It’s a use-it-or-lose-it scenario. However, it’s important that you don’t force your body into painful positions.

For example, maybe you can get into a very low squat, but it hurts your knees and/or hips. Stick to a shorter range of motion, bending at the hips and knees only as far as you can do so without pain, Behrns says.

Learn Isometric Exercises

In some joints, just about any motion can be painful – and that’s where isometric exercises come in handy. In them, rather than moving up and down or side to side, you hold a position.

With isometric exercises, it’s important to remember that you’ll only challenge and strengthen your muscles in the positions that you’re holding. So, if possible, hold each exercise in multiple positions. For instance, if you’re performing isometric lunges, try holding the exercise for 30 seconds near the bottom of your available range of motion and again for 30 seconds near the top.

Other isometric exercises to try include squats, glute bridges and shoulder raises. These are particularly helpful since osteoarthritis most commonly affects the knees, hips and shoulders.

Keep Things Short and Frequent

Sprinkling short activity sessions throughout the day is a great way for anyone to fit exercise into their daily routine and break up time spent sitting. But for anyone with osteoarthritis, short activity sessions can also be useful in ensuring that, when you do exercise, you don’t overstress your joints, Pilkington says.

Any movement, no matter how brief, counts toward your daily activity goals. Behrns recommends getting 150 cumulative minutes of moderate-intensity or 75 minutes of vigorous-intensity exercise per week. A combination of the two also works.

Tune Into Your Body and Adjust as Necessary

Exercising with osteoarthritis can be frustrating, especially if exercise mistakes contributed to your condition or you’re a longtime exerciser who’s suddenly limited in what your body can and can’t do.

However, if you move forward based on how your body feels – rather than what you’re used to or what you expect your body to do now – you’ll be far better off, Behrns says. He recommends listening to your symptoms and if you experience any pain, to immediately think through what aggravated your body and do something about it. That could mean switching up exercise variations, scheduling more recovery work into your routine or adjusting the time during the day that you work out.

 

Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

6 Exercises for Osteoarthritis

6 Exercises for Osteoarthritis

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Article Featured on US News

OSTEOARTHRITIS IS THE most common type of arthritis, affecting 31 million people in the U.S., says Marcy O’Koon, senior director, consumer health, Arthritis Foundation.

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Easing the Pain of Osteoarthritis of the Knee

Easing the Pain of Osteoarthritis of the Knee

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Article Featured on AMTA

There’s been more than one study suggesting massage therapy helps relieve the pain associated with osteoarthritis of the knee. More recently, the results have again been affirmed by research supported by the National Center for Complementary and Alternative Medicine.

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Osteoporosis and Spinal Fractures

Osteoporosis and Spinal Fractures

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Article Featured on AAOS

As we get older, our bones thin and our bone strength decreases. Osteoporosis is a disease in which bones become very weak and more likely to break. It often develops unnoticed over many years, with no symptoms or discomfort until a bone breaks.

Fractures caused by osteoporosis most often occur in the spine. These spinal fractures — called vertebral compression fractures — occur in nearly 700,000 patients each year. They are almost twice as common as other fractures typically linked to osteoporosis, such as broken hips and wrists.

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